Medical Theory Labeled as Pseudoscience: "Excited Delirium" Should Be Prohibited as a Diagnosis in NY.
Across the United States, the term "excited delirium" has been listed as the cause of death in more than 150 cases involving police custody over the past decade. This controversial term, often criticized for its lack of clear diagnostic criteria and evidence-based validation, has been a subject of debate in medical and legal circles.
History and Definition
The term "excited delirium" was first coined in the 1980s and 1990s, primarily within law enforcement and forensic circles. It was used to describe a state characterized by agitation, aggression, acute distress, and sudden death, often in police custody or during encounters with law enforcement. The supposed symptoms of this state include agitation, confusion, hallucination, elevated temperature, rapid heart rate, and sweating.
Unlike classical delirium, which is characterized by fluctuating consciousness, cognitive impairment, and an identifiable medical cause, "excited delirium" lacks official recognition by major medical diagnostic manuals such as the DSM-5 or ICD-10.
Controversy and Criticism
Medical authorities and psychiatrists often criticize "excited delirium" for its lack of clear diagnostic criteria and evidence-based validation. Some label it a pseudomedical term used primarily to justify or explain deaths that occurred due to excessive force, especially involving restraint or taser use.
Research and watchdog groups have highlighted that the term is disproportionately applied in cases involving Black individuals and other marginalized groups, contributing to systemic racial bias in policing and medical examination. This raises concerns about how "excited delirium" can potentially obscure actual causes of death, such as positional asphyxia or trauma from police restraint.
Current Status
Many hospitals, medical examiner offices, and mental health organizations do not recognize "excited delirium" as a valid medical diagnosis. Instead, deaths previously attributed to it are increasingly being reexamined with careful attention to procedural justice, forensic evidence, and known medical causes of delirium or sudden death.
Some police forces and emergency responders still use the term operationally, although with increasing scrutiny and calls for better training on recognizing true medical emergencies and avoiding excessive use of force.
In Summary
"Excited delirium" remains a deeply controversial and medically disputed term, criticized for its role in masking the impact of excessive police force and racial bias in law enforcement-related deaths. It lacks official recognition in diagnostic manuals and is increasingly challenged by mental health professionals advocating for transparency and medically valid explanations in cases of sudden death during arrest or restraint.
The use of "excited delirium" in police custody cases can potentially endanger the public by justifying excessive force and eroding public trust in law enforcement. As such, efforts are being made to abandon the term in favor of clearer, evidence-based descriptions of symptoms and causes of sudden deaths involving agitation and delirium.
In New York, state Sen. Samra Brouk and others are advocating for a bill (A.697/S.1714) that aims to prevent instances of excessive force and ensure accurate cause of death reporting by retiring the term "excited delirium" in New York. This reflects a growing consensus in the medical and public health community to move away from this controversial term towards a more transparent and medically valid approach to understanding and addressing sudden deaths during police encounters.
- Science and policy-and-legislation intersect in the debate surrounding the use of the term "excited delirium" in police custody cases, with medical experts calling for its removal from official causes of death due to its lack of evidence-based validation.
- Mental health, health-and-wellness, and general-news outlets have highlighted the disproportionate application of the term "excited delirium" in cases involving marginalized groups, sparking discussions about systemic racism and bias in policing.
- Amidst growing controversy, crime-and-justice organizations face scrutiny as they grapple with the use of "excited delirium" in police encounters, prompting calls for better training and more transparent reporting to ensure procedural justice in sudden deaths.
