Medical-Legal Alliances: Encounters with Excited Delirium in Ontario Coronial Law

This theoretical paper analyzes Ontario coroner inquest reports that reference excited delirium from 1996 to 2023. The author argues that coroner inquest reporting engaged medical experts in work to exonerate law enforcement of white supremacist violence. Excited delirium as a racializing assemblage illustrates how the coroner inquest functions as a medico-legal tool that pulls focus from, and in so doing is designed to maintain, the violent institution of policing. To that end the author describes the anti-racist abolitionist theoretical approach driving this paper’s analysis, to show the limitations of reliance on what is ultimately a reformist response to death-by-police. Through this lens the author explains the invention and development of excited delirium in medical scholarship. Then in a review of Ontario coroner inquest reporting, the author shows how the causes of death identified and the summaries of death presented come to constitute excited delirium, both by focusing on conditions located in the body-mind of the deceased, and by reframing – and ultimately displacing legal scrutiny away from – restraint use and other patterns of violence found in police encounters. Further, jury recommendations and coroner elaborations related to training and research align with a reformist ethos that enlists medical authorities in the work of keeping institutions of policing intact and beyond meaningful reproach despite the violence they continually enact.