However, the case against him was bolstered on Sunday, approximately a week after the judiciary announced it had upheld the death sentence. The state television segment reportedly included confessions from Jalali himself, although these naturally came under immediate suspicion in the international press and human rights community on account of Jalali’s previous denials, the general lack of evidence, and the Islamic Republic’s long track record of securing forced confessions under torture, especially in political cases like those brought against Iranians who are also Western nationals.

In addition to closely following the confirmation of his death sentence, the media report on Jalali’s case also came within weeks of similar propaganda broadcasts about at least two other imprisoned Westerners: the American graduate student Xiyue Wang and the Iranian-British charity worker Nazanin Zaghari-Ratcliffe. But in those cases, the defendants, who have been sentenced to 10 and five years in prison respectively, did not offer confessions. Instead, the case against them was presented to the public on the basis of such things as a pay stub from Zaghari-Ratcliffe’s previous employer, a charitable wing of the British Broadcasting Corporation.

The 38-year-old woman was the subject of two such state television features, which were broadcast in the run-up to a visit to Tehran by British Foreign Secretary Boris Johnson, who reportedly discussed her case with Iranian officials. It has been suggested that the propaganda dump was intended in part to raise the profile of the case in order to encourage the British government to follow through on repaying a decades-old debt-cum-ransom payment worth more than 500 million dollars.

Several Western nationals currently being held in Iran have been referred to as “hostages,” and Jalali is no exception. In this sense, it is possible that the confirmation of his death sentence, followed by the similar propaganda dump and possible forced confession, was intended to raise the profile of his case, as well. But whatever Tehran’s motivations for the latest action, there is certainly cause for skepticism about the alleged confessions that emerged on Sunday.

The problem of forced confessions in the Iranian criminal justice system is well-known. In fact, it was a major topic in a letter written by the political prisoner Narges Mohammadi on December 12. Predating the news of Jalali’s confession by several days, the letter instead focused on the cases of journalists Sasan Aghaei and Yaghma Fashkhami, who have been held in solitary confinement and without charge since August.

“If there is evidence against them, why haven’t they been put on trial?” asked Mohammadi, a prominent human rights activist who is serving a 16-year sentence for her peaceful activities. “The more likely scenario is that there is no evidence and the suspects themselves must ‘confess’ so that evidence can be fabricated against them.”

The letter went on to highlight the prevalence of confessions extracted under torture, threats, and denial of medical treatment, according to the Center for Human Rights in Iran. It also called attention to the torturous use of solitary confinement, by which law enforcement officials routinely ignore the Islamic Republic’s own laws. Furthermore, Mohammadi challenged lawmakers and the administration of President Hassan Rouhani over the lack of due process and other violations of prisoners’ rights.

These issues have been on prominent display in the cases against Western nationals, and certainly in the case against Ahmadreza Jalali. The rejection of his sentencing appeal was the result of a secret process by the Iranian Supreme Court, which informed his defense lawyers of the outcome without giving them any opportunity to present a defense.

Amnesty International has worked to call attention to this and other aspects of his case, including the apparent fact that Jalali was tortured during his three-month solitary confinement in Evin Prison prior to his trial. This torture was evidently unsuccessful in eliciting a false confession, as Jalali not only continued to maintain his innocence but also wrote a letter from prison explaining that he had previously been approached by the Ministry of Intelligence and asked to use his contacts in the West in order to spy for Iran, and that he was arrested after rejecting this request.

But there are various different forms of torture that are employed systematically by Iranian authorities, and naturally some detainees break under the strain of one after withstanding others. These tactics include threats against a detainee’s family, as well as continual denial of access to medical care. This latter practice was also newly highlighted by CHRI on Friday, with specific reference to the case of Reza Shahabi, who has been arrested multiple times for his labor rights activism.

Shahabi was granted early release on medical grounds from a six year sentence in September 2014, but was arbitrarily ordered to return to prison this year and informed that he would have to complete his original sentence as well as serving an additional year. Now CHRI reports that he has been denied transfer to a hospital despite suffering a stroke.

A statement by Shahabi’s labor union points out that medical professionals had already declared him not healthy enough to continue serving time in the harsh conditions of Rajai Shahr Prison, and it highlights the stroke as proof of this assessment. “We hold the security agencies, the Tehran prosecutor, and prison officials responsible for Shahabi’s life,” the statement adds.

But the deaths of prominent activists may in fact be the desired outcome in some instances of denial of medical services. Deaths from this and other dubiously natural causes adds to the death toll from the Iranian prison system, without adding to the actual statistics that make Iran the nation with the highest rate of executions per capita.

In the case of dual nationals, however, torturous practices like the denial of medical treatment may have a different intended outcome, and although Jalali has been sentenced to death, many critics of the Iranian regime still believe that he stands to be used as a bargaining chip in negotiations with Western governments for ransom money, policy concessions, or something else of value to the Islamic Republic.