Making Up Excited Delirium

Abstract

This article examines the emergence of a medical condition increasingly cited as a cause of death in fatality inquiries in Canada: excited delirium. Beyond concerns arising from the association between excited delirium and police use of electrical weapons known as Tasers, one common concern about the medical condition is whether or not it is "real." Bypassing strictly realist or purely constructivist accounts, this article uses the conceptual language of historical ontology and science and technology studies to investigate how excited delirium is enacted in medico-legal sites. Contributing to sociologies of death and dying and category formation, it attends to the textually mediated practices of legal and medical experts in the United States and Canada that enact excited delirium as a coherent medical condition.

Acute behavioural disturbance: a physical emergency psychiatrists need to understand

“…Indeed, some civil rights campaigners have stated that it is a ‘fake diagnosis’, aimed at exonerating officers from charges of excessive use of force (Paquette 2003). Further, legal proceedings have contested ABD as a recognised medical condition (Anaïs 2014), and most hospital records do not have ABD as a diagnosis, instead ascribing patients’ symptoms to conditions such as ‘agitated delirium’, ‘cocaine-induced mental illness’ or ‘malignant catatonia’ (Fink 1999; Detweiler 2009).…”

Making Sense of ‘Excited Delirium’ in Cases of Death after Police Contact

“…In the US, a National Institute of Justice (NIJ) review into ED defined it as 'an altered mental state with impaired cognition and perception, and severe psycho-motor agitation' (NIJ, 2011: 37). Moreover, there is significant debate within the medical and scientific community about whether ED is a recognised medical condition (Anaïs, 2014).…”

“…The available literature on ED in relation to police interactions comes principally from the US, but also from Canada. Whilst there is debate in the US literature as to whether ED exists as a 'condition' or cause of death, the Canadian literature is sceptical about its existence and thus its relevance as a cause of death after police interaction (see, for example Razack, 2015, Anaïs, 2014, Brodeur, 2010. This paper investigates ED using empirical evidence in cases of DAPC in England and Wales during the period 2009-2015.…”

“…The use of force also tends to be a factor in such deaths, and in England and Wales this typically manifests itself as the use of physical restraint by police officers (IPCC, 2016). Cases of DAPC, then, tend to be contentious due the disproportionately high number of people who die from a combination of the factors noted above (Razack, 2015, Anaïs, 2014. It might not be surprising, therefore, to note that when ED is mooted as a cause of death, this is qualified by its presence within a constellation of symptoms (RCEM, 2016, Hall et al 2013, Storey, 2012, Vilke et al 2012, IAP 2010 underlining equivocal causality in cases of DAPC.…”

“…Thus ED is marked by a wide variety of possible symptoms, causes, and contested definitions. It can relate to contentious police interactions with individuals of BME origin; with mental health and/or substance issues, and also relate to the use of force (Anaïs 2014, Storey 2012, Brodeur 2010. Small wonder that Wetli (2006: 99) cites a New York chief police officer stating that ED accounts for 1% of their cases but 99% of their headaches.…”