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Emergency Medical Association Withdraws Paper On Controversial ‘Excited Delirium,’ A Term Used To Justify Excessive Force

Emergency Medical Association Withdraws Paper On Controversial ‘Excited Delirium’,  A Term Used To Justify Excessive Force By Police
(Photo by Celal Gunes/Anadolu Agency via Getty Images

​​The American College of Emergency Physicians (ACEP) recently formally withdrew its approval of a 2009 paper on “excited delirium,” which has been criticized for its potential use to justify excessive force by the police.

According to the Associated Press, the leading doctor’s organization stated that the paper was outdated, and they discouraged its use by their members when testifying in civil or criminal cases. This decision was made by the group’s directors during a vote in Philadelphia last Thursday.

“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,” said Dr. Brooks Walsh, a Connecticut emergency doctor who pushed the organization to strengthen its stance.

The term “excited delirium” has been controversial for some time, with critics arguing that it is unscientific and rooted in racism. Earlier in the month, California became the first state to prohibit the use of “excited delirium” and related terms as a cause of death in autopsies, and police officers are now barred from using it in their reports to describe people’s behavior.

In March, the National Association of Medical Examiners also took a stance against the term, recommending that it not be listed as a cause of death. Other medical groups, including the American Medical Association, had previously rejected “excited delirium” as a diagnosis.

The 2009 ACEP report described “excited delirium” as a condition with symptoms such as unusual strength, pain tolerance, and bizarre, potentially life-threatening behavior. However, it has been criticized for reinforcing and codifying racial stereotypes.

The withdrawal of support from ACEP is significant, as the 2009 paper had influenced police training and was used in legal cases related to deaths in police custody. It has often been cited by attorneys defending officers and had come up in high-profile cases like the trial of Derek Chauvin, who was convicted in the death of George Floyd, as well as the trials of police officers charged in the deaths of Elijah McClain and Manuel Ellis.

This move by ACEP reflects a broader shift in the medical and legal communities away from using the term “excited delirium” and suggests a more critical examination of its implications in cases involving police use.

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