The problem starts with reliability. When we’re given the official stats on police killings, we assume them to be accurate. After all, it’s not as if each of us, individually, can run around and investigate each death, and why would they lie, always the question for which no good answer exists. And yet, it happens, maybe not so much lies as in deliberate falsehoods, but less than full and accurate information.

Researchers say they’ve done the digging, plus some statistical extrapolation, and come to the realization that deaths at the hand of police have been under-reported. No, under-reported fails to capture the scope of what’s wrong here. The numbers are twice as bad as previously believed.

The study, conducted by researchers at the University of Washington and published on Thursday in The Lancet, a major British medical journal, amounts to one of the most comprehensive looks at the scope of police violence in America, and the disproportionate impact on Black people.

Researchers compared information from a federal database known as the National Vital Statistics System, which collects death certificates, with recent data from three organizations that track police killings through news reports and public records requests. When extrapolating and modeling that data back decades, they identified a startling discrepancy: About 55 percent of fatal encounters with the police between 1980 and 2018 were listed as another cause of death.

To some extent, a legitimate question exists as to what constitutes a cause of death. If someone dies of a heart attack, surely that’s not the same as being killed by police. But what if that heart attack occurred after being tased and beaten a bit by the cops?

While The Lancet study did not mention specific cases, there have been recent examples where the initial findings of coroners or medical examiners downplayed or omitted the role of the police when a Black man was killed: Ronald Greene’s death in Louisiana, for instance, was attributed by the coroner to cardiac arrest and classified as accidental before video emerged of him being stunned, beaten and dragged by state troopers.

Or maybe after choking a guy to unconsciousness, then mistakenly injecting him with a drug he never should have been given?

In Aurora, Colo., the manner of Elijah McClain’s death was ruled undetermined after the police put him in a chokehold and paramedics injected him with ketamine, a powerful sedative. Almost two years later, three officers and two paramedics were indicted.

And then, there’s the obvious knee on the neck question.

Even in the case of George Floyd, whose agonizing last breaths under a Minneapolis police officer’s knee were captured on bystander video, the police and the county medical examiner first pointed to drug use and underlying health conditions.

The problem with the study is that these anecdotes leave little doubt that it happens, that deaths in the hands of police are attributed to other causes when the immediate cause wasn’t a bullet to the head. And there is a fair argument to be made that someone with comorbidities who is subject to police action that wouldn’t do harm to an otherwise healthy person might not be fairly attributed to the cops.

In many of these cases, the question of who is to blame, or what the “real” cause of death was as a matter of exculpating the police from responsibility for being part of, if not the, cause of death, is in serious dispute. And with good reason. It might be easy to state that when a drunken cop driving 97 mph in his RMP runs down some kid crossing with the light, it was the cop’s fault, but since this would be somewhat outside the scope of employment, does it still qualify as a police-caused death?

In cases of violent or unexplained death, medical examiners do autopsies and coroners decide the cause of death. Coroners, who are elected and aren’t necessarily qualified to decide what to eat for breakfast, Between cops not informing medical examiners of all the salient details, coroners fudging outcomes for reporting and cops not bothering to provide the stats despite the duty to do so, for which there are no negative consequences, there are a great many gaps in what goes into the stats that enjoy the presumption of regularity and upon which we, accordingly, rely.

The system has long been criticized for fostering a cozy relationship with law enforcement — forensic pathologists regularly consult with detectives and prosecutors and in some jurisdictions they are directly employed by police agencies.

But the Lancet article is also subject to similar issues. The article is largely conclusory, requiring a reader to “trust” the researchers.

While The Lancet study did not mention specific cases…

That anecdotal evidence exists proves that the reporting system has flaws and police-related deaths happen that fail to find their way into the statistical reporting system. At the same time, each instance is sui generis, requiring someone to specifically consider whether a death should be attributed to police conduct or whether it’s coincidental. People die in prison. Sometimes of natural causes. Sometimes because they were scalded to death or left to bleed out in their cell for lack of medical treatment. Which it is matters, and to say that anyone dying in prison was somehow caused by law enforcement wouldn’t be any more accurate than to say the opposite.

“There’s been an attempt to limit the reality of what is,” said Edwin G. Lindo, a scholar of critical race theory and professor at the University of Washington School of Medicine, who examined the findings of the study but was not involved in putting it together. “And what I would suggest is, when we don’t have good data we can’t actually make good policy decisions, and I don’t know if that’s an accident for it to be so greatly underreported.”

Without facts, we’re left to speculate as to the extent and causes of the problem and, consequently, what to do about it. Does this research provide the facts necessary to conclude that there has been massive underreporting? Maybe. But what it clearly shows is that the reporting system has too many flaws, too many gaps, too many uncontrolled variables to be reliable.

If twice as many people are being killed at the hands of police than previously thought, we have problems that need to be addressed, the first of which is how to ascertain what the real numbers are. The only thing abundantly clear now is that we can’t shut our eyes and trust the official numbers.