A war crimes court in Sierra Leone has dismissed a request to drop murder charges against the former rebel leader, Foday Sankoh, on the grounds that he is too ill to stand trial.
Sankoh's doctors say he needs treatment overseas
The court said it was not competent to rule on Mr Sankoh's state of health.
The judge, Cameroonian-born Benjamin Itoe, also rejected a similar appeal by another rebel commander, Alex Brima, who was also denied bail for fear that he might abscond.
Mr Sankoh's application was filed with the United Nations-backed court on 24 April following medical examinations suggesting that he was suffering from serious mental and physical ailments.
He has been detained for the last three years and is the former leader of the Revolutionary United Front, which was accused of widespread atrocities during the brutal 10-year civil war.
The doctors treating Mr Sankoh said that he was in a "catatonic state" - incapable of walking, talking or even of feeding himself and he cannot recognise his immediate surroundings.
They said that the 70-year-old former rebel leader urgently needed treatment overseas.
This is the second time in a month that Mr Sankoh's fitness to stand trial has been questioned by doctors.
Thousands were tortured by the rebels
In June Robin Vincent, registrar at the Special Court for Sierra Leone, said the tribunal had hoped to send him abroad for medical treatment.
However, the court had then reported that it could not find a country that was willing to accept the rebel leader even for short-term treatment.
Mr Sankoh founded the RUF, which became notorious for mass rape, hacking off the hands, feet, ears and noses of thousands of civilians during a 10-year terror campaign in Sierra Leone.
He was indicted in early March by the Special Court after spending two years in prison.
A month later, after suffering from a partial stoke, Mr Sankoh was moved from the UN detention centre on the island of Bonthe to Choithrams hospital in western