The American College of Emergency Physicians (ACEP) has made a significant decision by disavowing the term “excited delirium” and withdrawing its approval of a 2009 white paper on the subject. This term has been used to explain cases where an agitated person dies in police custody, without attributing any fault to the force used by the police. However, critics argue that it is associated with racism and has been disproportionately used in cases involving the deaths of Black individuals. The ACEP’s decision will no longer allow “excited delirium” to be used as evidence in court cases, representing a pivotal moment in rejecting the term. Other medical associations, including the American Psychiatric Association and the American Medical Association, have also opposed its usage. Furthermore, California has become the first state to ban “excited delirium” as a diagnosis and cause of death. ACEP does acknowledge the existence of a similar condition called “hyperactive delirium with severe agitation,” which they view as a potentially life-threatening clinical condition that should be treated by emergency physicians.
The Background of Excited Delirium
The definition of excited delirium
Excited delirium is a term that has been used to explain the phenomenon of how an agitated person could die in police custody without any fault of the force used by the police. It is characterized by a state of extreme agitation, delirium, and often leads to a surge of adrenaline and heightened physical strength. The individual may exhibit erratic behavior, hallucinations, and extreme paranoia.
The criticism of the term
Over the years, the term “excited delirium” has faced significant criticism. One of the primary criticisms is its association with racism. Many argue that the term has been disproportionately used in the deaths of Black people, further exacerbating racial disparities in policing and the criminal justice system. Critics argue that the term has been weaponized to justify excessive force used by law enforcement officers and has contributed to the systemic mistreatment of marginalized communities.
The association with racism
The association of excited delirium with racism is deeply troubling. The overrepresentation of Black individuals in cases where the term is invoked is a grim reminder of the systemic biases that exist within our society. The disproportionate use of force against people of color, often leading to tragic outcomes, underscores the urgent need for a comprehensive examination of this issue.
The use of the term in court cases
In court cases, the term “excited delirium” has often been used as evidence to explain the cause of death in cases involving police encounters. For instance, it played a crucial role in the trial of Derek Chauvin, the former police officer charged with the murder of George Floyd. The acceptance of excited delirium as a legitimate medical condition has significant implications for the judicial process and shifts the burden of responsibility away from law enforcement officers, making it challenging to hold them accountable for any potential misconduct.
ACEP’s Decision to Disavow the Term
ACEP’s withdrawal of approval
The American College of Emergency Physicians (ACEP) recently made headlines by disavowing the term “excited delirium” and withdrawing its approval of a 2009 white paper on the subject. This decision marks a significant shift in acknowledging the problematic nature of the term and its impact on the healthcare community.
The implications of ACEP’s decision
ACEP’s decision to disavow the term has far-reaching implications. It sends a powerful message that the medical community is taking a stance against the use of terms that perpetuate racial biases and inequalities. By discrediting excited delirium, ACEP aims to promote equality and advocate for the fair treatment of all individuals, regardless of their race or ethnicity.
Expert Opinions on Excited Delirium
The scientific meaninglessness of the term
Experts have long criticized the term “excited delirium” for lacking scientific validity. The concept is not recognized as a mental disorder in psychiatric diagnostic manuals such as the DSM-5. The absence of a clear and universally accepted definition makes it difficult to effectively diagnose and treat individuals who may exhibit symptoms associated with excited delirium.
The misuse of the term as a diagnosis or cause of death
Furthermore, experts argue that excited delirium has been improperly used as a diagnosis or cause of death, ignoring the underlying factors that contribute to an individual’s deteriorating health during an agitated state. This misuse of the term raises concerns about the accuracy of medical documentation and the potential for misinterpretation in legal proceedings.
Other Medical Associations’ Stance on Excited Delirium
The opposition from the American Psychiatric Association
The American Psychiatric Association (APA) has also expressed its opposition to the term “excited delirium.” The APA recognizes the need for a comprehensive and evidence-based approach to understanding and addressing the complexities of agitated states. It emphasizes the importance of considering underlying medical conditions, substance use, and the impact of psychosocial factors when evaluating individuals in distress.
The opposition from the American Medical Association
The American Medical Association (AMA) has joined the chorus of opposition against excited delirium. Recognizing the racial disparities in healthcare and criminal justice, the AMA acknowledges the need for eliminating biased terminology and promoting equity. The organization encourages healthcare professionals to approach agitated states with empathy, understanding, and culturally sensitive care.
California’s Ban on Excited Delirium
California as the first state to ban the term
In a significant step towards addressing the issues associated with excited delirium, California became the first state to ban the use of the term as a diagnosis and cause of death. The state recognizes the potential harm and bias associated with the term and seeks to promote a more equitable approach to the assessment and treatment of individuals in agitated states.
The implications of California’s ban
California’s ban on excited delirium marks a pivotal moment in reevaluating the terminology and practices used in law enforcement, healthcare, and legal proceedings. It serves as a model for other states and jurisdictions, highlighting the importance of dismantling systemic biases and promoting fair and just treatment for all individuals.
Comparison to Another Term Recognized by ACEP
The acknowledgment of hyperactive delirium with severe agitation
While ACEP has disavowed the term “excited delirium,” it recognizes a similar condition known as hyperactive delirium with severe agitation. This term is used to describe a potentially life-threatening clinical condition that emergency physicians should be prepared to treat. By distinguishing hyperactive delirium from excited delirium, ACEP aims to focus on providing appropriate medical care rather than perpetuating racial biases.
The potential life-threatening nature of the condition
Hyperactive delirium with severe agitation is a clinical condition that requires immediate attention and intervention. It emphasizes the urgency of providing appropriate medical care to individuals exhibiting extreme agitation, regardless of their race or ethnicity. This recognition ensures that individuals in distress receive the necessary medical attention while avoiding the stigmatization and potential harm associated with the term excited delirium.
In conclusion, the disavowal of the term “excited delirium” by ACEP, the opposition from other medical associations, and California’s ban on its use as a diagnosis and cause of death are crucial steps towards addressing racial biases and promoting equitable healthcare practices. The recognition of hyperactive delirium with severe agitation emphasizes the need for accurate terminology that prioritizes patient care over perpetuating disparities. It is vital for the medical community, law enforcement agencies, and the judicial system to continue working collaboratively to ensure fair treatment and eliminate systemic biases when addressing agitated states in individuals. By doing so, we can strive towards a more just and equal society.
