Divisive diagnosis raised in George Floyd case under scrutiny

A movement to discredit a controversial medical diagnosis is being bolstered by a new study out of McGill University. Excited delirium describes a state of agitation, aggression, and distress and has become a common defense to counter charges of police brutality. In the case of George Floyd, the syndrome was initially used as a legal defense for the Minneapolis police officer charged in his death.

In a study titled "Making up monsters, redirecting blame: An examination of excited delirium," appearing in Philosophy, Psychiatry, & Psychology, the researchers present compelling evidence that excited delirium exploits racial stereotypes, encourages excessive use of force, and deflects responsibility for sudden deaths away from law enforcement.

Essentially, the diagnosis creates a new category of people, often characterized by "superhuman" strength and an immunity to pain. Those diagnosed tend to be Black men, Indigenous people, individuals with mental illness, those who use drugs, and other marginalized groups.

While much debate has centered on the diagnosis's medical validity, the findings in this philosophical and ethical analysis delve into its tangible societal impacts, highlighting the urgent need for re-evaluation by medical practitioners and the criminal justice system. In the U.S., excited delirium is involved in about 10% of deaths in police custody. But a major shift is underway, as California recently became the first state to legislate a ban on the syndrome as a cause of death, while Colorado removed the term from police training. In Canada, four provinces no longer accept excited delirium as a cause of death.

"The diagnosis of excited delirium is widely contested, but continues to circulate within emergency medicine, on coroner's reports, and in police training. Our examination shows how racial stereotypes, conflicts of interest, convenient causal stories, and slippery logic all underlie the continued use of the term," says Phoebe Friesen, one of the study's authors and Assistant Professor in the Department of Equity, Ethics and Policy at McGill University.