Judge Sullivan began the instructions specific to the charges with criminal responsibility. That placement makes sense because criminal responsibility applies before the jury can convict Clancy of any crime.

The judge instructed:

“To prove the defendant guilty of any crime, the Commonwealth must first prove beyond a reasonable doubt that the defendant was criminally responsible at the time the alleged crime was committed.”

The burden belongs entirely to the Commonwealth. Clancy does not have to prove that she lacked criminal responsibility. Under Massachusetts law as explained to this jury, a person is not criminally responsible if she has a mental disease or defect AND, as a result of that condition, lacks substantial capacity either:

• to appreciate the criminality or wrongfulness of her conduct; or
• to conform her conduct to the requirements of law.

Importantly, Judge Sullivan told jurors that “mental disease or defect” is a legal term rather than a medical term and does not have to correspond to a formal medical diagnosis. That is particularly significant in a trial containing extensive arguments over diagnoses, the DSM, postpartum psychosis and whether Clancy’s symptoms fit particular psychiatric categories. The jury does not have to diagnose Lindsay Clancy. It has to determine whether the legal standard for criminal responsibility has been proven.

The Commonwealth Did Not Necessarily Have to Prove Clancy Wasn’t Mentally Ill

This may be one of the most misunderstood aspects of the case. Judge Sullivan gave jurors two ways in which the Commonwealth could establish criminal responsibility. It could prove beyond a reasonable doubt:

1. Clancy did not suffer from a mental disease or defect at the time of the crimes; OR

2. Even if she did suffer from a mental disease or defect, she nevertheless retained substantial capacity to appreciate the wrongfulness or criminality of her conduct AND conform her conduct to the requirements of law.

That second path is critical. A finding that Lindsay Clancy suffered from serious mental illness does not automatically produce a verdict of not guilty by reason of lack of criminal responsibility. Neither, by itself, does a finding that she was psychotic. The jury still has to determine what effect that mental condition had upon the capacities required by the law. And that is where the prosecution and defense closing arguments sharply diverged.

This distinction could also be one source of disagreement during deliberations. A juror could fully accept that Clancy suffered from a serious mental disease or defect and still conclude that the Commonwealth proved she retained the capacities required for criminal responsibility. Another juror could accept the same underlying mental illness but reach the opposite conclusion about those capacities.

In other words, jurors do not necessarily have to disagree about whether Lindsay Clancy was mentally ill in order to disagree about the verdict.

Reddington’s Argument: Her Mental Disease Explains the Unexplainable

Kevin Reddington’s closing was built largely around a simple and emotionally powerful proposition:  How does a woman who loved her children become the woman who killed them? His answer was mental illness, medication and what he characterized as inadequate medical treatment.

“Because of the damn medicine and the lousy medical care that she got,” Reddington told the jury. He repeatedly returned to the Lindsay Clancy who existed before January 24: nurse, wife, daughter and devoted mother. He pointed to family photographs, social-media posts, the family’s wish jar and testimony describing her relationship with her children.

His argument was essentially that the killings themselves made no rational sense when compared with the woman the evidence showed Clancy had previously been. Something catastrophic, he argued, had happened to her mind. That theme fits an important part of the criminal-responsibility inquiry.

But the instructions required another step. It was not enough to establish that Clancy had deteriorated psychologically, suffered from a mental disease or defect, experienced psychosis or behaved in ways profoundly inconsistent with her previous character. The question was what that condition did to her ability to appreciate wrongfulness or criminality and conform her conduct to law at the time of the killings.

A Crucial Distinction in Reddington’s Description of the Burden

At one point in closing, Reddington characterized the Commonwealth’s burden as requiring it to prove both that Clancy was guilty and that she “was not suffering from a disease or defect” at the time of the killings. Judge Sullivan’s instruction was more nuanced.

Proving that Clancy did not suffer from a mental disease or defect was one way for the Commonwealth to establish criminal responsibility. It was not the only way. Even if jurors concluded she did suffer from a qualifying mental disease or defect, they could still find her criminally responsible if the Commonwealth proved the required capacities remained intact. That instruction may become extremely important during deliberations.

