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HOUSE OF REPRESENTATIVES |
H.C.R. NO. |
198 |
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THIRTY-THIRD LEGISLATURE, 2026 |
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STATE OF HAWAII |
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HOUSE CONCURRENT
RESOLUTION
FINDING that "excited delirium" and "excited delirium syndrome" are not medical diagnoses recognized by any leading medical or other scientific organization and requesting all state and county government entities to refrain from indicating "excited delirium" or "excited delirium syndrome" as a cause of death.
WHEREAS, "excited delirium" is an unofficial term characterized by agitation, aggression, acute distress, and sudden death, often in a pre-hospital care setting; and
WHEREAS, "excited delirium" is not recognized as an official medical diagnosis by any leading medical or other scientific organization; and
WHEREAS, the Senate Committees on Health and Human Services and Public Safety and Military Affairs held a joint hearing on S.B. No. 228, S.D. 1 (2025), a measure addressing excited delirium, and issued Senate Standing Committee Report No. 528 (Regular Session 2025), stating:
Your Committees find that "excited delirium", or "excited delirium syndrome"[,] is not a real medical diagnosis, has no basis in medicine, and has no consistent or diagnostic criteria. Your Committees further find that for decades, "excited delirium" has been invoked to justify law enforcement violence, especially against people of color and those experiencing mental health crises.
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WHEREAS, the Senate Committee on Judiciary held a hearing on S.B. No 228, S.D. 1 (2025), and issued Senate Standing Committee Report No. 954 (Regular Session 2025), which included similar findings:
Your Committee finds that the majority of major national and international medical organizations do not classify "excited delirium" as a medical diagnosis. Your Committee further finds that historically, excited delirium has been often utilized and weaponized to shield law enforcement from accountability when negative outcomes occur from police-civilian interactions. Therefore, by prohibiting the use of the term "excited delirium" in medical and law enforcement reports, this measure will ensure that only scientifically proven diagnoses are employed in official reports and legal proceedings.
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WHEREAS, the House Committee on Health held a hearing on H.B. No. 36, H.D. 1 (2025), a measure also addressing excited delirium, and issued House Standing Committee Report No. 322 (Regular Session 2025), stating:
Your Committee finds that "excited delirium" is a term with no medical basis that is used to justify the use of excessive force by some law enforcement officers against individuals experiencing a mental health crisis. Your Committee further finds that "excited delirium" has no consistent definition or diagnostic criteria and is not currently included in the DSM-5, the authoritative classification system for mental health disorders used by medical professionals in the United States. Your Committee believes that the interests of justice and public health and safety dictate that "excited delirium" should not be recognized as a valid cause of death, used in incident reports, or admissible in civil cases in the State.
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WHEREAS, the Hawaii House Committee on Judiciary and Hawaiian Affairs held a hearing on H.B. No. 36, H.D. 2 (2025), and issued House Standing Committee Report No. 1056 (Regular Session 2025), stating:
Your Committee finds that the term "excited delirium" has been widely discredited by medical and scientific organizations and has been improperly used to justify deaths occurring in law enforcement custody. This unrecognized diagnosis has contributed to legal outcomes that obscure the true causes of death, preventing accountability and justice for affected individuals and their families. This measure ensures that law enforcement and medical determinations are based on scientifically valid and evidence-based practices by prohibiting the use of the term "excited delirium" as a medical diagnosis, cause of death, or legal defense.
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WHEREAS, the House Committee on Judiciary and Hawaiian Affairs held a hearing on S.B. No. 228, S.D. 1, H.D. 2, and issued House Standing Committee Report No. 1784 (Regular Session 2025), stating:
Your Committee finds that the term "excited delirium" is now disavowed by major medical organizations, including the American Medical Association, American Psychiatric Association, American Academy of Emergency Medicine, National Association of Medical Examiners, American College of Medical Toxicology, and American College of Emergency Physicians. Your Committee further finds that the concept of excited delirium has been used in various cases over the years to justify, excuse, or negate liability for police misconduct in cases involving the deaths of individuals in custody. This measure would strengthen accountability on the part of law enforcement.
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WHEREAS, the World Health Organization also recognizes that "excited delirium" is not a valid medical diagnosis or cause of death, and "excited delirium" has never appeared in any version of the Diagnostic and Statistical Manual of Mental Disorders; and
WHEREAS, the ninth and tenth revisions of the International Classification of Diseases have not included a classification code for "excited delirium," which prevents it from being listed as a cause of death on a death certificate for purposes of statistical reporting; and
WHEREAS, despite this, "excited delirium" improperly appears in Hawaii autopsy reports and death certificates, and the Department of Health reported that "excited delirium" has been listed as an immediate cause of death nine times since 2006; and
WHEREAS, even when "excited delirium" did not appear as a cause of death in an autopsy report or death certificate, defense experts in Hawaii wrongful death cases have testified that a person who was killed by law enforcement actually died of "excited delirium," as happened to Oahu military veteran Sheldon Haleck; and
WHEREAS, in 2005, S.B. No. 228, S.D. 1, H.D. 2, which proposed to prohibit the use of "excited delirium" as a valid cause of death or medical condition in the State of Hawaii, passed the Hawaii House of Representatives with zero "no" votes, and had no opposition from the law enforcement or medical communities, but was denied a Conference Committee hearing; now therefore,
BE IT RESOLVED by the House of Representatives of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2026, the Senate concurring, that the Legislature finds that "excited delirium" and "excited delirium syndrome" are not medical diagnoses recognized by any leading medical or scientific organization; and
BE IT FURTHER RESOLVED that all state and county government entities are requested to refrain from indicating "excited delirium" or "excited delirium syndrome" as a cause of death on any autopsy report or death certificate and from indicating that "excited delirium" or "excited delirium syndrome" was a cause of death in any context; and
BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Health, Medical Examiner or Coroner of each county, and Chief of Police of each county.
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OFFERED BY: |
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Excited Delirium; Cause of Death; Health