Closing arguments in the Lindsay Clancy trial are due to begin in Massachusetts on 27 August, where jurors will soon decide whether the Duxbury mother was a calculating killer or a woman destroyed by untreated illness.
In a Plymouth County courtroom, prosecutors say Clancy, now 36, knew exactly what she was doing when she strangled her three young children at their home in suburban Boston in January 2023.
Her defence team insists she was in the grip of severe mental illness, including what they describe as postpartum psychosis, and that she should not be held criminally responsible.
The Lindsay Clancy trial has unfolded over five weeks of often harrowing testimony about psychiatric medications, suicidal thoughts and a family that repeatedly begged for help.
At the centre of it all is a blunt question that the law demands an answer to, even as medicine is still arguing over the details.
The Lindsay Clancy trial has repeatedly returned to the weeks leading up to the killings, when relatives and doctors documented a sharp decline in her mental state.
Defence lawyers say her 'big spiral' began about a month before the children died, after the birth of her third child.
Her ex‑husband, Patrick Clancy, told jurors that she started losing weight, became deeply depressed and began voicing thoughts of suicide. He said she was 'having a really hard time', seeking help on and off from medical professionals and taking a series of psychiatric medications.
Over the course of her treatment, court testimony shows Clancy was prescribed more than a dozen medications and at one point reached out to both a suicide hotline and a hospital emergency room.
Her legal team argues that she developed postpartum psychosis, a rare condition in which some women shortly after childbirth can experience mania, depression or a mixture of both, alongside hallucinations and fixed delusions.
Clinical and forensic psychologist Paul Zeizel told the court that Clancy suffered from hallucinations and delusions that began after the birth of her third child and that she was 'unable to conform her behaviour to the rule of law and she had no appreciation for the wrongfulness of her act'.
Prosecutors, however, say Clancy made a calculated decision to kill, pointing to evidence that she allegedly sent Patrick out on errands so he would not be home. They argue that whatever distress she felt, it did not strip her of the ability to plan or to understand that murder is wrong.
The Lindsay Clancy trial has seen more than ten expert witnesses called by both sides, a parade of psychiatrists and psychologists who often clashed with each other and with the lawyers questioning them.
One of Clancy's treating psychiatrists, Dr Jennifer Tufts, testified for the prosecution that during months of appointments she did not observe psychosis. Tufts told the court there were 'no serious signs that her safety or anyone else's safety was at risk', even as Clancy cycled through different medications.
Defence lawyers tried to use Tufts' own medical notes to undermine her position. They highlighted an entry that appeared to describe Clancy's speech as 'not hyper, pressured', arguing that pressured speech can be a sign of mania.
