Luigi Mangione will mount a psychiatric defense at his New York state trial for the killing of UnitedHealthcare Chief Executive Brian Thompson, Judge Gregory Carro said Wednesday during a hearing in state court in Manhattan. Carro said the defense strategy was discussed at a sealed proceeding earlier this month. Defense lawyers intend to argue that Mangione killed Thompson due to an extreme emotional disturbance at the time, according to the judge.
Mangione, 28, sat silently at the defense table during the 20-minute hearing, wearing a dark blue suit, white button-up shirt and handcuffs.
The psychiatric defense would significantly alter the nature of the trial. Mangione’s lawyers would acknowledge he killed Thompson but contend that he acted while emotionally disturbed. If a jury agrees, the murder charge would be downgraded to manslaughter, which carries a shorter potential prison term.
“Extreme emotional disturbance is about a loss of self-control for which there was a reasonable explanation or excuse,” said Gary Galperin, a former prosecutor in Manhattan who now teaches at Cardozo School of Law. “The classic case is, you come home and find your spouse in bed with someone else.”
Prosecutors face headwinds in rebutting the defense but have a key piece of evidence: a journal found in the backpack Mangione had with him when he was arrested at a McDonald’s in Altoona, Pennsylvania. The notebook contains entries that prosecutors say show Mangione’s motive and planning. “The investor conference is a true windfall,” Mangione wrote, according to the Wall Street Journal. “It embodies everything wrong with our health system.”
The judge ruled last month that prosecutors could use the notebook and a 3D-printed ghost gun equipped with a silencer that was also found in the backpack.
Prosecutors say Mangione shot Thompson with the ghost gun outside a Midtown Manhattan hotel in December 2024, as Thompson was in New York for an investor conference. Mangione then fled on an E-bike, kicking off a dayslong manhunt that ended with his arrest at the McDonald’s in Altoona.
The state trial is scheduled to begin Sept. 8. Mangione also faces a separate federal case, to which he has pleaded not guilty. The psychiatric defense does not apply to the federal trial, which is scheduled for early next year.
The next state court date is Aug. 11.