Sprague’s Argument: Mental Illness Is Not the End of the Inquiry

Jennifer Sprague’s closing approached the case from almost the opposite direction. The prosecution did not need jurors to believe that Lindsay Clancy had never been sick. Rather, Sprague attempted to move them away from the enormous amount of testimony about treatment, medications and the failures or shortcomings of the mental-health system and toward a narrower question:

What was Lindsay Clancy capable of understanding and doing on January 24, 2023?

That approach tracks the legal instructions closely. Judge Sullivan told jurors that in determining criminal responsibility they could consider the facts surrounding the crime, Clancy’s actions before and after it, and the opinions of the experts. Sprague therefore concentrated heavily on behavior.

The prosecution argued that Clancy created an opportunity to be alone with the children, used the CVS errand to get Patrick out of the house, acted within a limited window of time, killed all three children, attempted suicide afterward, and demonstrated through her conduct that she understood what she had done.

The Commonwealth’s theory was not simply:

She planned something, therefore she wasn’t mentally ill.

It was:

Her purposeful behavior is evidence of the mental capacities the Commonwealth is legally required to prove.

“Appreciate” Means More Than Simply “Know”

There is another safeguard in the instructions that prevents the criminal-responsibility question from becoming too simplistic. Judge Sullivan specifically explained that appreciate means understand rather than merely know. The Commonwealth therefore could not satisfy its burden merely by showing that Clancy possessed an intellectual awareness that killing her children was illegal or wrong.

The judge instructed that she must have been capable of realizing “in some meaningful way” the legal or moral significance of her conduct. That matters enormously when considering the defense experts.

Dr. Phillip Resnick’s opinion, for example, was not simply that Clancy failed to know killing was illegal. His criminal-responsibility opinion centered heavily on the other portion of the test — her capacity to conform her conduct — and his theory of her psychotic belief system. Thus, evidence suggesting that Clancy knew society prohibited killing does not necessarily answer the entire legal question.

The jury must determine whether the Commonwealth proved the capacities defined by Judge Sullivan beyond a reasonable doubt.

Why Planning Doesn’t Automatically Decide Criminal Responsibility

Much of the prosecution case focused on planning. That evidence potentially serves more than one purpose. For criminal responsibility, purposeful behavior before and during the killings can provide circumstantial evidence concerning Clancy’s mental capacities. But planning is also directly relevant to the separate question of deliberate premeditation.

For first-degree murder under that theory, the Commonwealth must prove that Clancy:

1. caused the child’s death;

2. intended to kill; and

3. killed with deliberate premeditation.

Judge Sullivan explained that deliberate premeditation means deciding to kill after a period of reflection. That period need not last hours or even minutes. It can occur in seconds. The required sequence is essentially:

consideration → decision → killing.

But the judge also specifically told jurors that there is no deliberate premeditation when the action occurs so quickly that the defendant has no time to reflect and decide. That makes the prosecution’s evidence concerning the CVS search, the request for Patrick to leave, the timing of his absence and the sequence of the killings potentially relevant not only to criminal responsibility but also to first-degree murder.

This is another important feature of the instructions. Even if the jury finds Clancy criminally responsible, the evidence concerning her mental condition does not simply vanish. Judge Sullivan specifically instructed jurors that they could consider credible evidence of mental impairment or the effects of prescription drugs when determining whether she possessed the intent required for deliberate premeditation.

He gave a similar instruction regarding extreme atrocity or cruelty. He also applied mental impairment and prescription-drug evidence to the knowledge component of manslaughter. And after the closing arguments, Judge Sullivan returned to the subject because he wanted to make something especially clear:

The jury could also consider Clancy’s mental condition and the effects of prescription drugs when determining the elements of second-degree murder, particularly intent.

Thus, there are really two separate mental-state inquiries.

First: Was Clancy criminally responsible at all?

Then, if the answer is yes: Did the Commonwealth prove the mental state required for the particular degree of homicide?

That answer opens the door to verdicts other than the two outcomes most often discussed publicly — first-degree murder or lack of criminal responsibility.

That creates another potential point of division. Even jurors who agree that Clancy was criminally responsible may disagree over what the Commonwealth proved about her intent, whether she deliberately premeditated the killings, or how her mental impairment affected those determinations.

A unanimous finding on criminal responsibility, therefore, would not necessarily produce a unanimous verdict on the degree of homicide.

