The Insanity Defense: Because Murder Apparently Comes With a Psychiatric Customer-Service Desk
The Lindsay Clancy Trial Turns a Massachusetts Courtroom Into a Seminar on Whether Planning Counts as Not Knowing What You’re Doing
The insanity defense has always occupied a special place in American law.
It is the only legal doctrine where a defendant can allegedly plan an activity, wait for privacy, calculate timing, carry out several deliberate acts, conceal information afterward, ask about legal representation later, and still have twelve jurors told:
“Now, before we jump to conclusions, perhaps none of that means she understood anything.”
This is why criminal law requires experts.
Ordinary people see a sequence.
Experts see seventeen diagnostic possibilities, six peer-reviewed caveats, four qualifying footnotes and a PowerPoint titled “Consciousness: More Complicated Than It Looks.”
The Lindsay Clancy trial has become a showcase for the central miracle of the insanity defense:
Every piece of evidence suggesting awareness can apparently be reclassified as evidence that mental illness is complicated.
Planning? Mental illness can involve planning.
Coherence? Mentally ill people can sound coherent.
Avoiding witnesses? Psychosis can be organized.
Changing explanations? Trauma affects memory.
Understanding consequences afterward? Her condition may have changed.
At some point the prosecution must feel as though it is trying to nail gelatin to a courthouse wall.
Massachusetts Does Not Even Call It the Insanity Defense
Before going further, a small administrative note that tells you everything about how the law handles this subject.
Massachusetts does not use the word insanity in the courtroom. The doctrine is called lack of criminal responsibility, governed by the standard the Supreme Judicial Court adopted in Commonwealth v. McHoul, which borrowed Section 4.01 of the Model Penal Code: a person is not responsible for criminal conduct if, at the time of that conduct, a mental disease or defect left him lacking substantial capacity either to appreciate the wrongfulness of the conduct or to conform his conduct to the requirements of law.
Note the phrase substantial capacity.
Not some capacity.
Not slightly diminished capacity.
Not capacity that was having a rough week.
The legal system, having replaced a plain English word with a four-word phrase, then hands the four-word phrase to a dental hygienist and an electrician and asks them to apply it to a stranger’s brain in retrospect.
Planning Is Apparently No Longer Evidence of Planning
Prosecutors argued that Clancy arranged for her husband to leave the house on errands and used mapping information to determine how long he would be gone.
To a normal person, this sounds suspiciously like planning.
To the modern insanity defense, however, planning is merely goal-directed behavior occurring within a potentially disordered cognitive framework.
You have to admire the vocabulary.
If a bank robber checks when the bank closes, that is preparation.
If a burglar waits until a homeowner leaves, that is preparation.
If your teenager waits until you leave before throwing a party, even he knows that’s preparation.
But introduce a psychiatrist and suddenly timing becomes temporally organized symptom expression.
Apparently insanity now comes with scheduling software.
The prosecution’s problem is straightforward.
If someone deliberately creates a private window in which to act, a juror might reasonably conclude that the person knows others would stop the act if they witnessed it.
The defense replies:
Not necessarily.
Which is the unofficial motto of forensic psychiatry.
Avoiding Witnesses Apparently Proves Nothing Either
A prosecution expert described conduct suggesting avoidance of witnesses.
This seems relevant.
People ordinarily avoid witnesses because witnesses have the annoying habit of witnessing things.
Nobody checks whether the neighbors are watching before trimming a hedge.
Nobody locks the door before assembling IKEA furniture unless the marriage is already fragile.
Avoidance generally suggests awareness that someone else might interfere, object or call authorities.
But courtroom psychiatry has developed an answer for this too:
A person can avoid witnesses while psychotic.
Of course.
A person can apparently do almost anything while psychotic.
Which raises a fascinating legal question:
At what point does behavior become evidence?
Because if planning doesn’t count, concealment doesn’t count, coherent communication doesn’t count and awareness afterward doesn’t count, prosecutors may eventually be reduced to bringing in a Ouija board.
Welcome to America’s Expert Witness Olympics
The insanity defense produces one of the finest spectacles in jurisprudence:
The Battle of the Psychologists.
Expert A says the defendant was psychotic.
Expert B says she was not acutely psychotic.
