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.

HR188

HOUSE OF REPRESENTATIVES

H.R. NO.

188

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

HOUSE 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.

; and

����
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.

; and

����
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.

; and

����
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.

; and

����
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.

; and

����
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, 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 Resolution be transmitted to the
Director of Health, Medical Examiner or Coroner of each county, and Chief of
Police of each county.

OFFERED BY:

_____________________________

Report Title:

Excited
Delirium; Cause of Death; Health