“Excited delirium” is defined by the National Institutes of Health as “characterized by agitation, aggression, acute distress…and, most notably, sometimes with death of the affected person in the custody of law enforcement.”
It’s not hard even for laymen to understand the etiology: A person, high on drugs that hyper-stimulate the brain, is confronted by police in the act, or shortly afterward, of committing a violent crime. His heart rate increases exponentially; with his physical resistance, his blood pressure soars; with the drugs overwhelming his system, the perpetrator succumbs to a heart attack and dies.
For years, “excited delirium” was the official cause of death in many instances of police shootings, especially of Black men. But the term has come under attack in these post-Ferguson/post-George Floyd days of intense criticism of law enforcement. For example, the American College of Emergency Physicians has disavowed the diagnosis entirely. The American Medical Association alleges that the term “has been associated with racism in medicine and law enforcement.” Stat News, an online medical site, editorialized “It is time--past time, actually--for organized medicine to denounce [excited delirium’s] diagnostic validity and its use as a shield to justify excessive police force.” And Physicians for Human Rights determined that excited delirium “is not a valid medical diagnosis and should no longer be used by clinicians, attorneys, or law enforcement” due to “its baseless scientific underpinnings and roots in anti-Black racism.”
In one sense, it doesn’t matter what a coroner puts on a death certificate as the cause of death. The person is dead; nothing can bring him back, and whether or not the cause is “excited delirium” or something else will be of little difference to the deceased’s friends and family left behind.
Now, the Oakland Police Department itself, backed by the Police Commission, has decided to eliminate “excited delirium” as a cause of death. “We will remove the term from documents and as a diagnosis,” the Chronicle quoted Anthony Tedesco, an OPD police captain for East Oakland, as saying. “Gone completely.” This is probably something OPD felt it had to do, given the intense scrutiny it has received from police critics. It’s a minor concession that won’t impact how Oakland cops fight crime, but in another sense it’s another example of withholding information from the public that might help people understand what actually causes many instances of death in arrested criminals.
For example, when Derek Chauvin put his knee on George Floyd’s neck, Chauvin’s attorneys unsuccessfully tried to pin the cause of death on excited delirium exacerbated by drugs and COVID. “A full autopsy report on George Floyd, the man who died after being restrained by Minneapolis police last month,” NPR reported, “reveals that he was positive for SARS-CoV-2, the virus that causes COVID-19. The 20-page report also indicates that Floyd had fentanyl and methamphetamine in his system at the time of his death…”. A reasonable person might conclude that all these factors contributed to Floyd’s death. At the same time, several medical experts testified otherwise; according to the Associated Press, “The county medical examiner’s office ruled Floyd’s death a homicide due to cardiopulmonary arrest [caused by Chauvin’s knee], not an overdose, even though he had fentanyl and methamphetamine in his system.”
Can’t we agree that there were multiple contributing causes of Floyd’s death? Granted, had Chauvin not pinned his neck with his knee for nine minutes, Floyd might have lived. On the other hand, had Floyd not ingested fentanyl and meth, he might have survived Chauvin’s barbaric action. In all likelihood it was a combination of the two factors that led to Floyd’s heart giving out.
I, personally, don’t give a hoot whether “excited delirium” is used as a cause of death or not. But in media reporting of these events, it’s terribly important to let the public have all the facts. If reporters can’t or won’t talk about the drugs that a criminal took prior to his death in a police encounter, then half the facts of the case have been censored. This is another example of cancel culture, and why we need to have fully open, transparent discussions about these tragic events. It’s also only fair to point out that if someone is planning on committing a felony, they might want to decide not to take fentanyl or meth prior to doing so, as that only increases their risk of dying.
Steve Heimoff