How Would You Have Applied Massachusetts Law in the Lindsay Clancy Trial?

[A.] I know lots of people have opinions about the Lindsay Clancy trial, and I wanted to pass along the Massachusetts standard criminal jury instructions for such matters. (I can’t be certain that this is the instruction that was actually given in the case, but it’s the recommended instruction for such cases, so I assume the actual instruction wasn’t far off.) If you have followed the factual allegations in the case, please post a comment and indicate how you would have voted if you were a juror, based on your knowledge (even if limited) of the factual allegations, and why you would have so voted.

Please keep in mind two important things:

[1.] Once evidence triggering the defense is raised, the government must disprove it beyond a reasonable doubt. To draw an analogy from how people talk about the reasonable doubt standard as to other guilt/innocence questions, Massachusetts takes the view that it is better that 10 non-insane people are wrongly acquitted than that one insane person is wrongly convicted.

This is not the uniform rule in the U.S.; for instance, in federal cases, the law is almost the opposite—the defendant must prove insanity by clear and convincing evidence. Indeed, my quick research suggests that this is the rule only in a minority of states. But the law in Massachusetts on this is as settled.

[2.] The substantive rule is that a defendant is not criminally responsible if

(a) he or she “suffer[ed] from a mental disease or defect at the time of the alleged offense” (with no further definition of the terms, at least as part of 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, it is that she suffered from a mental disease and lacked the substantial capacity to refrain from killing her children—or at least there’s a reasonable possibility that this was so.)

This substantive standard is likewise not a uniform view throughout the country; many other states follow different approaches. According to a Paul Robinson et al. study from 2015, about 1/3 of the states take the same substantive approach as Massachusetts does.

[B.] Please focus in your comment on how you would apply Massachusetts law, not whether you think the law should be changed (either as to the burden and quantum of proof, or as to the substantive definition of when the defendant isn’t legally responsible).

Also, please focus on how you think this standard should apply in this case to this person. The question isn’t the prevalence of postpartum psychosis as such, or of how often women can be highly distraught and not kill their children. Nor is it whether Clancy’s public supporters or detractors are acting badly or opining foolishly. Rather, the question is whether, on the facts of this case, you would think that there’s a reasonable doubt about Clancy’s sanity (as defined by the Massachusetts law summarized in item A.2 above).

[C.] If you want more details on the Clancy case, here’s a summary by Dr. Sally Satel (The Free Press), whom I know in some measure and whose work I’ve generally found to be thoughtful and balanced. She ultimately comes down in favor of acquittal, but the factual summary generally appears consistent with what I’ve heard from other news sources:

On January 24, 2023, Clancy took her children, one by one, into the basement of the family’s home in Duxbury, Massachusetts. “Go to God, baby,” she allegedly said as she asphyxiated each of them with exercise bands. She then made cuts on her wrists and neck, and jumped out of a second-story window in a suicide attempt that left her paralyzed below the waist. She did these things during the hour it took her husband to complete an errand she asked him to run.

The tragedy was the culmination of five months of anguish and help-seeking. Although Clancy said she initially felt well following Callan’s birth in May 2022, she saw a psychiatrist in late summer for help with depression, severe insomnia, and feelings of being overwhelmed by simple tasks like dressing or showering.

Over time, she allegedly began having suicidal ideation and experiencing what have been variously described as “intrusive thoughts” and “auditory hallucinations” telling her that she was “damaged” and would “not be the same,” and 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 was worried that other people could hear those thoughts.

After Clancy’s husband left to pick up food and medication on January 24, 2023, she said that a loud, demanding male voice told her over and over, “This is your last chance. You have to kill the kids so you can kill yourself.” She allegedly entered “a dreamlike state” and watched herself act, feeling as if she had “no choice.” A hospital chaplain who met with Clancy within weeks of the crime testified that Clancy said 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, a relatively common diagnosis that occurs in one out of eight deliveries, postpartum psychosis is rare, occurring just once or twice in every 1,000 deliveries.

Clancy’s situation was also not textbook postpartum psychosis. She did not have symptoms for three months after Callan’s birth, although, according to the DSM-5, postpartum psychosis manifests rapidly within the first month after delivery. Also, expert witnesses at her trial debated whether Clancy suffered actual psychotic episodes before the killing and whether the voice she heard in her basement on January 24 was a true command hallucination or merely an insistent internal thought that she chose to obey.

Also, Clancy did not consistently report suicidal or homicidal thinking or hallucinations to clinicians, perhaps because her mood and ideation fluctuated over the course of the day—a standard feature of postpartum psychosis….

In reaching these conclusions, I have accepted the truth of Clancy’s description of the voice she heard and her explanation of why she followed its command.

I believe her account because absolutely nothing in her past foreshadowed her cataclysmic act. She was uniformly regarded by family members, friends, and her nanny as an excellent mother and a caring, sensitive woman. She had no history of aggression, child abuse, or violence—apparently, she had never even spanked her kids.

Nor is there an alternative explanation outside of psychosis: Clancy did not want to be rid of her children to be with another man, nor was she punishing her husband….

Note also that Clancy had apparently planned the killing:

Prosecutors believe that Lindsay planned to kill her three children by sending her husband to pick up takeout from a restaurant they didn’t normally visit. She also reportedly used Apple Maps to determine how long it would take for him to return home.

That is not legally inconsistent with the insanity defense, which doesn’t require a total loss of the capacity for rational thought, or a sudden impulse. But consider, as you’re applying the legal rules, how you think this might or might not bear on the legal standard.

[D.] And here’s the full instruction, which I’ve summarized at the beginning:

If the Commonwealth has proved the elements of the offense beyond a reasonable doubt, the Commonwealth 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 referred to as not guilty by reason of insanity. There is no burden on the defendant to prove that they lacked criminal responsibility.

The Commonwealth may meet its burden of proving a defendant was criminally responsible for their conduct in either of two ways.

The first way is for the Commonwealth to 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 need not fit into a formal medical diagnosis. It is a legal term, not a medical term. It does not, however, include an abnormality that presents itself only by repeated criminal or otherwise antisocial behavior. It is for you to determine from the evidence whether the defendant had a mental disease or defect at the time of the alleged offense.

The second way for the Commonwealth to prove a defendant was criminally responsible for their conduct is for the Commonwealth to prove beyond a reasonable doubt that, even if the defendant suffered from a mental disease or defect at the time of the alleged offense, the defendant nonetheless 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 appreciated—that is, that the defendant knew or understood in some meaningful way—that their conduct was either illegal or wrong.

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 at the time of the alleged offense did not deprive the defendant of their ability to behave as the law requires—that is, to obey the law.

To summarize, if the Commonwealth proved beyond a reasonable doubt that the defendant did not have a mental disease or defect at the time of the alleged offense, the Commonwealth has satisfied its burden of proving that the defendant was criminally responsible.

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 alleged offense, the defendant nonetheless retained the substantial capacity to appreciate the wrongfulness or criminality of their conduct and to conform their conduct to the requirements of the law, the Commonwealth has satisfied its burden of proving the defendant was criminally responsible.

Remember that there is no burden on the defendant to prove that they lacked criminal responsibility at the time of the offense. Rather, 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 that they committed the offense.

If you have a reasonable doubt 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 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….