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Glenn and John have responded to Radley Balko, who has been attempting to discredit the documentary The Fall of Minneapolis. Balko has thus far written two articles, [1] and [2], and a third is planned. Balko has an obnoxious writing style, so I made a summary of the main arguments with the help of ChatGPT (free version):
In previous videos, Glenn and John reacted to TFOM and interviewed the filmmakers. I'm sure none of this is news to many people here. I'm hoping to elicit some discussion and also to check my understanding of what happened when Floyd died. My current thinking is:
Chauvin's actions that day, while not sanctioned in the training manual, were perhaps not unusual within the MPD. I strongly suspect that he kept Floyd in that position simply because it had worked for him in the past and he hadn't been corrected.
With high confidence, Chauvin meaningfully contributed to Floyd's death.
Floyd's drug use, including any drugs he may have taken immediately prior to his death, probably made him more fragile than he otherwise would have been, but I find it unlikely that the drugs alone alone killed him.
I find it implausible that any of the officers acted with malice.
Convicting Chauvin of manslaughter or second degree unintentional murder, but not third degree murder, would have made more sense.
There was a Metaculus question for the Chauvin trial. At the time, the community was divided on whether he would be convicted of anything. This gives us a sense of how surprising the reaction to Floyd's death was. Have we been able to make sense of it since then? Decades from now, will anybody care? Or will none of it matter in the grand scheme of things, especially compared to the pandemic?
We've dinged people before for posting stuff written by ChatGPT, but usually because either they tried to obfuscate it or because they were being snide.
I'm not sure what to make of "I had ChatGPT summarize this article for me." That's actually not a bad use case for ChatGPT, but my own inclination is to say that if you can't be bothered to actually read and summarize the thing you are referring to yourself, this isn't the place for using ChatGPT to do the work for you.
This isn't an official ruling (yet), nor a mod warning, but I'm taking it up with the other mods and I am inclined to say "Don't do this in the future."
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I really like Glenn and John but was shocked at their rapid credulity over a partisan documentary. TFOM is important, but my default is skepticism and alarm bells started ringing when (iirc) the doc started impugning a defense attorney for based praise of his (criminal underworld) clients. Also, as a viewer, I had to pause the sections covering the MRT manual and speculate why Chauvin allegedly/technically didn't use it. I guess I've come to expect to good faith steelmanning.
I'm camped in this epistemic ground but with low confidence because I see plenty of space for reasonable doubt (ie an unhealthy 47 y/o male with heart problems and plenty of drugs on board dying of a heart attack while stressed and recovering form covid is a reasonable explanation), and/or I think it's arguable that Chauvins actions were reasonable enough given the situation.
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I only briefly perused one of the Balko posts (and haven't watched any of the videos he's responding to). I wanted to skip to the bit about the departmental training manual. I found the post very confused and focused on a further step of tying up a suspect, at which point you'd need to do various things like put them on their side, monitor them medically, etc. The post seemed to simply not understand that most of what it was citing wasn't relevant unless you had tied up the suspect.
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I think it will get the Rosa Parks and Nelson Mandela treatment, where pointing out that Parks was a committed activist who volunteered to provide a useful court case, and Mandela was the head of the armed wing of a communist terrorist organisation, becomes proof that the speaker is up to no good. Parks becomes nothing more than a sweet old lady who didn’t get off the bus when a racist told her to, and Mandela becomes a peaceful protestor against apartheid who hoped that blacks and whites could live together peacefully.
Then the streamlined version of the story appears in documentaries, children’s programmes and morality plays, and the inconvenient elements are permanently forgotten by later generations.
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I think this is a fair take. Aggressive restraint techniques for people experiencing "excited delirium" (i.e. they're high on drugs and about to give themselves a heart attack from overexertion) were common among various police departments. This was probably not wise. Manual restraint by people untrained in medicine is inherently risky for people with compromised cardiopulmonary health (i.e. they're heavily dosed on opiates). Physicians can strap patients who are a danger to themselves to their beds with purpose-designed devices and monitor their vitals; some beat cop with inadequate training is really rolling the dice when they sit on a suspect's neck or back.
The Minneapolis police swore up and down that Chauvin's actions were contrary to department policy. This is probably technically true, but if you told me it was nevertheless common practice and they were covering up a systemic training issue by scapegoating a single cop, I'd find it plausible.
It is not possible to safely restrain a patient. Their are more and less safe ways to do so, and it is tightly regulated - however these regulations essentially exist not to maximize safety, but instead to introduce liability to some poor individual staff member or the facility (for example: making a sleep deprived resident run to the opposite end of the hospital to lay eyes on granny for 2 seconds to make sure she's alive before running back to the other end of the hospital to deal with the emergency surgery they were supposed to be performing. Now if they fucked up and granny's arm was pinched they are liable...).
Places deal with this problem in various ways, with the worst being for-profit psychiatric hospitals, often they elect to "ban" restraints, meaning that they did some math and having staff and other patient's attacked is better for the system than the risk of a poorly managed physical restraint. Often they just sub dangerous amounts of chemical restraints (medications) instead, which is much better at causing invisible morbidity in the long term.
It's extremely easy to have a decompensated patient in the ED who refuses to stop trying to murder the staff, get placed in a restraint bed for 10 days, scream constantly the entire time (and give themselves Rabdo in the process), and manage to choke themselves on a combination of their clothing and spittle and expire when the 1:1 steps out of the room for two minutes because of another fight elsewhere in the ED (for legal reasons this is not a true story).
