What the jury must decide
The McHoul standard, who carries the burden and to what level, the rule on prescribed medication, and what each available verdict would mean.
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A person is not responsible for criminal conduct if, at the time of that conduct, as a result of mental disease or defect, they lack substantial capacity either to appreciate the wrongfulness of the conduct or to conform the conduct to the requirements of law.
The Commonwealth must prove criminal responsibility beyond a reasonable doubt.
Guilty of murder in the first degree
The jury finds the Commonwealth proved the elements and criminal responsibility beyond a reasonable doubt, on at least one of the theories charged.
A life sentence without the possibility of parole.
Guilty of murder in the second degree
Malice is proved but the jury is not satisfied of the aggravating theory that would raise it to the first degree.
A life sentence with eligibility for parole.
Not guilty by reason of lack of criminal responsibility
The jury has at least a reasonable doubt that the defendant was criminally responsible. It is a complete defense, and a verdict of not guilty.
Not release. The court may order hospitalization for up to forty days for observation and examination. Within sixty days the district attorney, a facility superintendent, or the medical director of Bridgewater State Hospital may petition for commitment on a showing of mental illness and dangerousness. A commitment order runs six months, and afterwards may be renewed for one year at a time, indefinitely.
Not guilty
The jury is not satisfied of the elements of the offense.
Release. Given the stipulation to the acts, this is not a realistic path in this case, but it remains formally available.