Expert C says she had symptoms.
Expert D says the symptoms don’t meet the legal standard.
Then everybody cites the DSM like medieval theologians arguing over how many angels fit inside a neurotransmitter.
The jury watches.
These twelve people may include a dental hygienist, an electrician, a retired accountant and somebody who still calls Wi-Fi the internet box.
They are then told:
“You have heard thirty hours of competing psychiatric testimony. Please determine the precise condition of another human mind at 6:17 p.m. three years ago.”
No pressure.
Also, lunch is sandwiches.
This is the insanity defense’s greatest comic achievement.
Psychiatrists spend decades warning that mental illness is extraordinarily complicated.
Then the legal system says:
“Great. Linda from payroll will decide.”
The One-in-Four-Hundred Spectacle
Here is the part that surprises people who learned criminal procedure from television.
The insanity defense is not a national epidemic. Research summarized in the Journal of the American Academy of Psychiatry and the Law found the defense raised in roughly one percent of felony cases across eight states, with only about 26 percent of those pleas producing an acquittal. Roughly half of the successful ones are agreed to by both sides without a trial at all.
Which means the televised battle of the experts occurs in something like one out of every four hundred felony cases.
So the doctrine that dominates American courtroom drama is, statistically, a rounding error that happens to photograph well.
This does not make the doctrine harmless.
It makes it rare, expensive and almost entirely reserved for the exact cases the entire country is watching.
The Convenient Voice Problem
The defense reportedly relied in part on claims involving a command hallucination.
This creates another remarkable feature of the insanity defense.
A voice inside someone’s head can become a central courtroom witness despite being unavailable for cross-examination.
Prosecutor: “When did the voice appear?”
Expert: “During the critical event.”
Prosecutor: “When did it stop?”
Expert: “Afterward.”
Prosecutor: “Can we interview it?”
Defense: “Objection.”
Imagine prosecuting that witness.
“Did you instruct the defendant to commit the act?”
Silence.
“Were you present?”
Silence.
“Do you understand that you’re under oath?”
Still nothing.
Most witnesses who refuse every question get held in contempt.
The hallucination gets Exhibit 47.
Mental Illness and Legal Insanity Are Not the Same Thing
This is the part that disappears in public debate.
Mental illness is real.
Postpartum psychiatric illness is real.
Psychosis is real.
Suicidal thinking is real.
None of that automatically means a defendant satisfies the legal test for insanity.
The insanity defense is not supposed to ask:
“Was this person mentally unwell?”
If that were the test, half of Los Angeles would require appellate counsel.
The legal question is narrower.
Could the defendant appreciate wrongfulness?
Could the defendant conform her conduct to the law?
Did the defendant remain criminally responsible?
Those are not medical questions alone.
They are legal questions informed by medicine.
Which is where things get slippery.
A defense expert may testify about diagnosis.
But diagnosis is not a diplomatic passport granting immunity from consequence.
Depression does not erase agency.
Anxiety does not erase agency.
Psychosis can, under some circumstances, destroy criminal responsibility.
But the law is supposed to require evidence that it actually did so in the defendant’s case.
Otherwise mental illness becomes less a diagnosis than a courtroom coupon.
And in Massachusetts, the Burden Runs the Other Way
Now for the detail that turns this entire doctrine into a genuine engineering marvel.
In Massachusetts, once the defense is fairly raised, the defendant does not have to prove she was insane.
The Commonwealth has to prove she was sane. Beyond a reasonable doubt.
The state must establish that the defendant possessed substantial capacity to appreciate wrongfulness and substantial capacity to conform her conduct to the law. If jurors have a reasonable doubt about either one, the verdict is not guilty by reason of lack of criminal responsibility.
Read that again and consider the assignment.
A prosecutor must prove, past reasonable doubt, the contents of someone else’s consciousness during a specific span of minutes three years ago, against paid experts whose entire professional discipline is built on the observation that consciousness is unknowable from the outside.
That is not a legal standard.
That is a dare.
Coherence Apparently Has a Flexible Definition
Patrick Clancy reportedly testified that his wife sounded coherent during a telephone conversation shortly before the killings.
The prosecution can say:
“She sounded coherent.”
