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  Restraint Asphyxia

The (US) National Law Enforcement Technology Centre defines restraint asphyxia, positional asphyxia: "as death as a result of body position that interferes with breathing" (1).

According to experts, it arises from use of neck-holds which restrict breathing or when a person is laid on their stomach during restraint and/or transportation. This position compromises a person’s ability to breathe.

Handcuffing a person behind their back also restricts a person’s ability to breathe (2). Any weight applied to the back in this position (such as pressure by a law enforcement officer, including an attempt to keep a person still) increases breathing difficulty further.

A "natural reaction" to oxygen deficiency is increased physical struggle. In the face of such a struggle law enforcement officials are likely to apply additional pressure/compression to subdue the restrained person. Yet further compromising the restrained person’s ability to breathe.

Factors which may increase dangers of restraint asphyxia include: obesity; enlarged heart; alcohol and drug use or other things that impede the ability to breathe including, for example, the presence of chemical agents.

Guidelines to minimize the risk of positional asphyxia include restraining a person other than laying them on their stomach and monitoring the restrained person’s breathing and health.

(1) "Positional Asphyxia - Sudden Death", National Law Enforcement Technology Centre,
(a US national Institute of Justice Program), June 1995

(2) A forensic pathologist reportedly testified, during the inquest into the death of Wayne Douglas, that placing a person face down on their stomach with their hands cuffed behind their back is the "classic" position for positional asphyxia (AI Index 45/06/95).

Source: Amnesty International