Civil rights lawyers have applauded California’s decision to ban the diagnosis of “excited delirium” – often defined as a drug-induced behavioral state characterized by agitation, aggression and elevated strength – from official proceedings in cases accusing police officers of excessive force or wrongful death, particularly of black and Latino subjects.
Police, however, say the decision will place police officers at greater risk when dealing with dangerous suspects they say have abandoned rational thought and can achieve almost superhuman abilities to withstand pain and attempts to subdue them.
Gov. Gavin Newsom signed Assembly Bill 360 into law last October – the first governor to sign such a measure. Critics of the diagnosis call it baseless and point to its “racist and unscientific” origins, but law enforcement organizations have labeled California’s action an affront to free speech and indicate the American College of Emergency Physicians views excited delirium as a valid medical condition that officers must deal with during the course of their official duties.
California’s action may have started a national trend as Colorado, Hawaii, Minnesota and New York are also considering bills to restrict the use of the term “excited delirium,” according to the Kaiser Family Foundation.
“Excited delirium is junk science rooted in racism and sexism,” California civil rights attorney Julia Sherwin told the Southern California Record in an email. “... It can cause officers to use excessive force because when they are trained a person in excited delirium may have ‘superhuman strength’ and be ‘impervious to pain,’ officers may choose to use extreme force to overcome what they have been conditioned to expect, superhuman strength and imperviousness to pain.”
Sherwin is the co-author of a 2022 report by Physicians for Human Rights (PHR) that traced the origins of the term. It was coined by Dr. Charles Wetli and Dr. David Fishbain in attempting to explain the deaths of 12 black women in the 1980s in Miami who were suspected to be sex workers. The cause of their deaths was initially undetermined, and Wetli postulated that it was due to a lethal psychosis linked to cocaine use and sex, according to the study.
The deaths were eventually determined to be the result of asphyxiation carried out by a serial killer in the Miami area, based on a medical examiner’s findings, Sherwin’s report states. But Wetli continued to promote a related theory that certain black male deaths could be explained by a cocaine-related delirium.
“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 report says. “Instead, the use of the term ‘excited delirium’ grew.”
The company TASER International, now called Axon Enterprise, increased awareness about the term as company experts used the diagnosis “excited delirium” in scientific literature, according to the PHR study. The company seemed to use the term to challenge conclusions from pathologists reporting that deaths related to fatal police encounters with young black men were due to stun weapons technology, the report says.
The company often threatened pathologists with civil lawsuits when they attributed in-custody deaths to Taser use, according to a forensic pathologist in San Luis Obispo.
The origins of excited delirium was also examined in a recent BBC radio broadcast.
In the years 2010 to 2020, 166 reported deaths that occurred during police custody were linked to the diagnosis of “excited delirium” in reports, with black and young Latinos making up the majority of the deaths, the report says.
The National Police Association, however, defends the use of the excited delirium diagnosis, contending that suspects who display signs of sweating, aggression and irrationality present serious risks to law enforcement officers and first-responders.
“When a person feels no pain, their strength is multiplied because the normal sense of ‘This hurts, I’ve got to stop’ does not exist,” a former police chief from Colorado said in an article on the association’s website. “From a real-world perspective, that means that a single officer, no matter how skilled, is highly unlikely to successfully take custody of the person by themselves.”
Critics of the diagnosis are debating the issue under “the umbrella of politics” and not real-world situations that officers face, the post states.
Sherwin’s report calls on state attorneys general to review how the term is used and applied by police and correctional officers and urges police associations to stop promulgating questionable excited delirium protocols.