Another medical group withdraws support for controversial diagnosis used in Greg Edwards case
The American College of Emergency Physicians has said it no longer endorses the term "excited delirium" to describe the controversial syndrome authorities blamed for the 2018 death of Gregory Edwards in the custody of the Brevard County Sheriff's Office.
The associated said in a statement last month it "does not recognize" the term or "its use in clinical settings." A 2009 ACEP white paper supporting the term — widely cited by defenders of excited delirium — should be considered "outdated and inaccurate," the group's President Dr. Christopher Kang added in an April 25 episode of the Skeptics' Guide to Emergency Medicine podcast.
More: Major medical group disowns 'excited delirium,' controversial cause of death in Edwards case
"ACEP understands the evolution and challenges of preliminary concepts, awareness, knowledge and evidence, and has been proactive with conversations, updates, and more accurately defining this syndrome as the leaders in frontline medicine," Kang said on the podcast.
While the college rejected the term, however, it stood behind the cluster of symptoms it began referring to as "hyperactive delirium" in an updated 2021 report.
"ACEP supports continued multi-disciplinary research, dialogue, and consensus to better recognize, manage, and advocate for patients who show signs of hyperactive delirium accompanied by severe agitation using evidence based, safe care," it wrote in the April 14 statement.
The announcement followed a disavowal in March from the National Association of Medical Examiners. The two associations were the last remaining medical industry groups to endorse the term, according to the New York-based activist group Physicians for Human Rights.
Excited delirium has long drawn controversy as a clinical diagnosis most often invoked to explain deaths following the use of force in police custody.
Brevard County authorities listed "excited delirium" as the cause of death for former U.S. Army combat medic Gregory Edwards, who died after an altercation with deputies and subsequent restraint at the Brevard County jail in 2018.
The ruling drew skepticism from experts consulted by FLORIDA TODAY, including from the chair of the Florida Medical Examiners Commission.
More: Excited delirium: Rare and deadly syndrome or a condition to excuse deaths by police?
Excited delirium is described in a 2011 U.S. Department of Justice report as a collection of symptoms "broadly characterized by agitation, excitability, paranoia, aggression, great strength and unresponsiveness to pain."
The syndrome is not recognized by the World Health Organization or in major medical diagnostic manuals, including the International Classification of Diseases (ICD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The American Medical Association and the American Psychiatric Association have long opposed the diagnosis, arguing the term is undefined and too broad to be medically useful.
Joanna Naples-Mitchell, a research advisor for Physicians for Human Rights who spearheaded a 2022 report rejecting the term, said in a statement that ACEP's announcement was "years overdue."
"We look forward to working with ACEP and other stakeholders around the country to end the use of ‘excited delirium’ entirely, and toward a world where medical professionals, not police, respond to medical crises, including suspected delirium," Naples-Mitchell said.
Eric Rogers is a watchdog reporter for FLORIDA TODAY. Contact Rogers at 321-242-3717 or esrogers@floridatoday.com.
This article originally appeared on Florida Today: Another medical industry group disavows 'excited delirium' diagnosis
