I suppose that my question then would be, if the evil that a person does is driven by a brain defect or tumor or some such, is the person committing the acts truly doing them in order to be evil and through an engagement with being evil, or is that person split between doing the acts and regretting them and thereby not truly evil at the core. Serial killers and those who are psychotically predisposed to kill seem to me incapable of accurately assessing reality to the degree necessary for cognizance of evil as a state of being.
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