Extreme Atrocity or Cruelty Is Its Own Question

The Commonwealth also charged first-degree murder under the theory of extreme atrocity or cruelty. Judge Sullivan instructed jurors that they could not make that finding merely because the deaths were horrific. They had to consider specified factors, including whether Clancy was indifferent to or took pleasure in the children’s suffering, whether the method was reasonably likely to substantially increase or prolong conscious suffering, or whether the means used were excessive and disproportionate to what was necessary to kill.

The jury was again instructed that Clancy’s mental condition and prescription-drug effects could be considered when deciding whether the Commonwealth proved this element. That is significant because the prosecution’s evidence regarding the resistance bands, the mechanics and duration of strangulation, and the three separate killings potentially intersects with this theory.

But emotional reaction to the deaths is not the legal standard. Judge Sullivan separately cautioned jurors not to allow the graphic photographs of the children to produce a verdict based upon sympathy or emotion.

The Expert Battle Was Never a Vote

The trial featured an extraordinary number of mental-health experts. But the jury does not tally them. Judge Sullivan specifically told jurors that an expert occupies no higher position than any other witness simply because of specialized education or experience.

Jurors may accept all of an expert’s testimony, some of it or none of it. They may reject an opinion if they determine it does not fit the facts as the jury finds those facts. They may also consider whether an expert’s testimony was influenced by bias or interest. That instruction is especially important here because both closings attacked the opposing experts.

Reddington questioned the qualifications, timing, methods and credibility of the Commonwealth’s rebuttal witnesses and contrasted them with Resnick’s extensive experience. Sprague attacked weaknesses she saw in the defense evaluations and asked jurors to compare expert assumptions with the contemporaneous records and other evidence. Neither side wins simply because its expert has the better résumé.

The jury determines the facts first and then decides which expert opinions survive contact with those facts.

There is another instruction that may be easy to overlook but could have enormous importance during deliberations. Clancy made numerous statements about the killings during forensic psychiatric and psychological evaluations. Judge Sullivan told jurors that statements she made to evaluating psychiatrists or psychologists cannot be considered as proof that the facts contained in those statements are true. 

They cannot use those statements themselves as evidence of:

• premeditation;
• extreme atrocity or cruelty; or
• specific intent to kill.

Those statements are admissible only as they relate to the basis of the expert’s opinion concerning Clancy’s mental condition. That means the jury must be extremely careful about the source of some of the most dramatic details discussed during expert testimony. If a fact comes only from something Clancy told a forensic evaluator, its legal use may be much narrower than viewers following the testimony might assume.

Circumstantial Evidence Can Be Enough

The prosecution does not need a witness who somehow knows exactly what was occurring inside Lindsay Clancy’s mind. No such witness exists. Judge Sullivan instructed jurors that circumstantial evidence alone can establish guilt beyond a reasonable doubt. Jurors may draw reasonable and natural inferences from proven facts, provided those inferences are consistent with one another and together establish guilt beyond a reasonable doubt.

They may not rely on conjecture, guesswork or assumptions. That instruction explains much of Sprague’s closing.

The searches.
The timing.
The CVS errand.
Patrick’s departure.
The children’s locations.
The manner of killing.
Clancy’s actions afterward.
Her statements before and after January 24.

The prosecution asked jurors to assemble individual facts into a chain of circumstantial evidence about what Clancy intended, understood, and was capable of controlling.

The defense attacked that chain at virtually every link.

Reddington’s Reasonable Doubt Argument

Reddington repeatedly pointed to what he characterized as failures, inconsistencies or unanswered questions in the Commonwealth’s case.

The untested cup and powder.
The medication bottles.
The investigation of the suicide attempt.
The dispute over whether the resistance bands were knotted or wrapped.
The timing and circumstances of Clancy’s statements.
The experts’ disagreements.
The origins of the reported voice.
The treatment she received.

These issues can certainly be used to attack the Commonwealth’s evidence. But Judge Sullivan gave jurors an important limitation on what constitutes reasonable doubt. They were specifically told not to engage in guesswork about unanswered questions or speculate about what the “real facts” might have been beyond the evidence presented.

