According to doctors appointed to the case, Lileikis has been in critical condition since last November, when he suffered a heart attack after his first and only courtroom appearance.

Three panels of doctors have warned that a court appearance would jeopardize the defendant's life.

The decision added more weight to the argument that Lithuania has a poor record of prosecuting suspected Nazis.

Efraim Zuroff, who heads the Israeli branch of the Simon Wiesenthal center, called Lithuania a safe haven for war criminals.

Zuroff called on Lithuanian institutions to reconsider their decision on Lileikis and "to prove once and for all that they had nothing to hide."

Lileikis denies his alleged role in the Holocaust, but the court last year rejected an appeal by the defense to drop the charges against him.

Evidence gathered by the U.S. Justice Department's Office of Special Investigations and by the Lithuanian Prosecutor General's Office shows that from 1941 to 1944, Lileikis gave written orders to kill dozens of Jews jailed in a Vilnius labor prison.

On Thursday of last week, the judge rejected an appeal by the Office of Special Investigations for another medical examination of Lileikis.

The office's head, Eli Rosenbaum, has questioned the validity of conclusions made by previous panels, all four of which consisted of Lithuanian doctors. He is calling for a panel of independent international experts — including United States and Israeli representatives — to be appointed.

The head of all four medical panel, Antanas Garmus, rejected the proposal. The chief of Lithuania's State Forensic Service said he would not participate "in such a game."

The proposal insults "not only the experts, but also the whole country," Garmus was quoted as saying.

During the Nazi occupation of Lithuania from 1941-1944, approximately 94 percent of Lithuania's prewar Jewish community of 240,000 died in the Holocaust.

Historians say the scale of the tragedy could have been smaller had ordinary Lithuanians not helped with the killings.

Since Lithuania regained independence from the Soviet Union in 1991, it has not prosecuted any of the alleged Nazi collaborators living there.