But does insanity imply safe? My understanding is that it just implies a different course of action. Maybe we differ but I do more trust that decision to be made as a medical one, perhaps with layers of oversight or committee approval, than anything else.

To me the idea of denying this in a judicial setting even as a possibility is absurd. Maybe I misread it, but I thought the piece was arguing against the broader rationales about grounds rather than anything about the disposition of the particular case per se.