If you've been following the trials of officers linked to the killing of George Floyd, then you’ve likely heard the term "excited delirium" repeatedly come up as a defense for the officers who pinned Floyd to the ground until he died. Well, that term is hogwash, according to a 95-page report released on Wednesday from a physicians' group and cited at NBC News.
Physicians for Human Rights, a not-for-profit organization that investigates human rights violations, interviewed 20 medical and legal experts on in-custody deaths, six experts on severe mental illness and substance abuse, and two families who witnessed the effects of the term's use. “This report concludes that the term ‘excited delirium’ cannot be disentangled from its racist and unscientific origins,” authors of the findings wrote.
The physicians’ group called on Congress to investigate the use of "excited delirium" to justify deaths in police custody, to pass legislation to ban neck restraints, and to allocate funding for a national database tracking law enforcement’s use of force. It also called on the American College of Emergency Physicians and National Association of Medical Examiners to recognize that "excited delirium" is "not a valid medical diagnosis and cannot be a cause of death."
The National Institutes of Health wrote in its research of the alleged condition that it is typically associated with drug use and puts the victim in danger of suffering cardiopulmonary arrest.
Dr. Charles Wetli coined the term based on case reports of more than 12 Black women, presumed sex workers in Miami who died after ingesting small amounts of cocaine in 1981 and 1985. “For some reason, the male of the species becomes psychotic and the female of the species dies in relation to sex,” Wetli wrote in the research cited by Physicians for Human Rights. He also speculated—"without any scientific basis," the group noted—that "we might find out that cocaine in combination with a certain (blood) type (more common in Blacks) is lethal."
When a 14-year-old girl without cocaine in her system was determined to be dead, Wetli's supervisor reviewed his case files and concluded that in the case of every woman in Wetli's study, which grew to include 19, there was evidence of asphyxiation. Investigators later learned of a serial killer who murdered some 32 women from 1980 to 1989, the physician's group reported. “Wetli’s grave mischaracterization of the murders of Black women in Miami—and the racism and misogyny that seemed to inform it—should have discredited his other equally racialized and gendered theory of sudden death from cocaine,” the physicians’ group wrote. “Instead, the use of the term ‘excited delirium’ grew.”
As former Minneapolis police officer Derek Chauvin knelt on Floyd’s neck on May 25, 2020, outside of the Cup Foods convenience store, now ex-officer Thomas Lane said: “Roll him on his side?… I just worry about the excited delirium or whatever.”
Floyd is one of many who was killed by police but whose death in some regard was attributed to "excited delirium." Angelo Quinto, a 30-year-old Filipino-American U.S. Navy veteran, was showing signs of mental health crisis when his mother called 911 for help on Dec. 23, 2020. She heard her son plead with responding officers: "Please don't kill me." Still, they kneeled on his back for five minutes until he stopped breathing. He later died three days later at a hospital, his death a forensic pathologist determined was the result of “excited delirium,” Physicians for Human Rights reported.
Manuel Ellis, a Black man, died in police custody of a lack of oxygen due to the position officers held him in, restraints they forced on him, and a spit hood they deployed on March 3, 2020, in Tacoma, Washington. But officials deemed that “excited delirium.” Zachary Bear Heels, an Oklahoma man with a mental illness, died outside of a gas station in Omaha, Nebraska, after police punched his head and used a stun gun on him 12 times even as he was handcuffed. That too was “excited delirium,” according to officials The Associated Press cited.
Elijah McClain, 23, was wearing a ski mask and dancing on his walk home from a convenience store on Aug. 24, 2019, when someone called 911 to report that he "looked sketchy." Officers responded by forcing McClain to the ground and allowing paramedics to inject him with the sedative ketamine. McClain was taken to the University of Colorado Medical Center, declared brain dead on Aug. 27, 2019, and taken off of life support three days later. That was considered “excited delirium” too, Physicians for Human Rights reported.
Police shocked Natasha McKenna, a Black mother diagnosed with schizophrenia and bipolar disorder, with a Taser four times before her death, and Daniel Prude was naked, unarmed, and having a “mental health crisis” when officers mocked him, forced him to the ground, and put their body weight on him until he stopped breathing. All explained away as “excited delirium.”’
An Austin-American Statesman investigation cited by Physicians for Human Rights found that of the non-shooting deaths of people in police custody in Texas from 2005 to 2017, more than one in six of them, 289 in total, were attributed to “excited delirium.”
“When an autopsy says ‘excited delirium’ those are two words civil rights lawyers don’t like to hear, because it basically gives police a pass for their behavior,” Dallas attorney Scott Palmer told the newspaper. “Are they really saying he was moving, he was conscious, he was breathing—and he was just going to drop dead? The added element is unnecessary police conduct.”
Physicians for Human Rights wrote in its research:
PHR’s review leads to the conclusion that “excited delirium” is not a valid, independent medical or psychiatric diagnosis. There is no clear or consistent definition, established etiology, or known underlying pathophysiology. There are no diagnostic standards, and it is not included as a diagnosis in any version of the International Classification of Diseases, the international standard for reporting diseases and health conditions, currently in its tenth revision (ICD-10), or in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for psychiatric illness. Neither the American Medical Association nor the American Psychiatric Association currently recognize the validity of the diagnosis. In general, there is a lack of scientific data, and the body of literature supporting the diagnosis is small and of poor quality, with homogenous citations rife with conflicts of interest.
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