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Eric Garner’s death was ruled a homicide due to a chokehold and chest compression. However, while most media outlets have been focused on the chokehold, many have ignored the dangerous, yet overlooked, chest compression known as Restraint-Related Positional Asphyxia. This has largely been a concern of mental health care workers throughout the United States, who have to occasionally restrain patients who have become a danger to themselves or others. It came to the national light several years ago after a number of deaths during restraints at hospitals and police departments.
I’ve worked in mental health for six years and I teach verbal and physical crisis prevention to both behavioral health staff and emergency department personnel. It occurs, not from a “chokehold,” as seen in the video. Indeed, it doesn’t appear that the officer held onto Garner’s throat long enough to directly cause his death. Rather, restraint-related positional asphyxia is the result of the patient being face down on the ground or having someone put his weight on the individual’s chest, leaving the patient unable to expand his or her chest to inhale. In this way (and if this is truly the case), the death could be ruled a homicide (death caused by another human being) without being intentional murder. Officer Daniel Pantaleo is seen in the video first putting Garner in a chokehold and the group of officers wrestling him to the ground. However, once face-down on the concrete to put the cuffs on, Pantaleo is kneeling on Garner’s upper back and head. It was at this point that Garner began to say he couldn’t breathe.
In mental health, our prerogative is to maintain the safety of our patients, to not cause harm even if they represent a danger to us and require restraint. For this reason, we are trained to never put a patient face-down on the ground. The ground does not have any give, particularly concrete and hospital floors. Face-down on the ground, the patient is often unable to expand his chest to take a breath. This condition is exacerbated by people piling on top of the patient in an effort to keep him or her down, the patient’s weight and health conditions, and his or her stress level at the time. Obviously, Garner was in a stressful situation at the time, which would result in increased blood flow and heart rate. Those would, in turn, cause his breathing to become more rapid and strained. He also had officers placing their weight on top of him as they tried to place the handcuffs on him. Garner was about 350 pounds; his own body weight alone would have made it difficult to expand his chest when face-down on concrete. The added weight of the officers increased this weight and probably made it impossible for a body to withstand. Whenever the chest is compressed and restrained, the danger exists.
One of the arguments made was that the chokehold did not cause his death because he was able to speak and say, “I can’t breathe.” In the video he was making the statement that he couldn’t breathe after the officer had released the hold and he was being handcuffed face-down, with several officers on top of him. He would not have been able to speak if he were in a chokehold that cut off his airway, but he would have been able to say it if his death was due to chest compression. He was able to force breath from his lungs across his vocal chords, but he was not able to get any air back in. The same way a mouse can still squeak as a boa constrictor squeezes the life out him, Garner was able to make desperate pleas. But every time he did, his time grew shorter and shorter. A chokehold can either cut off air intake through the windpipe or cut off the carotid artery, sending blood to the brain. You can go unconscious quickly, but once it is released, you can continue to breathe normally (it happens in MMA all the time). Not so during an arrest, which can often take several minutes as the officers restrain, cuff, clear the area, and figure out what they are going to do next. With restraint-related asphyxia, it is not like holding your breath, but rather it is having no breath at all because every bit of air has been forced out. This has happened in numerous cases of hospital restraints across the country and has spurned legislation to curb its practice, which is one of the reasons I and other instructors educate mental health care workers in how to properly and safely restrain patients.
The police, however, put a suspect face-down in order to handcuff him. Whether or not this can be avoided through new tactics, I don’t know. To some degree it seems necessary in order to facilitate the arrest, but the dangers are amply demonstrated. Of course, this does not mean that no one should have been held accountable for Garner’s death. The cases that have appeared in hospitals and police departments have resulted in massive lawsuits and, considering the Garner family’s $70 million civil suit, the same will probably prove true in this case. In this way, the officer may not have been acting negligently by grabbing Garner from behind. However, having him face-down on the concrete for an extended period of time while screaming that he couldn’t breathe can be seen as negligence on the part of everyone involved. Perhaps educating officers in the danger of these kind of restraints would be appropriate if they don’t receive it already. However, if the officer(s) were acting within the scope of what they are trained and ordered to do, one can excruciatingly reconcile that the legalities didn’t add up to make an indictment.
This, of course, is all somewhat beside the point. Legality does not make something right or wrong. Six officers were used to execute a law against selling loose cigarettes. His death was, in all manner of speaking, wrong and I would argue that it was more negligence on the part of all the officers involved (who were given immunity) for not responding to Garner’s repeated cries that he couldn’t breathe, than to Officer Pantaleo’s “chokehold.” Several articles have come out regarding the “Broken Windows” theory of policing, particularly in Slate and Commentary, and these criticisms should be heeded. The technicality of how Garner died may have gotten Officer Pantaleo off the hook from indictment, but the bigger questions remain and are now at the forefront of our national discourse.
Marc E. Fitch is the author of “Paranormal Nation: Why America Needs Ghosts, UFO’s, and Bigfoot,” and is the recent recipient of the Robert Novak Journalism Fellowship. He lives in Connecticut with his wife and four children and works in the field of mental health.