# Luigi Mangione to mount emotional disturbance defense to justify killing of United Healthcare CEO > Source: > Published: 2026-06-17 16:30:11+00:00 **Getting your** [Trinity Audio](//trinityaudio.ai)player ready...Luigi Mangione plans to mount a psychiatric defense at his state murder trial this fall, an attempt to justify killing UnitedHealthcare CEO Brian Thompson on the grounds he was experiencing an extreme emotional disturbance, a Manhattan judge said Wednesday. [Manhattan Supreme Court Justice Gregory Carro](https://www.nydailynews.com/2026/06/03/ny-judge-holds-mystery-sealed-hearing-in-luigi-mangione-ceo-murder-case/) revealed the stunning development at a brief court hearing in announcing he would unseal a recent defense motion. The judge ordered Mangione’s lawyers to promptly share more details with the prosecution, including the precise mental defect they will allege he suffered and the name of their medical expert. “They need to know what the malady is that this defendant suffered,” and how it triggered his targeting of Thompson, the judge said. Mangione is accused of murdering Thompson on a Midtown sidewalk in a violent protest of overpriced medical costs in America on Dec. 4, 2024. If the jury accepts his defense — that he killed the executive in the throes of a psychiatric crisis — they could find him guilty of first-degree manslaughter instead of second-degree murder, if the judge allows consideration of the lesser charge. The jury could also reject that claim and find him guilty of second degree murder. Mangione’s lawyer, Karen Friedman Agnifilo, on Wednesday said his team had sought to seal the request concerning his defense strategy because it was not available in his federal case, and that it was prejudicial to that prosecution involving “the exact same facts.” In both matters, authorities allege Mangione lay in wait for the 50-year-old Thompson outside the Hilton hotel on W. 54th St and Sixth Ave, and fatally shot the 50-year-old in the back as he arrived early in the morning to set up for a conference. [Shell casings recovered at the scene bore the words: delay, defend and deny](https://apnews.com/article/unitedhealthcare-ceo-shooting-delay-deny-defend-depose-ee73ceb19f361835c654f04a3b88c50c), in apparent reference to health insurance companies habitually denying benefits claims to maximize profits. The victim, [a Minnesota resident, husband, and father to two teenage boys,](https://abc7ny.com/post/unitedhealthcare-ceo-shot-brian-thompsons-homes-subjected-suspected-swatting/15624109/) was scheduled to address a ballroom of fellow healthcare industry executives later in the day. His killer fled the scene on a bike, seemingly disappearing into Central Park without a trace, prompting a five-day manhunt that kept the nation rapt. The trials are set to take place back-to-back this fall, with the case Mangione is pleading guilty in scheduled to begin with jury selection on Sept. 8 and Manhattan Judge Margaret Garnett slated to hear opening statements in the federal case on Nov. 4. Mangione, who exhibited a somber demeanor in court Wednesday, wore a navy suit with an open collared white shirt to the proceeding. The Maryland man’s legal team, headed by former Manhattan DA prosecutor Friedman-Agnifilo and Marc Agnifilo — a husband and wife duo — got the top counts of murder as a crime of terrorism knocked off his state court indictment in September. In January, they convinced the judge in his federal case to dismiss death penalty-eligible charges. They [racked up another victory last month](https://webfiles.nycourts.gov/public/2026-05/luigimangione.decision.051826.pdf) when Carro agreed that Altoona, PA, police officers had violated Mangione’s rights in a search of his backpack at the McDonald’s[ where he was arrested](https://www.nydailynews.com/2024/12/13/new-info-indicates-luigi-mangione-accused-of-killing-unitedhealthcare-ceo-wont-fight-extradition-to-nyc-manhattan-da/) after a manager called 911 and said someone recognized him from wanted posters. The judge last month granted the defense’s motion to suppress a knife, a loaded magazine, a cellphone, a Faraday bag, a passport, a wallet and a computer chip retrieved from the backpack. But Carro found cops had lawfully recovered items back at the stationhouse — including a 9mm 3D-printed pistol and a red notebook, in which Mangione allegedly laid out plans to kill a healthcare executive — and that they could be shown to a jury. Mangione’s motive was made crystal clear in the notebook, according to prosecutors, [who have described it as a manifesto](https://www.nydailynews.com/2025/06/04/da-luigi-mangione-wanted-health-ceo-murder-to-trigger-widespread-action/). The young man allegedly wrote that Americans pay more for healthcare than citizens of any other nation, despite the U.S. ranking No. 42 in life expectancy. He also allegedly wrote about UnitedHealthcare’s immense profits — placing it behind only a handful of companies, including Apple, Google and Walmart. Mangione allegedly wrote that he acted alone, adding, “I do apologize for any strife of traumas but it had to be done. Frankly, these parasites simply had it coming.” With frustrations over expensive healthcare in the U.S. palpable among the public, those sentiments have seemingly fueled the unprecedented outpouring of support for Mangione, including from crowds of fans who have dutifully attended his court hearings, hailing him a Robin Hood folk hero. In the year and a half since his arrest, Mangione has become a household name. The accused suspect has been held in pretrial custody at the Metropolitan Detention Center in Sunset Park, a notorious federal jail worlds away from his [white-picket-fence upbringing](https://www.nydailynews.com/2024/12/14/alleged-ceo-killer-luigi-mangiones-privileged-life-get-away-murder-brian-thompson-unitedhealthcare/) outside of Towson, Md.