This week, California became the first US state to ban the term “excited delirium” as an official cause of death.
A growing number of doctors and medical associations have distanced themselves from using it as a diagnosis, stating that it has no scientific or medical validity.
In addition, the term is most often used to describe the deaths of men and women of color, adding a racial element to the controversial diagnosis.
“The only place where this term is used consistently is to describe deaths that occur in police custody,” California State Assemblyman Mike Gipson, who sponsored the bill banning the term, said in a news release.
“Since the beginning, the term has been disproportionately applied to communities of color and only used in specific contexts related to encounters with law enforcement,” Gipson added.
California’s Gavin Newsom signed the bill into law on Sunday, Oct. 8.
What is excited delirium?
Excitable delirium is a vaguely defined term that describes symptoms including aggressive behavior, high tolerance for pain, extreme agitation and emotional distress.
California’s Gavin Newsom signed a bill this week that would ban the use of “excited delirium” as the official cause of death.AP
The diagnosis appeared on death certificates, police records and coroner’s reports during the crack cocaine epidemic of the 1980s, according to a report from Physicians for Human Rights. Soon, the term was used as a catch-all for deaths that occurred in the context of law enforcement restrictions, often coinciding with substance use or mental illness.
By 2009, the American College of Emergency Physicians (ACEP) had confirmed excited delirium as a valid cause of death.
The term was adopted by police training manuals and promoted at conferences of medical examiners and police chiefs, the Physicians for Human Rights report said.
Is excited delirium real?
Despite its widespread support and use, excited delirium has never been recognized by psychiatrists or other mental health professionals.
“Excited delirium is not a reliable, independent medical or psychiatric diagnosis,” Gipson says.
“There are no diagnostic guidelines, and it is not recognized in the DSM-5 [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition], which is the primary diagnostic guide for mental health providers,” he added. “Neither the American Medical Association nor the American Psychiatric Association recognize this term as a valid diagnosis.”
Indeed, the AMA and APA have never acknowledged “excitable delirium” as a real syndrome, and critics have repeatedly called it unscientific and rooted in racism.
This image shows a Rochester, New York police officer as he places a hood over Daniel Prude’s head. Prude died after police arrested him and he later stopped breathing.AP
Misuse of the term
“Excited delirium is often used when there are deaths associated with physical altercations between citizens and law enforcement,” said Dr. Roger A. Mitchell Jr., chairman of the pathology department at Howard University in Washington, DC, to the Associated Press.
“It’s not the real explanation for the death,” Mitchell added.
In recent years, the term has emerged as an explanation for the deaths of blacks, Latinos and others at the hands of white police officers.
In 2021, excited delirium was mentioned in the death of Daniel Prude, a 41-year-old black man in Rochester, New York. A grand jury dismissed charges against police officers in the case.
Excited delusions surfaced again in the 2021 trial of former Minneapolis police officer Derek Chauvin, who was later convicted of George Floyd’s death. And the term has resurfaced in the ongoing trials of police officers charged in the deaths of Elijah McClain in Colorado and Manuel Ellis in Washington state.
“In 2020, Angelo Quinto, a Filipino-American Navy veteran dealing with a mental health crisis, stopped breathing while two police officers knelt on his back and neck. Mr. Quinto’s official cause of death was determined to be delirium,” Gipson said. “That really doesn’t make sense.”
Excited delirium is declared obsolete
By March of this year, the National Association of Medical Examiners took a stand against the controversial term, declaring that “excited delirium” or “excited delirium syndrome” should not be used as a cause of death.
And yesterday, ACEP officially rejected any use of excited delirium as a valid diagnosis. calling its 2009 endorsement outdated.
“This means that if someone dies while in custody … the public cannot point to excited delirium as a reason and cannot show ACEP’s validation of the concept to support their case,” Dr. Brooks Walsh, a Connecticut emergency physician, told the Associated Press.
Dr. Joyce deJong, president of the National Association of Medical Examiners, said the group’s rejection of euphoria stems from concerns that the phrase might be used to justify excessive force by police.
“Anything we can do to avoid the retention of phrases that might cause harm,” said deJong, a medical examiner in Michigan.
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Source: thtrangdai.edu.vn/en/
