Updated: Oct 17
The American College of Emergency Physicians (ACEP) withdrew its approval of a paper on “excited delirium,” stating the term is outdated and has been used to justify police violence.
Excited delirium has been used to characterize people who become extremely agitated or aggressive due to mental illness or drug use The term came up multiple times during the trial of the officers responsible for George Floyd’s death. Derek Chauvin’s legal team argued that it was reasonable for Chauvin to put his knee on Floyd’s neck because he was experiencing excited delirium.
The directors of the organization voted to withdraw its approval Thursday, writing “ACEP’s 2009 White Paper Report on Excited Delirium Syndrome is outdated and does not align with the College’s position based on the most recent science and better understanding of the issues surrounding hyperactive delirium.” ACEP initially signaled its disapproval of the term in April 2023, stating it “does not recognize the use of the term ‘excited delirium’ and its use in clinical settings.”
The American Psychiatric Association (APA) released a study in 2022 that said that “excited delirium” is mostly cited as a cause of death when the person who died had been restrained.
“There is no evidence to support ExDS [excited delirium] as a cause of death in the absence of restraint,” the APA study’s abstract said. “When death has occurred in an aggressively restrained individual who fits the profile of either ExDS or AgDS [agitated delirium], restraint-related asphyxia must be considered a likely cause of the death.”
ACEP advised that the term should be avoided by the wider medical and public health community, law enforcement organizations and ACEP members when testifying in court. Reuters reported in 2017 that, since 2000, excited delirium was listed as a factor in 276 deaths where a Taser was used.
California became the first state to ban the use of excited delirium as a cause of death Thursday.