An unanswered question therefore does not automatically equal reasonable doubt. The question is whether the uncertainty creates reasonable doubt about something the Commonwealth actually has the burden to prove. That is a very different standard.

Sprague’s Argument Has the Same Limitation

The prosecution does not escape that rule either. A suspicious circumstance is not automatically proof. Planning-like behavior is not automatically premeditation. A factual inconsistency is not automatically deception. A calm action is not automatically sanity.

And post-crime behavior is not automatically consciousness of guilt.

Judge Sullivan specifically instructed jurors that conduct after the killings may support an inference of consciousness of guilt only if the jury finds that inference reasonable under all the circumstances.

He warned that innocent people may also exhibit behavior associated with guilt and that consciousness-of-guilt evidence can never, standing alone, support a conviction. So both sides face the same discipline:

Tie the evidence to the law.

What the Jury Is Actually Deciding

Stripped of the emotionally charged arguments surrounding this case, the jury’s task can be understood as a series of questions.

First:

Has the Commonwealth proved beyond a reasonable doubt that Lindsay Clancy was criminally responsible on January 24, 2023? If Clancy had a mental disease or defect, did it deprive her of substantial capacity to appreciate the wrongfulness or criminality of killing her children? Or did it deprive her of substantial capacity to conform her conduct to law?

If the Commonwealth fails to carry its burden on criminal responsibility, the verdict is not guilty by reason of lack of criminal responsibility. If the Commonwealth proves criminal responsibility, the jury moves into the homicide offenses.

Did Clancy intentionally kill after reflection?
Did the Commonwealth prove deliberate premeditation?
Did it prove extreme atrocity or cruelty under the specific factors Judge Sullivan provided?
If first-degree murder is not proven, has the Commonwealth proven second-degree murder?
And if murder has not been proven, has it proven manslaughter?

Mental impairment and medication evidence can remain relevant throughout several of those determinations. That is why the verdict form contains considerably more possibilities than “guilty” or “insane.”

For each child, jurors have options including not guilty, not guilty by reason of lack of criminal responsibility, first-degree murder, second-degree murder and manslaughter.

The Closing Arguments Through the Lens of the Instructions

Seen through Judge Sullivan’s instructions, the two closing arguments reveal fundamentally different approaches.

Reddington asked the jury to understand why this happened. He presented the killings as the catastrophic endpoint of psychiatric deterioration, medication, psychosis and failed treatment. He emphasized the radical discontinuity between the mother Lindsay Clancy had been and the acts she committed.

Sprague asked the jury to concentrate on what Lindsay Clancy demonstrated she was capable of doing and understanding when it happened. She focused on behavior, choices, timing, planning, opportunity, inconsistencies and the absence of contemporaneous evidence supporting parts of the later psychosis narrative.

Both approaches intersect with the law. But neither closing argument is the law.

Judge Sullivan explicitly reminded jurors of that after both attorneys finished: closing arguments are not evidence, and jurors must rely upon their own recollection of the testimony.

Ultimately, the jury is not being asked to choose between Reddington’s story and Sprague’s story. It is being asked to determine which facts were actually proven and then apply those facts to Judge Sullivan’s instructions.

Perhaps the most important lesson from the Lindsay Clancy trial extends far beyond this particular case. Mental illness and criminal responsibility answer different questions. A person can suffer from severe mental illness and remain criminally responsible. Conversely, a person does not necessarily need a neat diagnostic label appearing in the DSM to satisfy the legal definition of mental disease or defect.

The diagnosis is not the verdict. The existence of psychosis is not necessarily the verdict. The number of medications is not the verdict. Whether the mental-health system failed someone is not the verdict.

The legal question is what the defendant’s mental condition did to the capacities the law requires at the moment of the crime.  That is the line Judge Sullivan gave this jury. And after five weeks of extraordinarily emotional testimony, competing psychiatric opinions and two dramatically different closing arguments, that is the line the twelve deliberating jurors must now follow.

The jury’s inability thus far to reach unanimity does not tell us that jurors misunderstood these instructions. It may demonstrate precisely the opposite: twelve people attempting to faithfully apply a complicated legal standard to deeply contested psychiatric evidence may simply reach different conclusions. The question is whether further deliberation — now aided by Judge Sullivan’s Tuey-Rodriguez instruction — can bring those conclusions together.