RELATING TO EXCITED DELIRIUM.
SB228 would prohibit the State of Hawaii from recognizing “excited delirium” as a valid medical diagnosis or cause of death. It would bar medical examiners, coroners, health care providers, and state or county government personnel from documenting, testifying to, or otherwise using the term in an official capacity, including on death certificates and reports. The bill also directs law enforcement officers not to use the term in incident reports, while still allowing them to describe the underlying facts and observed behavior.
The bill further amends Hawaii’s Rules of Evidence to make evidence that a person suffered or experienced excited delirium inadmissible in civil actions. Parties and witnesses could still describe the factual circumstances, but could not characterize those facts as excited delirium or attribute the condition to that term. The measure also renames Chapter 327C from “Medical Diagnosis; Cause of Death” to “Medical Diagnosis; Death,” reflecting the bill’s removal of excited delirium as a recognized cause-of-death label. The act is set to take effect on July 1, 3000, which is effectively a delayed or placeholder effective date.
The bill’s impact would be to change how certain deaths, incidents, and civil cases are documented and litigated in Hawaii. It would affect medical examiners, coroners, physicians, nurses, physician assistants, law enforcement officers, state and county agencies, and civil litigants by limiting the use of a contested term in official records and courtroom evidence. It does not prevent professionals from describing symptoms, conduct, or contributing causes of death; it only bars the specific label “excited delirium” from being used as a diagnosis, cause of death, or evidentiary characterization.
Overall sentiment in the available legislative history appears supportive. The bill passed the Senate Health and Human Services Committee unanimously and the Senate Judiciary Committee unanimously, and it also advanced through the Senate Public Safety, Intergovernmental and Military Affairs Committee with a 4-1 vote after amendments. The committee record provided does not include transcript debate, but the vote pattern suggests broad agreement with the bill’s core policy.
The main point of contention is the underlying rejection of “excited delirium” as a legitimate medical or forensic term. Supporters appear to view the term as scientifically unsupported and potentially misleading in death investigations, police reports, and civil litigation. Any opposition likely centers on concerns that removing the term could limit professional discretion or affect how officials describe extreme behavioral or medical events, but the bill preserves the ability to document the factual circumstances and contributing causes without using the prohibited label.
The bill would amend Hawaii Revised Statutes chapters 327C and 353C and add a new rule to section 626-1 of the Hawaii Rules of Evidence. It would prohibit state recognition of excited delirium as a diagnosis or cause of death, bar its use in death certificates, official reports, and incident reports, and make evidence of excited delirium inadmissible in civil actions. It would affect medical examiners, coroners, health care providers, law enforcement officers, government entities, and civil litigants by restricting use of the term while preserving the ability to describe underlying facts and contributing causes.
The available voting history indicates strong support for the bill. It passed the Senate Health and Human Services Committee unanimously, passed the Senate Judiciary Committee unanimously, and advanced from the Senate Public Safety, Intergovernmental and Military Affairs Committee with only one dissenting vote. No committee transcripts were provided, but the pattern suggests the measure was viewed favorably by most legislators and was not highly controversial within committee.
The central contention is whether “excited delirium” should be treated as a legitimate medical or forensic concept. Supporters of the bill appear to argue that the term lacks sufficient scientific basis and should not be used in official diagnoses, death determinations, or civil evidence. Potential critics would likely argue that banning the term could constrain medical, forensic, or law-enforcement documentation of extreme agitation or sudden death scenarios. The bill addresses that concern in part by allowing factual descriptions of behavior and contributing causes, while prohibiting only the specific label.