Physical holds (as the police do) are safer since they are necessarily actively maintained, but aren't great either, especially when their insufficient number disparity and a notable size disparity (as was the case with Floyd I believe).
You can end up with someone like a group of 5 or 6 hundred pound nurses trying to restrain a lineman sized agitated patient and have someone accidentally collapse his trachea in the scuffle, or have a guy tear his scrotum because agitated patients often don't wear clothes and skin can easily caught on stuff during a scuffle.
No restraint is safe.
Restraints are however necessary.
Police have much better training (and practice), significantly higher levels of physical ability and size (which is critical) and more options (including stuff like tasers) and flexibility (generally speaking beating up an agitated but not-sick person a little bit is the best option to facilitate a safer restraint, not an option in healthcare though). It's generally safer (assuming no malfeasance, not making an argument that was present or not present in the Chauvin case).
As another random example - patients who are restrained rarely have vitals monitoring (since most patients by volume are substance, psych, or ED boarded on a stretcher in front of the nursing station to keep a close eye on them).
I can believe that police restraint is safer for generally healthy but uncooperative people, given that hospitals aren't primarily in the business of provisioning well-built men to wrestle criminals into submission. By the same token, police aren't primarily concerned with the finer details of managing overdose patients, and training in this area seems to be spotty. Every source I've found indicates that the knee-on-neck restraint Chauvin used was a bad choice for someone who was obviously high on drugs. Having a nurse on hand to give pointers could have averted a major fiasco, just as nurses could stand to have a few burly guys on hand in a pinch.
My suspicion is that medical support on hand would be of minimal help - front line and psychiatric nurses tend to be extremely burn out and intolerant of certain kinds of bad behaviors and therefore unsympathetic to people like Floyd.
Scene securing also comes first and the crowd made the situation worse IIRC. That's a good example of something a layman doesn't really think about and is not sympathetic to as a complicating factor but is an absolutely critical facet of emergency situations. A well trained nurse is likely going to strongly differ to an officer getting the scene under control before moving onto provisioning medical care.
A poorly trained nurse is probably going to be yelling at him and calling him a shit head.
You'd be shocked at how useless most people are deescalating this stuff even when trained and supposedly well equipped.
Yeah, I meant it more figuratively. Literally embedding nurses with police isn't going to work out for the reasons you mention, and hiring random meatheads without police training to manhandle uncooperative patients could also go very wrong. Police need adequate, medically-informed training in identifying overdosing suspects and adjusting their restraint techniques to minimize accidental death. Instead of a nurse literally standing over their shoulder, they need to internalize the basic knowledge to make the best calls.
Step 1 in any emergency is secure the scene first, even with more "medically informed" training an irritable crowd with an insufficient number of officers and a very large suspect is going to mean that options are excruciatingly limited. I'm not sure there really is anything different to do with more medical training anyway. There isn't any secret sauce for managing overdose or agitated patients. Additionally "I can't breath" or "that hurts" "you're hurting me" is not useful information from a restrained perp or patient, since the fact that they aren't going to be a useful source of information is intimately related to why you are doing it. Excessive struggle (secondary to discomfort) or no struggle at all (secondary to the position being...unhealthy) are not useful pieces of information since most patients will either go crazy or try and wait and save energy.
Obviously their are minor things you can do to make things safer but its never "safe" it's all risk mitigation, and elsewhere in this thread someone noted that this whole thing could easily be Chauvin getting abandoned for following standard operation procedure, or a small miscalculus based on how long it was supposed to take backup.
Now you may say "doc you paint a pretty stark picture, where the fuck are the rest of the people in the medical community agreeing with you?" I have no idea. It was a huge black pill for me. We know this.
I agree that, speaking fully generally, it's very difficult to detain a suspect who is high on drugs in a way that is completely benign when considering all the unknowns in securing a scene and maintaining officer and public safety. This is not a fully general scenario, though, but one with a very specific fact pattern:
Under this specific fact pattern, where officers were well in control and could spare time to contemplate the well-being of the suspect, the refusal to try changing restraint position seems incompetent or negligent. This wasn't some split-second decision made under gun fire, it was simply a bad call by the senior officer, and it led to an unnecessary death.
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Just to steelman the alternative here, people lie, especially when they do not want to be restrained. There are also no gurneys with straps easily available to beat cops. Because people lie, you really can’t take people at their word when they’re claiming distress. If the only available restraint is sitting on the guy, and the guy knows you can’t do that if he says the magic words “I can’t breathe,” a whole bunch of people under such restraint are going to develop breathing problems. And given th fact that a fair percentage of those people will be armed, I think it’s going to cause either more cops being shot or shooting people because restraining is effectively no longer allowed.
Floyd had already been patted down and cuffed. He was uncooperative, but not a threat to the officers or others at the time. He was obviously on drugs, so his compromised physical condition was apparent regardless of his statements one way or another. It's possible for suspects in other, different encounters to lie in order to escape or threaten officers, but that wasn't part of the calculus in this case. The restraint technique Chauvin executed was simply too dangerous for someone with depressed cardiopulmonary function. Whether this was a systemic training failure or just criminal depravity on Chauvin's part is the interesting question. The jury seems to have concluded the latter.
It's probably inevitable that some percentage of people who overdose on hard drugs and then encounter police will end up dying in custody under ambiguous medical circumstances. That said, police should not be employing techniques that are more dangerous than necessary to protect themselves and the public.
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