
Luigi Mangione, who allegedly shot and killed UnitedHealthcare CEO Brian Thompson in Midtown Manhattan, arrives at a heliport with members of the New York Police Department on December 19, 2024 in New York City.
Luigi Mangione—Accused of Murdering UnitedHealth CEO—to Invoke Psychiatric Defense in State Trial
The legal strategy—which is not an insanity defense—would be an admission that Mangione killed UnitedHealth's Brian Thompson, but did so under mitigating circumstances.
Luigi Mangione, who stands accused of murdering UnitedHealth CEO Brian Thompson in 2024, will assert a psychiatric defense in his state murder trial, the New York judge presiding over the case revealed Wednesday.
The Associated Press reported that Judge Gregory Carro of the New York State Supreme Court in Manhattan said Mangione’s legal team informed him that they will argue that the 28-year-old defendant suffered from “extreme emotional disturbance" when he allegedly gunned down Thompson outside the New York Hilton Midtown Hotel just after dawn on December 4, 2024.
The defense strategy would be an admission that Mangione killed Thompson, but did so due to mitigating circumstances. The precise nature of the claimed psychiatric issue remains under seal, but it has been reported that Mangione suffered chronic back pain for years and harbored deep animosity toward the for-profit health insurance industry that dominate the US system.
Court documents indicate that Mangione's lawyers previously sought additional time to decide whether to pursue a mental health defense.
Extreme emotional disturbance is not the same as pleading guilty by reason of insanity, which would result in a convicted defendant being sent to a psychiatric facility instead of prison.
On Wednesday, Carro revealed that he had held a secret hearing on the matter earlier this month, and that the session's proceedings were sealed "to give the defense an opportunity to determine whether they were going forth" with the extreme emotional disturbance defense.
The June 3 hearing focused on the psychiatric basis for such a defense, its procedural consequences, disclosure obligations, and potential examinations.
Mangione's attorney, Karen Friedman Agnifilo, decried Carro's decision to unseal details of the secret hearing.
“The reason why we asked for the sealing is that this defense is not available federally and Mr. Mangione is being prosecuted federally and this is prejudicial to his defense to the exact same facts,” she said.
Last year, then-US Attorney General Pam Bondi said she would seek the death penalty for Mangione at his federal trial. New York state effectively abolished capital punishment in 2004.
Mangione allegedly shot Thompson, 50, as he walked to the New York Midtown Hilton for UnitedHealth Group’s annual investor conference. Police said the words “delay,” “deny,” and “depose”—a description of how insurance companies avoid paying claims—were engraved in shell casings of bullets used in the attack, which was carried out with a 3D-printed pistol. New York police also said they recovered a three-page handwritten note that expressed "some ill will toward corporate America."
Five days after the shooting, Mangione was arrested after a customer in an Altoona, Pennsylvania McDonald's recognized him and alerted authorities.
Thompson's murder exposed the depth of public rage over corporate greed and a for-profit healthcare system in which thousands of people die each year because they have no insurance, while millions more face financial hardship or bankruptcy.
Mangione is facing state charges of second-degree murder, multiple weapons violations, and possession of a fake ID. More serious charges, including first-degree murder and terrorism, have been dismissed. Mangione's New York trial is set to begin on September 8.
An Urgent Message From Our Co-Founder
Dear Common Dreams reader, It’s been nearly 30 years since I co-founded Common Dreams with my late wife, Lina Newhouser. We had the radical notion that journalism should serve the public good, not corporate profits. It was clear to us from the outset what it would take to build such a project. No paid advertisements. No corporate sponsors. No millionaire publisher telling us what to think or do. Many people said we wouldn't last a year, but we proved those doubters wrong. Together with a tremendous team of journalists and dedicated staff, we built an independent media outlet free from the constraints of profits and corporate control. Our mission has always been simple: To inform. To inspire. To ignite change for the common good. Building Common Dreams was not easy. Our survival was never guaranteed. When you take on the most powerful forces—Wall Street greed, fossil fuel industry destruction, Big Tech lobbyists, and uber-rich oligarchs who have spent billions upon billions rigging the economy and democracy in their favor—the only bulwark you have is supporters who believe in your work. But here’s the urgent message from me today. It's never been this bad out there. And it's never been this hard to keep us going. At the very moment Common Dreams is most needed, the threats we face are intensifying. We need your support now more than ever. We don't accept corporate advertising and never will. We don't have a paywall because we don't think people should be blocked from critical news based on their ability to pay. Everything we do is funded by the donations of readers like you. When everyone does the little they can afford, we are strong. But if that support retreats or dries up, so do we. Will you donate now to make sure Common Dreams not only survives but thrives? —Craig Brown, Co-founder |
Luigi Mangione, who stands accused of murdering UnitedHealth CEO Brian Thompson in 2024, will assert a psychiatric defense in his state murder trial, the New York judge presiding over the case revealed Wednesday.
The Associated Press reported that Judge Gregory Carro of the New York State Supreme Court in Manhattan said Mangione’s legal team informed him that they will argue that the 28-year-old defendant suffered from “extreme emotional disturbance" when he allegedly gunned down Thompson outside the New York Hilton Midtown Hotel just after dawn on December 4, 2024.
