California law now prohibits doctors from citing ‘excited delirium’ as a cause of death.
California Bans Use of “Excited Delirium” as Medical Diagnosis or Cause of Death in Police Custody
Doctors and government officials in California are no longer allowed to use the term “excited delirium” as a valid medical diagnosis or cause of death for individuals who die while in police custody. This groundbreaking decision was made when Governor Gavin Newsom signed Assembly Bill (AB) 360 into law on October 8, making California the first state to ban the use of the term. The law will take effect on January 1.
Assemblyman Mike Gipson, the author of the bill, stated that “excited delirium is not a reliable, independent medical or psychiatric diagnosis.” He further emphasized that the term has been disproportionately applied to communities of color and has only been used in specific contexts related to encounters with law enforcement.
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Excited delirium syndrome, as described by the National Library of Medicine, includes bizarre and aggressive behavior, shouting, paranoia, panic, violence toward others, unusual physical strength, and hyperthermia.
Assemblyman Gipson introduced the bill following the death of U.S. Navy veteran Angelo Quinto, who died after being restrained by Antioch police in December 2020. Reports indicate that Quinto died three days after police restrained him with a knee on the back of his neck. The coroner’s office attributed his death to “excited delirium syndrome due to acute drug toxicity with disturbances,” according to his attorney.
The new law not only bans the term from official use but also prohibits state and local government agencies, employees, and contractors from testifying in court or documenting “excited delirium” as a recognized medical diagnosis or cause of death. Coroners, medical examiners, physicians, and physician assistants are also prohibited from using the term on death certificates or reports. Furthermore, law enforcement is not allowed to use the term in police reports, and it cannot be used as evidence in civil court actions.
The Department of Public Health is expected to spend $50,000 from its general fund to develop a system for identifying the prohibited term and notifying relevant medical professionals to change the cause of death on death certificates.
The California Public Defenders Association has expressed support for the legislation, stating that “excited delirium is not a medical diagnosis” and opposing the use of certain pharmacological interventions solely for law enforcement purposes.
The bill passed unanimously in the Assembly and received overwhelming support in the Senate, with only one senator voting against it. The Los Angeles Police Department has yet to comment on the new law.
George Floyd Death Shines National Spotlight on Term
The term “excited delirium” gained national attention following the high-profile death of George Floyd in 2020. Defense attorneys in the subsequent trials argued that Floyd’s “excited delirium” justified the use of force, but the judge expressed skepticism.
In December 2020, the American Psychiatric Association raised concerns about the term, stating that it was excessively applied to Black men in police custody and used to explain or justify injury or death. The American Medical Association also adopted a policy opposing the use of “excited delirium” as a medical diagnosis and warned against the use of certain drugs, including ketamine, as interventions for law enforcement.
It is clear that the use of the term “excited delirium” has undergone a significant shift in policy, with California leading the way in banning its use as a medical diagnosis or cause of death in police custody.
How did the circumstances surrounding Angelo Quinto’s death contribute to the introduction of AB 360 and the ban on ”excited delirium”?
Tants are now required to use alternative terms or diagnoses when certifying the cause of death or providing medical documentation.
The decision to ban the use of “excited delirium” stems from concerns about its lack of scientific validity and its disproportionate application to communities of color. Assemblyman Mike Gipson, the bill’s author, emphasizes that the term is neither a reliable nor an independent medical or psychiatric diagnosis. It has been primarily utilized in the context of encounters with law enforcement, further raising concerns about its potential bias and misuse.
Excited delirium syndrome, according to the National Library of Medicine, is characterized by abnormal and aggressive behavior, shouting, paranoia, panic, violence towards others, unusual physical strength, and hyperthermia. While these symptoms may be observed in certain situations, the term itself has been deemed unreliable and unsubstantiated as a standalone diagnosis or cause of death.
The tragic death of U.S. Navy veteran Angelo Quinto served as a catalyst for the introduction of this bill. Quinto died in December 2020 after being restrained by Antioch police, with a knee placed on the back of his neck. Three days after the incident, he passed away, and the coroner’s office attributed his death to “excited delirium syndrome due to acute drug toxicity with disturbances.” The circumstances surrounding his death and the application of the term further highlighted the need for reform.
With the signing of Assembly Bill (AB) 360, California becomes the first state to ban the use of “excited delirium” as a medical diagnosis or cause of death in police custody cases. The law, which will go into effect on January 1, 2023, not only prohibits doctors and government officials from using the term but also extends the ban to state and local government agencies, employees, and contractors. This ensures that “excited delirium” cannot be cited in court testimonies or documented as a recognized medical diagnosis or cause of death.
The decision to ban “excited delirium” reflects a commitment to ensuring transparency, accountability, and fairness in the assessment of deaths that occur in police custody. By removing a potentially biased and scientifically unvalidated term from official use, California takes a significant step towards addressing systemic issues and aligning medical practices with evidence-based standards.
Furthermore, this groundbreaking decision serves as a model for other states and jurisdictions to reevaluate their use of terms that may perpetuate bias or lack scientific validity. The importance of accurate and unbiased medical documentation cannot be overstated, particularly in cases involving the loss of human life. It is incumbent upon medical professionals and policymakers to adopt responsible and equitable practices that uphold the principles of justice and equality.
In conclusion, the ban on the use of “excited delirium” as a medical diagnosis or cause of death in police custody cases demonstrates California’s dedication to addressing systemic biases and promoting evidence-based practices. This bold step paves the way for greater accountability and fairness in the documentation and evaluation of deaths that occur within the criminal justice system. By recognizing the need for change and taking decisive action, California sets a precedent for other states to follow and reaffirms the importance of unbiased and scientifically valid medical practices.
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