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Giffords stands by as husband speaks to shooter

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Some victims, including Giffords, welcomed the plea deal as a way to move on. It spared victims and their families from having to go through a potentially lengthy and traumatic trial and locks up the defendant for life.

Christina Pietz, the court-appointed psychologist who treated Loughner, had warned that although Loughner was competent to plead guilty, he remained severely mentally ill and his condition could deteriorate under the stress of a trial.

When Loughner first arrived at a Missouri prison facility for treatment, he was convinced Giffords was dead, even though he was shown a video of the shooting. He eventually realized she was alive after he was forcibly medicated.

It's unknown whether Pima County prosecutors, who have discretion on whether to seek the death penalty against Loughner, will file state charges against him. Stephanie Coronado, a spokeswoman for Pima County Attorney Barbara LaWall, said Wednesday that no decision had been made.

It's unclear where Loughner will be sent to serve his federal sentence. He could return to a prison medical facility like the one in Springfield, Mo., where he's been treated for more than a year. Or he could end up in a prison such as the federal lockup in Florence, Colo., that houses some of the country's most notorious criminals, including Oklahoma City bombing conspirator Terry Nichols and "Unabomber" Ted Kaczynski.

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