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- CAP Supports Discontinuing Term ‘Excited Delirium’ as Cause of Death
“Excited delirium” is not a medical diagnosis and should no longer be used as a cause of death, the CAP said in a statement on October 13 in support of a recent position issued by the National Association of Medical Examiners (NAME). This position is also supported by the American Medical Association and the American Psychiatric Association.
The term excited delirium has been around for decades but has been used increasingly over the past 15 years to explain how a person experiencing severe agitation can die suddenly through no fault of the police. It was cited as a legal defense in the 2020 deaths of George Floyd in Minneapolis; Daniel Prude in Rochester, New York; and Angelo Quinto in Antioch, California, among others. “This terminology has been used by medical examiners, forensic pathologists, and law enforcement personnel,” explained Michelle Aurelius, MD, FCAP, chair of the CAP’s Forensic Pathology Committee. “However, there are concerns that use of this term can mask physical restraint use and that this terminology targets persons of color.”
In California, Democratic Gov. Gavin Newsom signed a bill October 8 to prohibit coroners, medical examiners, physicians, or physician assistants from listing excited delirium on a person’s death certificate or in an autopsy report. Law enforcement will not be allowed to use the term to describe a person’s behavior in any incident report, and testimony that refers to excited delirium will not be allowed in civil court. The law takes effect in January 2024.
“Instead, NAME endorses—and the CAP supports—that the death certificate list the underlying cause of death, natural or unnatural (to include trauma),” said Dr. Aurelius. “If possible, the underlying cause should be determined and used for death certification.” Read more.