Guatemalan dictator Efraín Ríos Montt is due to be retried for genocide and crimes against humanity on July 23 – after his 2013 conviction was set aside by the Constitutional Court – but a doctor’s determination last week that the military strongman is unfit for trial raises more questions than answers.

Last week, Guatemala’s National Forensic Institute presented a medical report concluding that Rios Montt was senile. In its two-page report, the institute concluded that the former general did not have full use of his mental capacities, could not properly understand the charges against him, and could not contribute to his own defense. The report further concluded that any additional evaluation would only cause unnecessary stress and would reach no different result.

Rios Montt’s defense attorneys have sought to close the case once and for all. However, the victims – the Center for Human Rights Legal Action (CALDH) and the Association for Justice and Reconciliation (AJR) – have questioned the impartiality of the medical evaluation and its appropriateness, as the trial court did not order the evaluation. It was instead conducted at the request of Judge Carol Patricia Flores, who does not have authority over the trial and is currently facing investigation herself for corruption.

The medical report itself raises questions. The psychiatrist who conducted the evaluation reported he did so while the 89-year-old former head of state was sedated. The psychiatrist additionally relied on information provided by Ríos Montt’s daughter Zury, who has been his most steadfast and visible supporter, and by his personal doctor, who was the health minister in the government of Rios Montt’s right-wing political party.

Rios Montt is not the first former dictator to challenge his prosecution on medical grounds. In 2006, Chile’s Supreme Court accepted that former Chilean dictator Augusto Pinochet was fit to stand trial at the age of 90, reversing various lower court judgments. Pinochet, however, died soon after, without ever facing prosecution. The Cambodia war crimes tribunal last year accepted that Pol Pot’s second in command could be prosecuted for genocide despite health problems. In August 2014, Nuon Chea was eventually convicted at the age of 87.

The trial of Rios Montt and his head of military intelligence, Mauricio Rodriguez Sanchez, is still scheduled for July 23, though what will happen on that date remains uncertain. The two men were tried in 2013 in connection with massacres of 1,771 Mayan Ixiles during Rios Montt’s brutal 1982-83 rule.

Also last week, on July 10, Guatemala’s electoral tribunal dismissed the candidacy of Zury Ríos, Ríos Montt’s daughter, who has sought to run in the September presidential elections. The country’s constitution prevents close relatives of former dictators from running for the country’s highest office. Zury has vowed to appeal.

Guatemala’s Congress still must rule on whether President Otto Pérez Molina must lose his immunity before his scheduled January 2016 end of term. On July 3, a designated congressional commission ruled that he should face a criminal investigation for his possible involvement in corruption cases. Seven networks of corruption, uncovered by the public ministry and the International Commission Against Impunity in Guatemala (CICIG), have shaken the country since April 16, forcing high-level resignations and putting prominent politicians behind bars and judges and legislators under the spotlight.

Perez Molina has steadfastly resisted resigning, even with tens of thousands marching in the streets. However, the corruption charges have gotten increasingly close to him. Last week saw the arrest and detention of Gustavo Martinez for influence peddling. Martinez was the president’s general secretary until his June 2 resignation and is the president’s son-in-law.