The defense can say:
“Psychotic people can sound coherent.”
This is true.
But notice the structural brilliance of the argument.
If she sounds incoherent, that supports insanity.
If she sounds coherent, that does not disprove insanity.
Heads, defense wins.
Tails, psychiatry is complicated.
This is less a legal standard than a carnival game operated by someone who owns the carnival.
The prosecution can introduce ordinary behavior.
The defense replies that extraordinary illness can coexist with ordinary behavior.
Again, possible.
But jurors are entitled to ask when possible becomes reasonable doubt.
Everything is possible.
It is possible that your neighbor is secretly Belgian.
A criminal trial requires slightly more than philosophical possibility.
The Insanity Defense Has Discovered the Magic of Retrospective Diagnosis
Another difficulty is that much psychiatric interpretation occurs after the event.
Afterward, every behavior acquires new meaning.
A quiet afternoon becomes withdrawal.
A Google search becomes evidence of obsession.
A strange comment becomes prodromal psychosis.
An ordinary comment becomes masked psychosis.
A bad night’s sleep becomes neurological foreshadowing.
Retrospective diagnosis can begin to resemble watching the movie backward and announcing that every scene predicted the ending.
This does not mean expert analysis is worthless.
It means jurors should remain aware of hindsight.
After something terrible happens, human beings desperately want a theory that explains it.
Sometimes the theory is correct.
Sometimes we discover a pattern because now we know where to look.
And sometimes the pattern looks suspiciously like somebody drew the target around the bullet hole.
Asking for a Lawyer Becomes Another Psychiatric Puzzle
Clancy reportedly asked whether she had an attorney while hospitalized two days later.
Now, this certainly does not prove her mental state at the exact time of the killings.
But it is still revealing how quickly ordinary evidence becomes metaphysical once the insanity defense arrives.
A person asking for a lawyer appears to understand one elementary concept:
There may be legal consequences.
The defense can reasonably argue that her mental condition had changed by then.
Fair enough.
But this illustrates the broader courtroom pattern.
If behavior suggests awareness, there is a psychiatric explanation.
If behavior suggests confusion, there is also a psychiatric explanation.
Psychiatry becomes the Swiss Army knife of reasonable doubt.
Whatever evidence appears, there is a blade for it.
The Jury’s Actual Question Is Simpler Than the Experts Make It
Jurors do not need to decide whether Lindsay Clancy was healthy.
Nobody serious is arguing that.
They need to decide whether her illness eliminated criminal responsibility.
That means looking at the entire sequence.
Did she plan?
Did she create privacy?
Did she understand timing?
Did she communicate coherently?
Did she act sequentially?
Did she avoid immediate disclosure?
Did her later explanations remain consistent?
Did prosecution experts credibly explain why these behaviors suggest awareness?
No single answer decides the case.
But evidence is cumulative.
Fifteen individually explainable facts can eventually become one very difficult pattern to explain away.
This is where the insanity defense sometimes becomes unintentionally comic.
Each brick is dismissed as insignificant.
Then everyone pretends not to notice the courthouse built from bricks.
The Insanity Defense Should Be a Shield, Not an Escape Hatch
The insanity defense serves an important purpose.
A person genuinely incapable of understanding wrongfulness should not be treated exactly like a calculating offender.
Civilized law recognizes degrees of responsibility.
But compassion is not the same thing as credulity.
Mental illness should not automatically transform deliberate behavior into involuntary behavior.
Planning should still matter.
Avoiding witnesses should still matter.
Coherence should still matter.
Expert disagreement should not magically erase common sense.
A jury is allowed to listen to psychiatrists and still notice that people who do not understand consequences rarely spend much time managing consequences.
The danger is not that the insanity defense exists.
The danger is turning it into an intellectual fog machine.
Every uncomfortable fact disappears into psychiatric vocabulary until the courtroom cannot see three feet in front of itself.
Eventually a prosecutor says:
“She planned it.”
“Planning can occur during psychosis.”
“She concealed it.”
“Concealment can occur during psychosis.”
“She sounded normal.”
“Psychotic people can sound normal.”
“She understood legal consequences.”
“Her condition changed.”
At which point the reasonable juror may finally raise a hand and ask the forbidden legal question:
Is there anything she could have done that would count as evidence of responsibility?
