Prior to Biko's inquest, magistrates had declined to examine the interrogation methods used, and had attributed detention deaths to natural causes, suicides or prison accidents. At the inquest into Biko’s death, no government official was prepared to condemn his treatment. The circumstances of his death were said to be inconclusive, and death was attributed to a 'prison accident.' However, evidence presented during the 15-day inquest into Biko’s death revealed otherwise.
During his detention in a Port Elizabeth prison cell he had been chained to a grill at night and left to lie in urine-soaked blankets. He had been stripped naked and kept in leg-irons for 48 hours in his cell. A scuffle with security police caused brain damage. He was then driven, naked and manacled in the back of a police van, to Pretoria. He died there on 12 September 1977.
Biko's funeral was the first big political funeral in South Africa. As bus-loads of mourners neared Biko's burial town (King William’s Town), they passed Black youths standing solemnly along the road with their clenched fists raised. Prominent white liberals, such as the parliamentarian, Helen Suzman, attended. So did the black American diplomat, Donald McHenry and other international dignitaries. At the funeral, 20 000 people marched and sang freedom songs. For five hours, speakers eulogised Biko. The Reverend Xundu, the Transkei Anglican priest, who presided over the funeral, appealed to God to take sides with the oppressed to overthrow the system.
Many incidents were reported of police disruption during and before the funeral. As the funeral received widespread international coverage, the funeral was also an opportunity to voice protest to a large audience. The South African government mobilised its riot police to break groups of mourners in anticipation of the protest, and people who were involved in the organisation of Biko’s funeral were arrested, detained, or banned. People travelling to King William's town for the funeral were also arrested for not carrying their pass books, to prevent them from attending the funeral.
However, according to The World newspaper, which was later banned, the biggest incidence of police interference occurred in the Dube Young Women Christian Association (YWCA), in Soweto. Mourners had gathered at the YWCA to hold a night vigil prior to their departure by bus. The Black People's Convention had decided to go ahead with the funeral arrangements even though the police had refused to give the two buses permits. Therefore, while the buses were loading people, the riot police arrived and began to smash windows and sjambok [whip] people on the bus. Police officers also fired teargas canisters into the hall where other mourners were praying. Those beaten by sjambok included then Bishop of Lesotho, Desmond Tutu’s wife, Leah Tutu and 71 year old reverend William Moalusi of Orlando West AME church.
Two years later the South African Medical and Dental Council (SAMDC) disciplinary committee found there was no prima facie case against the two doctors who had treated Biko shortly before his death. Dissatisfied doctors had presented a petition to the Council in February 1982 seeking another inquiry. However, this was rejected on the grounds that no new evidence had come to light. Biko’s death caught the attention of the international community, which increased the pressure on the South African government to abolish its detention policies and called for an international probe on the causes of Biko's death. Even close allies of South Africa, Britain and the United States of America, expressed deep concern over Biko’s death.
It took eight years of intense pressure before the South African Medical Council took disciplinary action. On 30 January 1985, the Pretoria Supreme Court ordered the SAMDC to hold an inquiry into the conduct of the two doctors who treated Steve Biko for five days before he died. In judgment handed down Judge President of the Transvaal Justice W. G. Boshoff said that there was prima facie evidence of improper or disgraceful conduct on the part of the “Biko” doctors in a professional respect.
Sadly, Biko’s death did not put an end to the ill-treatment of prisoners. Years later, when young Dr Wendy Orr made her disclosures about the treatment of detainees in the Eastern Cape, it became clear that conditions had changed very little. In September 1987, Helen Suzman once again produced claims of torture and ill-treatment in detention with thirty-seven signed affidavits.
In 1997, Biko’s killers appeared before the Truth and Reconciliation Commission (TRC) to request amnesty for the death of the student leader. However, they only claimed responsibility for assaulting him and maintained that his death was accidental. They also testified that they lied about his date of death. The family of Biko opposed the TRC hearings on the grounds that they would rob them of justice. They accused Harold Synman, the policeman responsible for Biko’s death, of adding more lies to the circumstances surrounding Biko’s death.