Good afternoon, Chairman and members. First, may I say I'm pleased to be here.
I only represent myself in these matters. My present status as an independent consultant has taken me to the issue of reviewing deaths, sudden deaths in particular, both in the criminal and civil areas of court, and in some circumstances the taser has been involved in these reviews.
My background has been as a pathologist for 37 or 38 years. I've been a medical doctor from the beginning and have held the position of senior death investigation authority and chief medical examiner of the Province of Alberta, and the Province of Nova Scotia latterly. I have done independent consulting for about 20 years, and I have done it pretty well exclusively since 2000. My practice includes cases both in Canada and the United States, and I have had referrals from the United States in the general area of discussion involving, in the greater context, persons who have been “taken down” by the police. That's a broad statement, but I hope to bring it to a somewhat narrower focus—and I'm sure my colleague, Dr. Hall, will be doing that as well.
So I'm only going to review the features that, on reflection in my mind, may be questions that you have in the first place or that may be somewhat contentious.
First of all, what is the role of the coroner or the medical examiner as an official? I say this in regard to them as an official, not necessarily in regard to another professional individual, for there are coroners in Canada, for example, who have no special qualifications, meaning they are not medically qualified and do not do autopsies. That's a separate office, as you may be aware, and there are statutory obligations for them to answer certain questions.
The two questions that are relevant to your own examinations are, first, what is the medical cause of death? It is a specific issue whether or not this exists; it's not always determinable. But of course in certain cases, it's very obvious. For example, in serious trauma it's very obvious. But as we'll see, there is no specific pathology associated with any of these take-down procedures. Very uncommonly is there specific pathology, including with the taser.
The other question that is asked of the coroner or medical examiner is, what is the manner of death? The manner of death is whether the death is natural, or, if it's unnatural, whether it is an accident, a suicide, or a homicide, or if those entities don't lead to a conclusion, if the manner of death is indeterminable.
In some situations, as I'm sure most are aware, there is a process called the inquest or, in some provinces, notably in Nova Scotia, Manitoba, and Alberta, a public inquiry. There, the questions that I mentioned formerly—the cause of death and the manner of death—are determined in an open public forum, sometimes by a jury.
The pathologist's role is different, and it is essentially to conduct an autopsy. In some provinces there are specialists in sudden death autopsies. You're all aware that there has been a substantial discussion about forensic pathology recently in the press, and many of you will be familiar with the types of issues in which pathologists are involved. The commonest one, of course, that reaches the press is murder. Without in any way belittling the issue of taser deaths, or making an issue of taser deaths, when they occur in public, they attract almost as much attention as a homicide does—in fact, in current memory, perhaps even more so.
The pathological features associated with these conditions I'm sure you're perhaps curious to know. There are no specific or unique features. Very seldom in taser deaths is there any form of injury. The dispersement of the two barbed probes or the use of the push stun method with a taser may cause isolated small areas of burning of the flesh, and I mean isolated. If you have seen the probes, you will know that they are very, very small, so the area of coagulation of the tissue is basically no bigger than the head of a pin.
As far as the mechanism of death is concerned, which I haven't discussed, the question becomes whether it is related to potentially one or two systems: the respiratory system or the cardiovascular system. I'm going to keep this brief by saying that the determination at autopsy of the effects of a cardiac arrhythmia is impossible. Under no circumstances where there has been a cardiac arrhythmia--under any circumstances--whether that relates to a recent heart attack or deployment of the taser...it is not possible at post-mortem to determine this, nor is it possible at post-mortem to determine under any circumstances, unless there's a bitten tongue, whether the person might have had a seizure.
There are very few changes that are even slightly related to the taser. One of them may be changes in the microscopic appearance of striated or voluntary muscle. I'm not going to go into the details of it, but it's more a feature of a high temperature than anything else. That's called hyperthermia. There may be small features associated with falling or with other minor blunt trauma when the person collapses as the result of the electrical shock.
Without question, I'm sure you have heard of the issue of excited delirium. I feature that, as I feel certain Dr. Hall will, because in the realm of medical practice and particularly that of the forensic pathologist or the death investigating officer, on the issue of excited delirium or syndrome, a group of symptoms is common, and one cannot ignore that.
I would comment on it further to say that it's regrettable that it has been said in the media that excited delirium is not in the parlance of psychiatry. Delirium is common in the parlance of psychiatry, and excited delirium I'm sure is well known to every doctor in the hospital who has to deal with patients who come in in an excited state. That's Dr. Hall's area.
Excited delirium is seen in other forms of takedown. It has been seen in the capsicum spray. It has been seen in the issue of neck holds and of physical restraints on the ground such as hog-tying, piling on top of the victim, and a number of other restraint techniques. Excited delirium has received more prominence, I believe, since cocaine has become a common drug in the community, and certain forms of cocaine, it is said, are more likely to cause excited delirium than others.
Excited delirium is also common in certain psychotic states, pure and simple. That means bipolar disorder in the acute phases of mania and the acute manic phase in schizophrenic disorders, both of these where the subject may have decided to withdraw his or her medication.
There are many arguments in favour of excited delirium. I'm not going to go over them. It has a strong historic context.
Witnesses relate these symptoms frequently as simply as in a call to the police--running around, knocking on doors, shouting, etc. In the clinical context, meaning symptoms and signs, there are plenty of things to allow this to be called a syndrome.
There are many important unanswered questions. I've tried to focus on those that I think are the most common in the relevance of the work I have done and in reviewing cases of sudden death associated with all forms of takedown in the excited state that most of these people are in.
The question is, what is the mechanism of fatal collapse in excited delirium? That is a very, very important question. In fact, I would opine that this is the most important question. It begs the question, well, are they going to die anyway? But it also gives note to the point that these deaths occurred long before the taser ever came along. Are excited delirium fatalities in the taser different from the sudden-death fatalities that are seen in the other modalities I've mentioned?
I don't have an answer to any of these things, and I don't know that anybody does. The next question brings up perhaps the reason why. Most such studies would be deemed unethical. You can't be tasering people for the purposes of a medical experiment.
My final question to the committee is, why would one curtail the use of a taser if it is an option to the use of lethal force?
Thank you very much for this opportunity.