Emergency physicians group rejects ‘excited delirium’

The American College of Emergency Physicians has withdrawn a white paper from 2009 on “excited delirium,” saying the term should not be used in civil or criminal cases. 

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The controversial medical term has been used by police officers, clinicians and in court to explain how an agitated person could die in custody from being in a state of extreme agitation. 

“ACEP’s 2009 White Paper Report on Excited Delirium Syndrome is outdated and does not align with the college’s position based on the most recent science and better understanding of the issues surrounding hyperactive delirium,” the ACEP said in an Oct. 12 statement, adding the term “should not be used among the wider medical and public health community, law enforcement organizations, and ACEP members acting as expert witnesses testifying in relevant civil or criminal litigation.”

Other medical groups, including the American Medical Association, have previously opposed excited delirium as a medical diagnosis, saying their decision came amid a pattern of “justification for excessive police force, disproportionately cited in cases where Black men die in law enforcement custody.” 

The ACEP’s white paper has been influential in court, experts told NBC News. Its formal withdrawal means, “If someone dies while being restrained in custody … people can’t point to excited delirium as the reason and can’t point to ACEP’s endorsement of the concept to bolster their case,” Brooks Walsh, MD, an emergency physician at Bridgeport (Conn.) Hospital who urged the group to take the stance, told the news outlet. 

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