Fort Leavenworth ? An Army sergeant accused of fatally shooting five service members at a combat stress clinic in Iraq does not deserve the death penalty, a defense attorney said Thursday, arguing his client’s actions could not have been premeditated because of his deteriorating mental health.

Sgt. John Russell, 46, is accused of carrying out the deadliest act of soldier-on-soldier violence in the war in Iraq as he was nearing the end of his third tour in 2009. He’s been charged with five counts of premeditated murder, two counts of attempted premeditated murder and one count of assault, and the government wants to pursue his prosecution as a capital case.

The Army concluded a four-day hearing Thursday on whether Russell should face a court martial. The presiding officer will recommend whether a trial should go forward or whether the charges should be modified or dismissed.

Russell’s attorneys have used testimony to suggest that he was under stress from multiple deployments and frustrated with what they have described as inadequate mental health treatment. One of them, Capt. Larris Hutton, said during closing arguments that Russell’s mind “was cracking, and it cracked and cracked again.”

“Sergeant Russell didn’t calculate. Sergeant Russell didn’t evaluate. Sergeant Russell didn’t premeditate,” Hutton said.

Government attorneys sought to show that whatever stress he faced, Russell remained coherent enough just before the shootings in May 2009 to reflect on his actions.

“There’s no doubt that Sergeant Russell murdered five people,” said one of the prosecuting attorneys, Capt. Patrick Scudieri. “He went down to the combat stress clinic, where he knew everyone in that clinic was unarmed.”

Killed in the shooting were Navy Cmdr. Charles Springle, 52, of Wilmington, N.C., and four Army service members: Pfc. Michael Edward Yates Jr., 19, of Federalsburg, Md.; Dr. Matthew Houseal, of Amarillo, Texas; Sgt. Christian E. Bueno-Galdos, 25, of Paterson, N.J.; and Spc. Jacob D. Barton, 20, of Lenox, Mo.

Russell’s case has raised questions about the mental problems for soldiers caused by repeated tours of duty in Iraq and Afghanistan and whether the Army’s mental health care is adequate. The case led to an investigation and a critical report.

Scudieri said defense attorneys are trying to pin blame on the people Russell encountered at Camp Liberty, outside Baghdad.

“The only person to blame for these five, cold-blooded murders is seated three seats behind me,” Scudieri said, referring to Russell.

Hutton said defense attorneys are not dismissing the seriousness of Russell’s actions, nor the scope of the tragedy or the loss to the other service members’ families. But, Hutton said, Russell was “wounded,” needed immediate help and did not get the assistance he needed.

“He had a fragile mind,” Hutton said.

Witnesses on Thursday included Capt. David Vasquez, the second in command of Russell’s unit, the 54th Engineer Battalion, based in Bamberg, Germany. He said Russell was upset the day before the shootings and again on the morning of the shootings, when he looked as though he had not slept.

“He was just rambling on about how we all had just given up on him and didn’t like him at all,” Vasquez said, testifying by phone from Afghanistan.

But during cross-examination by Scudieri, Vasquez acknowledged that Russell was coherent.

“I could understand him,” he said.