Canadian coroners starting to reject excited delirium as cause of police-related deaths

As a coroner's jury takes their seats Monday in the inquest into the death of Myles Gray, they may hear arguments that his death was the result of something called excited delirium, and not the actions of Vancouver police officers.

Excited delirium has also been cited by Ottawa police officers in connection with the death of Abdirahman Abdi during a violent arrest, a coroner's jury looking into a death in a New Brunswick jail, senior RCMP officers after the death of Robert Dziekanski at Vancouver's airport, and defence lawyers for the American officer who murdered George Floyd.

The highly contentious term describes a state of agitation, aggression and distress generally linked to drug use or mental illness, and it's been used as an explanation for sudden, unexpected deaths during interactions with police.

It was one of several possible explanations given by a forensic pathologist for the death of Gray, an unarmed 33-year-old who died in 2015 after being handcuffed, hobbled, punched, kneed, kicked, pepper-sprayed and struck with a baton by several Vancouver officers. He was making a delivery for his florist business at the time, and police had been called after he confronted a homeowner for watering her lawn during an extended drought.

But a major shift is underway, and medical examiners and coroners across Canada and the U.S. are starting to reject excited delirium as a cause of death. Both the American Medical Association and the American Psychiatric Association have dismissed the diagnosis entirely.

Dr. Michael Freeman's opinion on excited delirium is blunt.

"[It] might as well be a magician waving a wand and saying abracadabra for all the evidence that we have for it," he said.

Freeman is an associate professor of forensic medicine and epidemiology at Maastricht University in the Netherlands and a clinical professor of forensic psychiatry at Oregon Health and Science University, and he's analyzed the research on excited delirium.

"It's an interesting theory which always directs the gaze for the cause of the death away from the restraining personnel, and so if you say it's excited delirium, it's basically the fault of the person who died," he told CBC News.

"Then you don't have to look any further. You don't have to look at how potentially the restraint killed the person."

Freeman said his review of cases described as excited delirium in the scientific literature suggests the term is almost exclusively used when police are restraining a person with handcuffs, hobbles (leg restraints) or other forms of physical force, and death was most likely to result when the restraint was especially aggressive.

WATCH | What Dr. Michael Freeman's research suggests about excited delirium:

Police officers are often trained on identifying and responding to excited delirium. An online description for a one-hour course on the subject offered through the Canadian Police Knowledge Network and designed by the Calgary Police Service claims it "accounts for the majority of custody-related deaths."

The current Vancouver Police Department regulation and procedures manual says officers should be aware of the signs of excited delirium. Some of the officers on the scene when Myles Gray died said they believed he was suffering from excited delirium, according to a report completed for an investigation overseen by B.C.'s Office of the Police Complaint Commissioner.