"Excited Delirium" Diagnoses Have Protected Bad Cops, But Now Prominent Doctors Are Rejecting It

The American College of Emergency Physicians took a stand against the diagnosis of excited delirium, which is often used to justify deaths within custody.

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Elijah McClain and George Floyd pictures left by demonstrators line up the fence outside the Brooklyn Center police station while protesting the death of Daunte Wright who was shot and killed by a police officer in Brooklyn Center, Minnesota on April 14, 2021. - Minneapolis has been roiled by nights of violent protests after police officer Kim Potter, who is white, opened fire on Black 20-year-old Daunte Wrigh in his car on April 11. Potter, who shot dead Daunte Wright in a Minneapolis suburb after appearing to mistake her gun for her Taser, was arrested on April 14 and will face manslaughter charges.
Elijah McClain and George Floyd pictures left by demonstrators line up the fence outside the Brooklyn Center police station while protesting the death of Daunte Wright who was shot and killed by a police officer in Brooklyn Center, Minnesota on April 14, 2021. - Minneapolis has been roiled by nights of violent protests after police officer Kim Potter, who is white, opened fire on Black 20-year-old Daunte Wrigh in his car on April 11. Potter, who shot dead Daunte Wright in a Minneapolis suburb after appearing to mistake her gun for her Taser, was arrested on April 14 and will face manslaughter charges.
Photo: Kerem Yucel / AFP) (Photo by KEREM YUCEL/AFP (Getty Images)

Most people have never heard the term “excited delirium,” but for years, cops have been using the diagnosis as a get-out-of-jail-free card. Now, prominent medical groups, which once championed the diagnosis, are disavowing the term critics call unscientific and racist.

On Thursday, the American College of Emergency Physicians (ACEP) put out a statement rebutting their earlier report on excited delirium. The group also voted to prevent their members from being able to use the term whilst testifying in civil or criminal cases. The ACEP is following in the footsteps of the National Association of Medical Examiners, which earlier this year said that the term should not be listed as a cause of death. Earlier this month, California became the first state to ban doctors and medical examiners from using the term as a cause of death.

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To understand why this is such a big deal, we have to talk about excited delirium is and how cops have traditionally used it. Although the term had already been in use for decades, in 2009, the ACEP released a paper further legitimizing excited delirium as a cause of death for people in custody.

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According to the 2009 paper, excited delirium symptoms include superhuman strength, being impervious to pain, aggressive behavior, and sudden death. Instead of having to look into whether excessive force or poor conditions had played a part in an incarcerated person’s death, law enforcement, and medical examiners could simply write deaths off as a result of this illusive disease with no clear causes and no diagnostic tests. It also probably doesn’t take a medical license to notice that this diagnosis lines up perfectly with pervasive stereotypes about Black Americans.

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We don’t have to imagine a world in which this diagnosis has been weaponized against Black Americans because we’re already living in it. In 2019, medical examiners at the Adams County Coroner’s Office marked Elijah McClain’s cause of death as caused by excited delirium. Yes, the same Elijah McClain who died after police choked him and paramedics dosed him with ketamine. And during Derek Chauvin’s murder trial, the defense teased the idea that George Floyd might have died from excited delirium instead of the nine minutes Chauvin kneeled on his neck. One of the cops on the scene at the time directly questioned whether Floyd was suffering from the “condition.”

The American College of Emergency Physicians statement doesn’t mean the term will disappear. California is the only state where it’s actually outlawed. Still, the news last week was a positive sign for people hoping to remove a dangerous medical weapon from the hands of law enforcement.