[A.] I know that many people have formed opinions about the Lindsay Clancy trial, and I want to share the Massachusetts standard criminal jury instructions that apply to situations like this. I cannot be certain that this exact instruction was given in the case, but it is the recommended instruction for cases of this type, so I assume the actual instruction wasn’t far from it. If you have been tracking the factual allegations in the case, please leave a comment indicating how you would vote if you were a juror, based on what you know (even if imperfect) about the facts, and why you would vote that way.
Keep in mind two crucial points:
[1.] Once evidence that triggers the defense is raised, the government must disprove it beyond a reasonable doubt. To borrow a common way people discuss the reasonable-doubt standard in guilt/innocence questions, Massachusetts holds the view that it is preferable that ten non-insane people be acquitted even if there is a risk of wrongful acquittal, rather than convicting one insane person wrongly. This is not the uniform rule across the United States; for example, in federal prosecutions the defendant bears the burden of proving insanity by clear and convincing evidence. In fact, my quick review suggests that this rule exists only in a minority of states. Nevertheless, Massachusetts has a settled approach on this issue.
[2.] The substantive rule is that a defendant is not criminally responsible if
(a) they “suffer[ed] from a mental disease or defect at the time of the alleged offense” (without a further definition of the terms in the standard instruction), and
(b) either
(i) the defendant lacked “the substantial capacity to appreciate the wrongfulness or criminality of their conduct” or
(ii) the defendant lacked “the substantial capacity … to conform their conduct to the requirements of the law.” (From what I understand of the Clancy defense, the argument is that she suffered from a mental disease and lacked the substantial capacity to refrain from killing her children—or at least there is a reasonable possibility that this was the case.)
This substantive standard is not uniformly adopted nationwide; many states follow different approaches. A 2015 study by Paul Robinson and colleagues found that about one-third of the states employ the same substantive framework as Massachusetts.
[B.] Please center your comment on applying Massachusetts law, not on whether you think the law should be revised (whether in terms of the burden and quantum of proof, or in terms of the substantive definition of when a defendant isn’t legally responsible). Also, focus on how you think this standard should operate in this case to this person. The question is not about the overall prevalence of postpartum psychosis or about how often women in extreme distress do not kill their children. It is not about whether Clancy’s public supporters or critics behave well or poorly or express foolish opinions. Rather, the question is whether, given the facts of this case, you would find that there is a reasonable doubt about Clancy’s sanity as defined by the Massachusetts law summarized in item A.2 above.
[C.] If you want more detail on the Clancy case, here is a summary by Dr. Sally Satel (The Free Press), whose work I find generally thoughtful and balanced. She ultimately argues for acquittal, but the factual outline she presents is broadly in line with what I’ve seen from other outlets:
On January 24, 2023, Clancy allegedly took her children, one after another, into the basement of the family home in Duxbury, Massachusetts, and told them, “Go to God, baby,” as she suffocated each of them with exercise bands. She then inflicted cuts on her wrists and neck and jumped from a second-story window in a suicide attempt that left her paralyzed from the waist down. These acts occurred within the hour during which her husband was away running an errand she had asked him to perform.
The incident culminated five months of distress and attempts to seek help. Although Clancy initially felt well after Callan’s birth in May 2022, she subsequently consulted a psychiatrist in late summer for depression, severe insomnia, and feelings of being overwhelmed by ordinary tasks such as dressing or showering.
Over time, she reportedly developed suicidal thoughts and experienced what variously were described as “intrusive thoughts” and “auditory hallucinations” telling her that she was “damaged” and would “not be the same,” with the message that “the only option is to die.” In December 2022, she told her husband and mother that she had thoughts of harming her children and feared that other people could hear those thoughts.
After Clancy’s husband left to pick up food and medication on January 24, 2023, a loud, demanding male voice allegedly instructed her repeatedly, “This is your last chance. You have to kill the kids so you can kill yourself.” She entered a “dreamlike state” and watched herself act, feeling as though she had no choice. A hospital chaplain who met Clancy within weeks of the crime testified that the voice told her that if she did not follow the command, neither she nor her children would be safe.
From September 2022 to January 2023, Clancy received several formal diagnoses: adjustment disorder and generalized anxiety disorder at the Aster Mental Health clinic, and major depressive disorder at McLean Hospital. A psychiatric nurse practitioner raised the possibility of postpartum depression before the killings, though it was never formally diagnosed, and Clancy’s bipolar disorder and PTSD were not fully diagnosed until afterward.