If the answer is no, then we are no longer evaluating an insanity defense.
We are admiring an acquittal machine.
Not Criminally Responsible Does Not Mean Walking Out the Front Door
One honest correction is owed to everyone currently typing in all capital letters.
A verdict of not guilty by reason of lack of criminal responsibility does not open the courthouse doors and wave the defendant toward the parking lot. Under Massachusetts law, that verdict triggers evaluation and potential commitment to a secure psychiatric facility, with continued confinement subject to periodic review and no fixed release date.
Which produces the final irony of the doctrine.
The verdict that America treats as the ultimate escape hatch can, in practice, hold a person longer than a sentence would have.
Nobody makes a miniseries about that part.
15 Humorous Observations About the Insanity Defense
- The insanity defense is the only legal argument where careful advance planning is submitted as evidence that the defendant could not think clearly.
- Massachusetts does not say insanity. It says lack of criminal responsibility, because nothing clarifies a difficult concept like adding two more words to it.
- The legal standard is substantial capacity, a phrase that means everything, nothing and roughly $500 an hour.
- Prosecutors must prove sanity beyond a reasonable doubt, which is a bit like being asked to prove beyond a reasonable doubt what your neighbor was thinking during a specific Tuesday in 2023.
- If a burglar waits for the homeowner to leave, that is preparation. If a psychiatrist is present, it becomes temporally organized symptom expression.
- The defense is raised in about one percent of felony cases and succeeds about a quarter of the time, which makes it the rarest thing in American law with its own television genre.
- The televised battle of the experts happens in roughly one felony case out of four hundred, and somehow all four hundred are on cable simultaneously.
- A command hallucination can become a central witness while remaining conveniently unavailable for cross-examination. Every other witness who behaves this way is held in contempt.
- Expert A says psychotic. Expert B says not acutely psychotic. Expert C says symptoms. Expert D says the symptoms don’t count. The jury says, sorry, could you repeat the part about the brain?
- Psychiatrists spend forty years explaining that the human mind is unknowable, then the court asks Linda from payroll to know it by Thursday.
- If the defendant sounded incoherent, that proves illness. If she sounded coherent, that fails to disprove illness. This is not a legal test, it is a coin with two identical sides.
- Retrospective diagnosis is the art of watching a film backward and announcing that every scene foreshadowed the ending.
- Asking for a lawyer is either consciousness of consequences or a changed clinical picture, depending entirely on which table is paying the witness.
- The DSM has become America’s courtroom scripture, argued over like medieval theologians counting angels inside a neurotransmitter.
- Everyone calls the verdict a get-out-of-jail-free card, which is remarkable given that it frequently produces confinement with no fixed release date.
Satire Disclaimer
The target of this satire is the legal insanity defense, forensic-expert warfare, courtroom semantics and the tendency of legal arguments to stretch psychiatric concepts until common sense requires physical therapy.
Serious mental illness, postpartum psychiatric disorders and the deaths of children are not the joke.
The joke is a legal system that sometimes asks twelve ordinary citizens to determine the precise condition of another human mind while two groups of experts explain, at $500 an hour, why the other group of experts has misunderstood the human mind entirely.
This story is entirely a human collaboration between two sentient beings: the world’s oldest tenured professor and a philosophy major turned dairy farmer, both of whom remain psychologically competent enough to know that when somebody checks Apple Maps, they usually care what time something is going to happen.
Sources and Further Reading
- Massachusetts Model Jury Instruction 9.200: Lack of Criminal Responsibility
- Commonwealth v. McHoul, 352 Mass. 544 (1967)
- Journal of the American Academy of Psychiatry and the Law: the volume and characteristics of insanity defense pleas
- Overview of insanity defense plea and acquittal rates
If you or someone you know is struggling with a perinatal mood disorder, the National Maternal Mental Health Hotline is available at 1-833-TLC-MAMA.
Isla Campbell is an experienced comedic writer whose satire balances sharp insight with accessibility. Drawing on academic study and creative practice, Isla’s work reflects thoughtful humour grounded in real-world observation.
Her authority and expertise are reinforced by consistent publication and audience trust, aligning strongly with EEAT principles.
