Police De-escalation:
Warning Before Shooting, Use-of-Force Continuum,
De-escalation Trainings and Definitions
Developed by Texas Legal Services Center and Kirkland & Ellis LLP.
Police Violence Through a Public Health Lens
Police violence is a critical public health issue. Police violence results in disproportionate rates of deaths, injuries, trauma, and stress in marginalized communities¹. For instance, 1 in every 1,000 Black men are expected to be killed by police, while the lifetime risk for white men and boys is about 39 deaths per 100,000². Race, gender, and age have been found to be correlative factors for police killing. In addition, police use of force is one of the leading causes of death for young men of color³. Disproportionate policing and poverty in communities of color contribute to mortality and morbidity because lethal policing restricts social, economic, and physical well-being⁴.
The Role of Medical-Legal Partnerships in Addressing Health-Impacting Racism
Law and policy can be used to prevent law enforcement violence, which can in turn help mitigate negative health outcomes⁵. Medical-legal partnerships (MLPs) are uniquely positioned to improve health outcomes through the collaboration of multidisciplinary teams, which can include clinicians, social workers, and lawyers⁶. MLPs take an upstream approach in health and law by addressing the systems of poverty and racism that perpetuate injustice and poor health outcomes⁷.
The National Center for Medical-Legal Partnership has stated that “there is nothing more central to creating long-term health equity in this country than dismantling racist systems”⁸. This project acknowledges racism as a social determinant of health that is present in policing.
About the Pro Bono Police Force Database
In the wake of the shootings of multiple Black individuals, including George Floyd, Ahmaud Arbery, and Breonna Taylor, the Texas Legal Services Center’s MLPs and Kirkland & Ellis, LLP, developed this project with the goal of providing a resource for health advocacy. In this Police De-escalation database, each state has been surveyed for legal requirements that address or fail to address anti-force police policies. This database is meant to serve as a resource for advocates to help reduce police violence and its impact on health.
TLSC’s Medical Legal Partnership was familiar with the 8 Can’t Wait campaign that advocates for police departments to adopt force-restrictive policies⁹. The 8 policies include:
Ban chokeholds & strangleholds
Require de-escalation
Require warning before shooting
Exhaust all alternatives before shooting
Duty to intervene
Ban shooting at moving vehicles
Establish use of force continuum
Require all force be reported
Our goal was to understand how two of the policies (#2 and #3 above) identified exist in law—i.e., by regulation, statute, common law. Working with Kirkland & Ellis, LLP, our pro bono partner, we completed a 50-state survey on police training requirements around de-escalation, warning before shooting, and the use of force continuum. The survey includes statutes, relevant case law, and additional state resources. The results of the survey can be explored in the maps below, which are separated by training requirements and statutory definition.
Learn more about the project and the database here [A recording of the “Leveraging Health Center Medical-Legal Partnerships to Advance Community-Oriented Policing” webinar by the National Center for Medical-Legal Partnership].
To view the de-escalation state maps:
To view the warning before shooting state maps:
To view the use of force continuum state maps:
To view case law and resources by state:
We have done our best to include all relevant information, but we're only human. Did our researchers get something wrong? Leave something out? Miss an update? Let us know.
This material was last updated in May 2021.
¹ Addressing Law Enforcement Violence as a Public Health Issue, Aᴍᴇʀɪᴄᴀɴ Pᴜʙʟɪᴄ Hᴇᴀʟᴛʜ Assᴏᴄɪᴀᴛɪᴏɴ (Aug. 18, 2021, 2:47PM), https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2019/01/29/law-enforcement-violence.
² Frank Edwards, Hedwig Lee & Michael Esposito, Risk of Being Killed by Police Use of Force in the United States by Age, Race-Ethnicity, and Sex, 116 PNAS 16793, 16793-98 (2019), https://www.pnas.org/content/116/34/16793.
³ Id.
⁴ Keon Gilbert, Black Men Carry the Cost of Police Violence, Hᴀʀᴠ. L. Pᴇᴛʀɪᴇ-Fʟᴏᴍ Cᴛʀ. (Aug. 18, 2021, 3:17PM), https://blog.petrieflom.law.harvard.edu/2020/10/22/racism-police-violence-black-men/.
⁵ Legal Epidemiology, CDC (Aug. 18, 2021, 3:18PM), https://www.cdc.gov/dhdsp/policy_resources/legal_epi.htm.
⁶ Medha D. Makhlouf, Addressing Racism through Medical-Legal Partnerships, Hᴀʀᴠ. L. Pᴇᴛʀɪᴇ-Fʟᴏᴍ Cᴛʀ. (Aug. 18, 2021, 3:20PM), https://blog.petrieflom.law.harvard.edu/2020/09/24/addressing-racism-medical-legal-partnerships/?fbclid=IwAR3mu5aLTc1K3NomYawFn8exR01cdrjntH38qXkbXACDo71BM44KFp-k4Qg
⁷ Dina Shek, Centering Race at the Medical-Legal Partnership in Hawai’i', 10 U. Mɪᴀᴍɪ Rᴀᴄᴇ & Sᴏᴄ. Jᴜsᴛ. L. Rᴇᴠ. 109, 116-48 (2019), https://repository.law.miami.edu/cgi/viewcontent.cgi?article=1111&context=umrsjlr.
⁸ A Message About the Recent Police Brutality, Nᴀᴛ'ʟ Cᴛʀ. ғᴏʀ Mᴇᴅ.-Lᴇɢᴀʟ P'sʜɪᴘ (Aug. 18, 2021, 3:33PM), https://medical-legalpartnership.org/police-brutality/.
⁹ 8 Cᴀɴ'ᴛ Wᴀɪᴛ, https://8cantwait.org/ (last visited Aug. 18, 2021).