Why so many different diagnoses? And why might postpartum psychosis have been missed until after the killings? Unlike postpartum depression, which is relatively common and occurs in about one in eight deliveries, postpartum psychosis is rare, affecting roughly one to two per thousand deliveries.
Clancy’s situation did not fit the textbook model of postpartum psychosis. She did not exhibit symptoms for three months after Callan’s birth, although DSM-5 notes that postpartum psychosis tends to manifest rapidly within the first month after delivery. Additionally, expert witnesses at her trial debated whether Clancy experienced actual psychotic episodes before the killings and whether the voice she heard in the basement on January 24 was a true command hallucination or simply a persistent internal thought she chose to obey.
Furthermore, Clancy did not consistently report suicidal or homicidal thoughts or hallucinations to clinicians, perhaps because her mood and ideation fluctuated over the course of a day—a common feature of postpartum psychosis.
In arriving at these conclusions, I have accepted the truth of Clancy’s description of the voice she heard and her explanation for why she followed its command.
I believe her account because nothing in her past suggested such a catastrophic act. Family members, friends, and her nanny consistently described her as an excellent mother and a loving, sensitive woman. She had no history of aggression, child abuse, or violence—she apparently had never even spanked her children.
There is also no alternative explanation outside of psychosis: Clancy did not wish to be rid of her children to be with another man, nor was she punishing her husband….
Note that Clancy appeared to have planned the killings:
Prosecutors contend that Lindsay planned to kill her three children by sending her husband to pick up takeout from a restaurant they did not normally visit. She is also reported to have used Apple Maps to estimate how long it would take him to return home.
That point does not conflict with the insanity defense, which does not require a total loss of the capacity for rational thought or a sudden impulse. But as you apply the legal rules, consider how this might bear on the legal standard in question.
[D.] And here is the full instruction, which I summarized at the outset:
If the Commonwealth has proven the elements of the offense beyond a reasonable doubt, it must also prove beyond a reasonable doubt that the defendant was criminally responsible at the time of the alleged offense. Under the law, a person is not guilty if they lacked criminal responsibility when they committed the offense. This is sometimes described as not guilty by reason of insanity. There is no requirement that the defendant prove that they lacked criminal responsibility.
The Commonwealth may meet its burden of proving that a defendant was criminally responsible in either of two ways.
First, the Commonwealth may prove beyond a reasonable doubt that the defendant did not suffer from a mental disease or defect at the time of the alleged offense.
A mental disease or defect is a legal term, not a medical term. It does not require a formal medical diagnosis. It does not include an abnormality that appears only through repeated criminal or antisocial behavior. It is up to you to determine from the evidence whether the defendant had a mental disease or defect at the time of the alleged offense.
Second, even if the defendant did suffer from a mental disease or defect at the time of the alleged offense, the Commonwealth may still prove beyond a reasonable doubt that the defendant retained the substantial capacity to appreciate the wrongfulness or criminality of their conduct and to conform their conduct to the requirements of the law.
To establish that the defendant had the substantial capacity to appreciate the wrongfulness or criminality of their conduct, the Commonwealth must prove beyond a reasonable doubt that the defendant understood that their conduct was illegal or wrong in a meaningful way.
To establish that the defendant had the substantial capacity to conform their conduct to the law’s requirements, the Commonwealth must prove beyond a reasonable doubt that any mental disease or defect that may have existed did not deprive the defendant of the ability to act in accordance with the law.
In essence, if the Commonwealth proved beyond a reasonable doubt that the defendant did not have a mental disease or defect at the time of the offense, the Commonwealth has satisfied its burden of proving criminal responsibility.
Alternatively, if the Commonwealth proved beyond a reasonable doubt that, even if the defendant did suffer from a mental disease or defect at the time of the offense, the defendant nonetheless retained the substantial capacity to appreciate the wrongfulness or criminality of their conduct and to conform their conduct to the law’s requirements, the Commonwealth has satisfied its burden of proving criminal responsibility.
Remember that the defendant bears no burden to prove that they lacked criminal responsibility at the time of the offense. Instead, the burden is on the Commonwealth to prove beyond a reasonable doubt both that the defendant committed the offense and that the defendant was criminally responsible at the time they committed the offense.
If you have a reasonable doubt about whether the defendant committed any one of the required elements of the alleged offense, you must find the defendant not guilty. If you have a reasonable doubt about whether the defendant was criminally responsible at the time of the offense, you must find the defendant not guilty by reason of a lack of criminal responsibility.
