Medical Viewpoint: 'Excited delirium' is a stereotyped, racially-biased term. New York should prohibit its usage as a medical diagnosis.
In the medical community, the diagnosis of "excited delirium" is widely discredited and criticized as a problematic and pseudoscientific term. This controversial diagnosis has been particularly associated with justifying excessive police force and avoiding accountability, especially in deaths that occur in police custody, particularly involving Black men.
The term "excited delirium" originated outside of mainstream medical consensus and is often associated with pseudoscience. It was coined by a pathologist, Charles Wetli, in a 1985 research paper, but lacks reproducible scientific evidence or clear diagnostic criteria.
Critics argue that "excited delirium" functions as a convenient but medically unsubstantiated label used in cases where excessive force by law enforcement leads to death. This diagnosis lacks standardized, objective clinical criteria and is not recognized as a legitimate medical disorder by major medical organizations.
Delirium itself is a well-defined clinical syndrome characterized by acute disturbances in mental status, attention, and cognition. However, "excited delirium" is not part of these established diagnostic frameworks and does not meet the empirical standards of medical diagnosis.
TASER International (now known as Axon Enterprises) distributed literature on "excited delirium" to police chiefs and medical examiners in the early 2000s, contributing to its widespread use as police departments began purchasing and using tasers. In New York City, police are trained to respond to "excited delirium" with excessive force, and emergency medical service personnel are trained to treat it with potentially lethal doses of tranquilizers.
In Rochester, health department training materials for law enforcement and first responders show images of the Hulk, with symptoms including the victim saying, "I can't breathe." Notable cases where "excited delirium" has been cited include Manuel Ellis, Elijah McClain, Daniel Prude, and George Floyd, in whose murder Derek Chauvin raised "excited delirium" as a defense.
Harvard neurologist Altaf Saadi describes "excited delirium" as a "convenient diagnosis" due to its wide-ranging symptoms that are potentially characteristic of numerous real medical conditions. The use of the fictional medical term "excited delirium" allows police to justify ultra-aggressive tactics and avoid accountability when those tactics result in someone's death in custody.
In the last decade, more than 150 deaths in police custody have been listed as caused by "excited delirium." Wetli, while working as a medical examiner, repeatedly pushed the theory of "excited delirium" to explain deaths, particularly of Black people. The medical diagnosis of "excited delirium" is considered by many in the medical community and human rights advocates as a controversial, poorly defined diagnosis used to obscure causes of death related to police restraint and abuse.
- The increasingly contentious diagnosis of "excited delirium" has been linked not only to pseudoscience but also to the realm of politics, where it is often employed as an unsubstantiated label to justify excessive use of force by law enforcement.
- Beyond the medical-scientific community, the concept of "excited delirium" finds a home in the realm of health-and-wellness and mental-health discourse, with critics arguing that it is used as a convenient and problematic label, disguising real medical conditions and enabling justifyable actions that lead to deaths in police custody.
- In the current general-news environment, the controversial diagnosis of "excited delirium" has become synonymous with crime-and-justice issues, particularly cases involving deaths in police custody, prompting human rights advocates and major medical organizations to challenge its legitimacy and question its use in obscuring the true causes of death related to police restraint and abuse.