The defense strategy would be an admission that Mangione killed Thompson, but did so due to mitigating circumstances. The precise nature of the claimed psychiatric issue remains under seal, but it has been reported that Mangione suffered chronic back pain for years and harbored deep animosity toward the for-profit health insurance industry that dominate the US system.
Court documents indicate that Mangione's lawyers previously sought additional time to decide whether to pursue a mental health defense.
Extreme emotional disturbance is not the same as pleading guilty by reason of insanity, which would result in a convicted defendant being sent to a psychiatric facility instead of prison.
On Wednesday, Carro revealed that he had held a secret hearing on the matter earlier this month, and that the session's proceedings were sealed "to give the defense an opportunity to determine whether they were going forth" with the extreme emotional disturbance defense.
The June 3 hearing focused on the psychiatric basis for such a defense, its procedural consequences, disclosure obligations, and potential examinations.
Mangione's attorney, Karen Friedman Agnifilo, decried Carro's decision to unseal details of the secret hearing.
“The reason why we asked for the sealing is that this defense is not available federally and Mr. Mangione is being prosecuted federally and this is prejudicial to his defense to the exact same facts,” she said.
Last year, then-US Attorney General Pam Bondi said she would seek the death penalty for Mangione at his federal trial. New York state effectively abolished capital punishment in 2004.
Mangione allegedly shot Thompson, 50, as he walked to the New York Midtown Hilton for UnitedHealth Group’s annual investor conference. Police said the words “delay,” “deny,” and “depose”—a description of how insurance companies avoid paying claims—were engraved in shell casings of bullets used in the attack, which was carried out with a 3D-printed pistol. New York police also said they recovered a three-page handwritten note that expressed "some ill will toward corporate America."
Five days after the shooting, Mangione was arrested after a customer in an Altoona, Pennsylvania McDonald's recognized him and alerted authorities.
Thompson's murder exposed the depth of public rage over corporate greed and a for-profit healthcare system in which thousands of people die each year because they have no insurance, while millions more face financial hardship or bankruptcy.
Mangione is facing state charges of second-degree murder, multiple weapons violations, and possession of a fake ID. More serious charges, including first-degree murder and terrorism, have been dismissed. Mangione's New York trial is set to begin on September 8.
Luigi Mangione, who stands accused of murdering UnitedHealth CEO Brian Thompson in 2024, will assert a psychiatric defense in his state murder trial, the New York judge presiding over the case revealed Wednesday.
The Associated Press reported that Judge Gregory Carro of the New York State Supreme Court in Manhattan said Mangione’s legal team informed him that they will argue that the 28-year-old defendant suffered from “extreme emotional disturbance" when he allegedly gunned down Thompson outside the New York Hilton Midtown Hotel just after dawn on December 4, 2024.
The defense strategy would be an admission that Mangione killed Thompson, but did so due to mitigating circumstances. The precise nature of the claimed psychiatric issue remains under seal, but it has been reported that Mangione suffered chronic back pain for years and harbored deep animosity toward the for-profit health insurance industry that dominate the US system.
Court documents indicate that Mangione's lawyers previously sought additional time to decide whether to pursue a mental health defense.
Extreme emotional disturbance is not the same as pleading guilty by reason of insanity, which would result in a convicted defendant being sent to a psychiatric facility instead of prison.
On Wednesday, Carro revealed that he had held a secret hearing on the matter earlier this month, and that the session's proceedings were sealed "to give the defense an opportunity to determine whether they were going forth" with the extreme emotional disturbance defense.
The June 3 hearing focused on the psychiatric basis for such a defense, its procedural consequences, disclosure obligations, and potential examinations.
Mangione's attorney, Karen Friedman Agnifilo, decried Carro's decision to unseal details of the secret hearing.
“The reason why we asked for the sealing is that this defense is not available federally and Mr. Mangione is being prosecuted federally and this is prejudicial to his defense to the exact same facts,” she said.
Last year, then-US Attorney General Pam Bondi said she would seek the death penalty for Mangione at his federal trial. New York state effectively abolished capital punishment in 2004.
Mangione allegedly shot Thompson, 50, as he walked to the New York Midtown Hilton for UnitedHealth Group’s annual investor conference. Police said the words “delay,” “deny,” and “depose”—a description of how insurance companies avoid paying claims—were engraved in shell casings of bullets used in the attack, which was carried out with a 3D-printed pistol. New York police also said they recovered a three-page handwritten note that expressed "some ill will toward corporate America."
Five days after the shooting, Mangione was arrested after a customer in an Altoona, Pennsylvania McDonald's recognized him and alerted authorities.
Thompson's murder exposed the depth of public rage over corporate greed and a for-profit healthcare system in which thousands of people die each year because they have no insurance, while millions more face financial hardship or bankruptcy.
Mangione is facing state charges of second-degree murder, multiple weapons violations, and possession of a fake ID. More serious charges, including first-degree murder and terrorism, have been dismissed. Mangione's New York trial is set to begin on September 8.

