A leading doctors group has officially retracted its approval of a 2009 paper on “excited delirium.” This paper has been criticized for being used to justify excessive force by the police. The American College of Emergency Physicians (ACEP) stated that the paper is outdated and that using the term “excited delirium” should not be supported by their members in civil or criminal cases. The decision was made during a meeting of ACEP directors in Philadelphia.
Dr. Brooks Walsh, an emergency doctor from Connecticut, who urged the organization to take a stronger stance, explained, “This means if someone dies while being restrained in custody…people can’t point to excited delirium as the reason and can’t point to ACEP’s endorsement of the concept to bolster their case.”
This move comes after California passed a law prohibiting the use of excited delirium and related terms as a cause of death in autopsies, becoming the first state to do so. The legislation also forbids police officers from using the term in their reports to describe people’s behavior.
This is not the first time medical organizations have rejected the term excited delirium. The National Association of Medical Examiners and the American Medical Association have previously stated that it should not be listed as a cause of death. Critics argue that the concept is unscientific and rooted in racism.
The 2009 report by emergency physicians described excited delirium as a condition characterized by unusual strength, high pain tolerance, and bizarre behavior, labeling it as “potentially life-threatening.” However, Dr. Walsh and others claim that the document reinforced and perpetuated racial stereotypes.
The effects of the 2009 paper have extended to police training and have been brought up in cases of police custody deaths, particularly those involving Black men. Attorneys defending police officers have cited the paper to support testimony on excited delirium. Joanna Naples-Mitchell, an attorney and research adviser for Physicians for Human Rights, pointed out that the term was referenced in the New York attorney general’s report on the investigation into the death of Daniel Prude, a Black man. A grand jury later rejected charges against the police officers involved.
Excited delirium also became a topic during the trial of former Minneapolis police officer Derek Chauvin, who was subsequently found guilty in the death of George Floyd. It has resurfaced in ongoing trials of police officers charged in the deaths of Elijah McClain in Colorado and Manuel Ellis in Washington state. All three men were Black and died after being restrained by the police.
The ACEP had distanced itself from the term previously but had not withdrawn its support for the 2009 paper until now. Naples-Mitchell sees this as an opportunity for ACEP to break with the past and take a stronger stance against the paper.
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