Luigi Mangione, the man suspected of fatally shooting United Healthcare CEO Brian Thompson in New York City, will use a mental health defense at his upcoming trial.
Judge Gregory Carro said on March 19 that Mangione's lawyers had informed him they would argue their client was in a state of “extreme emotional disturbance” when he carried out the shooting in December 2024.
New York state law allows defendants in murder cases to argue that they should not be held fully responsible for their actions because they were experiencing extreme emotional disturbance at the time of the crime.
Thompson’s killing, which occurred outside a hotel in Manhattan, sent shockwaves through the United States. Video footage of the scene quickly spread on social media. The case also drew attention to widespread anger over the high cost of healthcare in the U.S. Police said the words “delay,” “deny” and “depose” were written on the suspect's ammunition, alluding to how health insurance companies avoid paying claims.
If the jury finds that Mangione was suffering from extreme emotional disturbance at the time of the killing, they could convict him of manslaughter instead of murder. Such a conviction typically leads to a lighter sentence.
Using the extreme emotional disturbance defense means Mangione will admit to committing the act, but under diminished judgment. This differs from an insanity defense, which could allow Mangione to be treated in a mental health facility instead of prison.
Mangione, 28, sat between his two lawyers in a blue suit and is scheduled to stand trial at the state level on September 8. He has pleaded not guilty to state and federal charges related to the killing. The federal trial, which includes stalking charges, is set to begin on October 13. Mangione could face life in prison if convicted in either case.
Federal District Judge Margaret Garnett, who is overseeing the federal case, dismissed murder and weapons charges against Mangione on technical grounds in January 2026. That ruling removed the possibility of Mangione facing the death penalty.
