'Perspective: 'Excited delirium' is a harmful pseudo-scientific concept. New York should prohibit its usage as a diagnosis.'
In the realm of medical diagnoses, the term "excited delirium" has been a subject of much controversy, particularly in relation to deaths in police custody. This controversial diagnosis, which lacks scientific validation, has been predominantly used to justify the deaths of Black men in custody.
The term was first coined by pathologist Charles Wetli in the 1980s, but it has since been widely discredited. Initially, it was used in autopsy reports to attribute deaths that occurred during police encounters, especially involving apparently agitated individuals, sometimes under the influence of drugs or suffering mental health crises.
Critics argue that labeling deaths as caused by excited delirium diverts attention from potential excessive use of force and masks institutional responsibility. The diagnosis is often criticized for racial bias as some early cases it was applied to disproportionately involved Black individuals.
Major medical associations now consider excited delirium as pseudoscience or "junk science." The Office of the Chief Medical Examiner in Alberta, Canada no longer recognizes excited delirium as a cause of death, and efforts are ongoing to replace the term with language focused on preventing arrest-related deaths without diagnostic bias.
The diagnosis has often been invoked in cases where individuals died following police restraint, potentially justifying the use of aggressive tactics by framing deaths as resulting from a sudden physiological syndrome rather than from asphyxia or trauma related to restraint. This has led to obstruction of accountability for police violence and impeded thorough investigations into deaths in custody.
The debate over excited delirium intersects with larger concerns about policing, mental health crisis response, and systemic racism in the criminal justice system. The federal government has recently resumed promoting dangerous conspiracy theories that pose a risk to the public and erode trust.
In summary, excited delirium is widely regarded by the medical and legal communities as an unvalidated, controversial diagnosis that has significant implications for interpreting police use of force and accountability in deaths in custody. Efforts to retire this term and develop clearer, unbiased frameworks are underway to better address and prevent such deaths.
Publicized cases include Manuel Ellis, Elijah McClain, Daniel Prude, and George Floyd, where the diagnosis was raised as a defense. Across the U.S., the false diagnosis of excited delirium is the listed cause of death for over 150 deaths in police custody in the last decade. Using a fictional medical term like "excited delirium" allows police to justify aggressive tactics and avoid accountability when those tactics result in deaths in custody. It is essential to address this issue to promote justice and ensure the safety of all individuals in police custody.
1) In the discourse of policy and legislation, the unvalidated diagnosis of 'excited delirium' has become a controversial topic, intersecting with political debates related to health-and-wellness, mental-health, and systemic racism in law enforcement.2) The use of 'excited delirium' as a defense in cases of deaths in police custody has been widely criticized for its racial bias and potential for policymakers to justify aggressive therapies-and-treatments, especially when it comes to the treatment of Black individuals.3) General news outlets, in their reporting on deaths in police custody, should be cautious in using the dubious medical term 'excited delirium', as it may obstruct accountability for police violence and hinder thorough investigations into such incidents.
