Abstract
How can death during police restraint be explained when the pathologist finds no structural or anatomic lesions to explain death? This is not an easy question to answer. When an in-custody restraint death occurs, there is a close physical and temporal association between the restraint process and the death that follows. Because of this, it is tempting to attribute the cause of death to the restraint procedure itself. However, this is an error of logic: the fallacy of post hoc ergo propter hoc, which is Latin for “after this therefore because of this.” This error in logic may mislead death investigators into building a case centered on the deadly effects of police restraint procedures and prevent consideration of other mechanisms and causes of death that occur contemporaneous with restraint. One such cause is cardiorespiratory arrest caused by the acute stress response occurring during police restraint. This cause of sudden death is unpredictable and rare, and results from a combination of individual perception of the threat posed by the restraint events and maladaptive pathophysiology of the acute stress response. This chapter examines the mechanisms, physiology, and medical issues associated with the acute stress response.
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Laposata, E.A. (2006). Restraint Stress. In: Ross, D.L., Chan, T.C. (eds) Sudden Deaths in Custody. Forensic Science and Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-015-7_5
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