Then, MacNeill insisted on plastic surgery for his 50-year-old wife and pushed through despite her reservations about high blood pressure and wanting to lose weight.
McVey further detailed that MacNeill had overmedicated his wife the day after she was released from the hospital, rendering her unconscious for nearly an entire day.
Then, on April 11, 2007, the day Michele MacNeill's body was found, MacNeill insisted he couldn't lift the 182-pound woman out of the bathtub because he was too weak from an illness, and when Kristi Daniels, a neighbor, came to help, he insisted on a "man's help."
"It's perplexing why he wouldn't let Mrs. Daniels help him," McVey said.
Then, once Michele MacNeill had been taken to American Fork Hospital, McVey said MacNeill made the "strange request" of offering the emergency physician $10,000 to stop resuscitation efforts, the judge noted.
"Perhaps evidence of a guilty mind might be the influence there," McVey said.
And once his wife had been declared dead, MacNeill cleaned up the area where his wife was found, disposing of medications and getting rid of stuffed animals and a medical bed his wife had used.
"This cleanup of the scene ... you think being a doctor that he would have kept the medications," McVey said. "That's all evidence of a guilty mind."
McVey's decision came at the end of a six-day preliminary hearing for MacNeill, who was charged in August with first-degree felony murder and second-degree felony obstruction of justice in the death of Michele MacNeill.
Prosecutors allege MacNeill gave his wife a deadly mixture of prescription drugs to free himself to continue an extramarital affair with another woman, Gypsy Jyll Willis, now 36.
Alexis Somers, Martin MacNeill's adult daughter, left the courtroom in tears Thursday, saying that her family was "so happy" with the judge's decision.
"My mother deserves to be fought for," she said. "It's just a big relief because this has been such a fight."
MacNeill's defense attorneys, Susanne Gustin and Randy Spencer, said they were not surprised their client had been ordered to stand trial. They maintain their client's innocence and say they will be ready to prove it to a jury.
"He has done some bad things in life," Gustin said. "But does that make him a murderer? No."
Evidence showed that throughout his life, MacNeill falsified many documents, including transcripts he used to get into medical school and identification documents used for Willis. He pleaded guilty to identity fraud and was sentenced in 2009 to spend four years in a federal prison for using his adopted daughter's Social Security number so Willis could open bank accounts under a false name.
MacNeill also faces forcible sexual abuse and witness-tampering charges in Utah County after he allegedly put his hands down the pants of an adult relative in 2007 and then asked her to sign a statement saying he did not touch her.
Calling Willis the "nanny with benefits," Deputy Utah County Attorney Chad Grunander said during closing arguments Thursday that MacNeill had a motive to get rid of his current wife to welcome in another. Grunander said Willis and MacNeill presented themselves as a married couple after Michele MacNeill's death, even listing their wedding date on a falsified military ID application as April 14, 2007 which was the day of Michele MacNeill's funeral.
But Spencer stated in his closing argument that prosecutors were making "silly speculations" about MacNeill's behavior around the time of his wife's death. He said that there is no evidence that Michele MacNeill's death was criminal as no medical examiner has ever ruled it a homicide.
"[Prosecutors] have taken an approach to this case that started with a conclusion," Spencer said. "The conclusion being that Martin MacNeill killed Michele."
After an autopsy in 2007, Assistant Medical Examiner Maureen Frikke who died in 2008 ruled the manner of Michele MacNeill's death was "natural," the result of "chronic hypertension and myocarditis, which are capable of causing acute unexpected arrhythmia and sudden death."
But McVey said Thursday he had doubts about her report and believes Frikke may not have been as thorough as she could have been because she was battling cancer at the time.
"She was just sick," McVey said, "and didn't do a very good job."
In 2010, in a new investigative report, Chief Medical Examiner Todd Grey changed the cause of death to the combined effects of heart disease and drug toxicity. The manner of death was changed to "undetermined."
Grey said there was some evidence that Michele MacNeill may have drowned, but he did not see the microscopic findings in the lungs that indicate a drowning occurred.
However, Joshua Perper, a medical examiner from Florida asked by prosecutors to review the case, said he thought Michele MacNeill did drown. He said he believes the drugs found in her system or her pre-existing health conditions may have contributed to her death, but neither was the cause.
"In my opinion, those drugs may have contributed in some way to the death, making the person more prone to drowning or more prone to a person drowning the [victim]," he testified Wednesday.
Perper said that although he felt Michele MacNeill drowned, he still ruled the manner of death as "undetermined," because it could not be determined whether her death was accidental or homicidal.
MacNeill is expected to enter pleas to the charges on Oct. 22, at which time a trial date could be set.