Mangione to Pursue Psychiatric Defense in UnitedHealthcare CEO Murder Trial

If the gamble pays off, he will be convicted of manslaughter instead of murder in the killing of UnitedHealthcare CEO Brian Thompson.

Luigi Mangione appears in Manhattan Criminal Court in New York City on Dec. 8, 2025. Sarah Yenesel/Pool Photo via AP

Luigi Mangione’s attorneys will attempt an “extreme emotional disturbance” defense in his upcoming trial for the slaying of insurance executive Brian Thompson, a judge announced on June 17. The defense is a gamble, because Mangione has to admit to the shooting.

Judge Gregory Carro told the court that Mangione’s attorneys had decided to use that strategy following a sealed court hearing on June 3.

“The reason for the sealing was to give the defense an opportunity to determine whether they were going forth with that defense and the nature of that defense,” Carro said.

Mangione, 28, is accused of fatally shooting the UnitedHealthcare CEO outside a Manhattan hotel in December 2024. State prosecutors have also charged him with stalking, forgery, and weapons-related charges.

He faces life in prison if convicted.

For his defense to succeed, a jury has to find that Mangione had a reason to be emotionally disturbed, that he acted “under the influence” of that distress, and that it was “so extreme as to result in and become manifest as a profound loss of self-control,” according to New York court guidelines.

If the jury deems Mangione’s claim credible, he will be found guilty of the lesser charge of manslaughter instead of murder.

Mangione faces both state and federal charges, and has pleaded not guilty; judges in both cases have postponed his trials until fall.

Judge Carro already threw out terrorism charges against him in September, saying the state had presented insufficient evidence.

In May, the judge also suppressed some of the evidence found in Mangione’s backpack when he was arrested, ruling that the search was unlawful.

However, he also ruled that items found during a second search at the police station—like the alleged murder weapon—can be used as evidence. A USB drive, a notebook, and a silencer will also be admitted.

In January, U.S. District Judge Margaret Garnett dismissed the federal murder and weapons charges on a technicality.

She ruled that, to bring those charges, federal statutes and Supreme Court precedent require the government to show that stalking is inherently a “crime of violence.” The government had not proved that from a legal standard, she wrote in her opinion, while also commenting on the “absurdity” of the loophole.

“The Defendant is charged with selecting a stranger to be killed based on his employment; carefully planning the killing, including identifying where and when the selected victim would be most vulnerable … and then gunning the victim down on a public street in midtown Manhattan, using a handgun equipped with a silencer,” she wrote.

“No one could seriously question that this is violent criminal conduct.”

The ruling means Mangione no longer has to worry about the death penalty, but will still face two federal charges of “fatal stalking.”

The Associated Press contributed to this report.