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I feel that Mac was institutionalized by civil commitment. If he had not gone to the ward he would have been in prison. He was not acquitted for his crimes, he was sentenced to a work farm and they thought he may be faking that he was insane.
3. McMurphy's (Mac) behaviors do not seem to be symptoms of insanity. The case of Durham vs. United States held that "the accused is not criminally responsible if his unlawful act was the product of mental disease or mental defect". Mac was trying to get out of the work farm by acting out and convincing the staff that he was insane. Once he was brought to the ward it was determined by the doctors and Nurse Ratched that he was not insane, but could be dangerous...
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