The Clinic's Psychiatric Case-Selection Policy

The Clinic's Psychiatric Case-Selection Policy is the Santa María de las Nieves Psychiatric Clinic’s stated practice of selecting psychiatric patients considered valuable to research. In the investigation, that policy becomes a point of contention: Amaia Salazar suspects that prison psychiatry and the clinic’s volunteer work may have provided a route to identify violent offenders whose cases carried what she describes as an additional dimension of evil. Doctor Sarasola acknowledges that staff were instructed to seek interesting cases, but insists that Doctor Berasategui acted without his knowledge when pursuing prisoners.

Policy and Public Rationale

Doctor Sarasola presents the clinic’s patient-selection policy as publicly known and grounded in research. He says that staff are trained to choose cases likely to be scientifically interesting, with the stated aim of advancing research and improving the quality of life of patients and their families. The clinic’s work with prisoners is likewise framed as generous and altruistic: its personnel provide psychiatric services in prisons, and Doctor Sarasola says he signs off on visits made by members of his team.

That account does not deny that cases are selected. Instead, it describes selection as a normal, purposeful part of the clinic’s work, directed toward research rather than exploitation. The difference between the clinic’s stated rationale and Amaia’s suspicion is therefore not whether staff were encouraged to identify particular patients, but what made those patients attractive and how the resulting access was used.

Prison Treatment and Investigative Leads

The prison-treatment records draw Amaia’s attention because they connect psychiatric contact with several offenders whose crimes share unusual features. She asks whether the Logroño prisoner who died by suicide had received therapy, and whether Jasón Medina and Ramón Quiralte had psychiatric treatment while imprisoned. Medina had not received therapy before his crime, but both he and Quiralte attended therapy in Pamplona, where the University Clinic of Navarra supplied a tutor. The Logroño file records contact with a psychiatric service but gives no psychiatrist’s name; the signature is illegible.

These inquiries arise within a broader investigation into murders in which abusive partners killed women and the victims’ forearms were amputated after death. Amaia argues that this repeated, concealed detail is too precise to be explained as imitation from press reports, particularly because the amputation in Johana Márquez’s case had been withheld from the public. The men’s apparent patterns otherwise diverge: many offenders had a history of violence, prolonged abuse, or alcohol or drug problems, while Medina did not fit the same aggressive, frustrated profile. The relationship between treatment and the crimes remains an investigative question, not proof that therapy caused or encouraged violence.

Amaia also identifies two more women born in the valley who were killed by their partners, one in Bilbao and the other in Burgos. Their deaths had been marked by funeral notices in the valley, but the available information did not establish whether their bodies had also been mutilated. The cases widen the inquiry while exposing how little the separate records had previously been brought together.

Amaia’s Allegation and Sarasola’s Response

Amaia’s suspicion sharpens when she hears that prisoners in Pamplona had attended therapy and that the University Clinic of Navarra routinely sent someone to supervise it. She also learns of prison reports bearing Sarasola’s signature but leaving the assigned psychiatrist unnamed. To Amaia, these ghostlike records suggest a process whose formal authorization could be visible while the individual practitioner remained difficult to identify. A prison official observes that the documents had been signed by a head of psychiatry, which helps explain why their irregularity was not challenged at the time.

Confronting Doctor Sarasola, Amaia argues that the clinic’s prison volunteering may have served a more selective purpose than public altruism: finding incarcerated patients with a particular psychological feature, the extra dimension she associates with evil. She further suspects that Doctor Berasategui’s search for such patients had not ended with the case of Rosario, and asks whether Berasategui, rather than Sarasola, was effectively directing the psychiatric work. These are Amaia’s allegations, not established findings about the clinic as a whole.

Doctor Sarasola responds that the selection policy and the clinic’s prison work are both public knowledge, and that staff were trained to identify cases of research interest. He says he signed visits for all members of his team but did not know about Doctor Berasategui’s parallel actions. He disavows both his own name and the clinic’s responsibility for any criminal acts that may have resulted from those actions. His answer accepts the existence of a structured selection practice while separating that practice from the alleged misconduct.

Accountability and Unresolved Questions

The records and the confrontation leave responsibility divided between institutional procedure and individual conduct. Amaia’s challenge rests on the gap between a routine system of signed prison visits and reports that do not clearly identify the psychiatrist assigned. Sarasola acknowledges his signatures and the clinic’s case-selection instructions, yet claims ignorance of Berasategui’s activities. The available evidence therefore establishes the policy and the disputed access to prisoners more firmly than it establishes who authorized any improper pursuit of particular patients.

The dispute is also linked to Doctor Franz’s objections to the procedure by which Rosario was transferred to the clinic. Doctor Franz had told several people that he intended to resolve questions with Sarasola, prompting the investigators to examine possible contact between the two doctors. Amaia asks Sarasola to review Rosario’s recent sessions for useful leads and requests help from the clinic’s head of security. The policy remains consequential not because it alone solves the murders, but because it directs the investigation toward the institutional pathways through which selected prisoners could be treated, recorded, and potentially recruited.