Public Safety Committee on April 28th, 2008

[Dr. Graeme Dowling]

That would be a tough one. I don't know if they would die for certain, but if they did, could I prove it? I think “I don't know” is the best answer.

[Serge Ménard, Bloc, Marc-Aurèle-Fortin, QC]

You quite rightly raised another issue in your presentation, namely the requirement to include a list in all police reports regarding cases where the taser was used.

As medical examiners, could you tell me whether there is already a compilation or list of the deaths caused by other means of restraint? That would enable us to compare the use of the taser to other methods of restraint that may result in death.

[Dr. Andrew McCallum]

In the mid-nineties there was a great deal of interest in what was called restraint asphyxia, or positional asphyxia, associated with the hog-tied position or associated with the piling on that Dr. Dowling alluded to earlier. A series of deaths were published in academic journals, journals of forensic science, that I'm sure my colleague remembers. That was very much the fashion of that time, concern being raised by bodies such as yours about that use of restraint. That seems to have become less of an issue now with the arrival of the taser, and the taser is the focus.

My personal view is that the rate of death is about the same. We are seeing roughly the same number of deaths associated with excited delirium followed by restraint and/or tasers as we once did. That would be my view. I don't know if there's a difference. I don't think there is.

[Serge Ménard, Bloc, Marc-Aurèle-Fortin, QC]

But we could make some comparisons, and that is the important thing.

[The Chair, Conservative, Garry Breitkreuz]

I would like one clarification. When you're doing the autopsy, you can measure the adrenalin levels and the potassium levels, can you not? You cannot measure that?

[Dr. Graeme Dowling]

After death, those levels are meaningless.

[The Chair, Conservative, Garry Breitkreuz]

Okay, that's what I was wondering about. Then you cannot determine if the death was caused by heightened adrenalin and lower potassium.

[Dr. Graeme Dowling]

What you have to understand is that when we talk about adrenalin and potassium, we're talking about what we refer to as a mechanism of death, not the actual cause of death. Just for your information, the cause of death is defined as the disease or injury that initiates a downhill sequence of events ending in death. That's very different from looking at the potassium or the adrenalin levels.

[The Chair, Conservative, Garry Breitkreuz]

Okay. Yes, I've been watching CSI and I've never seen them analyze the adrenalin either.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Mr. Chair, I think too many people watch too much CSI.

[The Chair, Conservative, Garry Breitkreuz]

Yes, okay.

Go ahead, Mr. Norlock.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

I have a couple of quick questions based on some of the questions you've been answering. This has to do with the death certificate and fear of being sued by Taser International.

Dr. Dowling or Dr. McCallum, if you felt the cause of death was the taser, would you be afraid of putting that on a death certificate?

[Dr. Graeme Dowling]

No.

[Dr. Andrew McCallum]

Absolutely not.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Is either one of you financially involved with that company?

[Dr. Andrew McCallum]

No.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Okay, thank you.

When I was doing some reading on excited delirium, I was surprised that it's a term we're all using, yet I don't believe it's actually a psychological diagnosis. It is becoming--and tell me if this is right--a medical condition, but not a diagnosis. Is that correct?

[Dr. Andrew McCallum]

It's a syndrome as opposed to a disease, which has a well-defined cause. It's a constellation of symptoms, which you've heard described repeatedly, and it's much more referred to in the forensic and law enforcement community than it is in the medical community. There's been lobbying by the American Psychiatric Association to include it in the DSM-IV, which is their diagnostic and statistical manual of psychiatric diseases, but as the cause is not well established, there's been reluctance to do that.

[Dr. Graeme Dowling]

Actually, the condition or syndrome, or whatever you want to call it, was first described by psychiatrists in the 1800s. The terms they used are slightly different--acute exhaustive mania, lethal catatonia, and some other terms--but psychiatrists were the first ones to describe it.

This was before cocaine. This is the mid-1800s. Where did you see these patients? Well, we mentioned that a psychiatric disease can be the underlyer; in the 1800s all those patients were in hospital, so that's where they saw it.

There's a theory--and I would emphasize that it's only a theory--that maybe one of the reasons we're seeing it more in psychiatric patients outside hospitals is that it's now our preference to keep psychiatric patients outside and living as normal human beings whenever possible, but if their disease becomes out of control, excited delirium is a possible--rare, but possible--consequence of that.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you very much.

I'd like to switch now to some of your personal comments, but I think anything you say personally is always.... Anything I say is based on my life experience in my job and other areas.

In particular, you said that if tasers are being used, you'd like to see them used by the right people with the right training under the right rules. By that statement, are you saying that in your personal and professional opinion--because the two are intertwined--it would be an appropriate tool if those three conditions are met, and that it would be appropriate for police personnel to use them?

[Dr. Graeme Dowling]

Yes, and the reason is that if I were in a state of excited delirium, I would rather a police officer pulled out a taser than a gun. It's that simple.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you.

Dr. McCallum, feel free to jump in at any time you wish.

That's where I'd like to go next. Police officers have these tools around their belts. What I believe to be the most powerful tool is their ability to communicate, but under excited delirium I would suggest that communication is probably not going to work, except in very few circumstances. Would that be correct?

[Dr. Andrew McCallum]

That's fair.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

So the next choices are pepper spray, the ASP baton--because most police officers carry that, or a big stick, something hard--the taser again, and/or the gun. With the ASP baton the proper usage is to incapacitate the person or to cause so much pain that it's pain compliance, very much like the taser. Basically you beat them until you get the kind of response you want, or you hit them once and hopefully don't have to hit them again.

[Dr. Andrew McCallum]

I'm not an expert on the use of force, so I can't say.