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  • Eric Jaeger

Sudden Death in Custody: Implicit Racial Bias

In EMS we must do the hard work to better understand sudden death in custody, including understanding the role implicit racial bias plays in the actions of EMS and law enforcement personnel.

Dr. Melissa Costello, an emergency physician, served on a panel commissioned by the City of Aurora, Colorado to examine the circumstances surrounding the death of Elijah McClain. She specifically examined the actions of the paramedics and other EMS providers present. In the report, she found:

Evidence shows that we “overestimate young Black men as taller, heavier, stronger, more muscular, and more capable of causing physical harm than young White men.’

Our “perceptions of Black people as more threatening…impact judgments about the force necessary to restrain Black suspects as compared to their White peers and influence non-officer civilians to excuse officers’ use of force against Black suspects.”

“Research [shows] that:

providers perceived Black patients to be ‘less compliant and less cooperative in medical settings than White patients’; and

perceptions and treatment recommendations for hypothetical Black patients differed significantly from those made for hypothetical White patients with the exact same symptoms.”


“The individuals most likely…to die from first responder actions, or as a consequence of administration of chemical sedation…,

are otherwise healthy Black males in their mid-30s who are viewed as aggressive, impervious to pain, displaying bizarre behavior, and using substances –

characterizations that may be based less on evidence and more on generalizations, misconceptions, bias, and racism.”

AMA CSAPH Report 2021

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