Publicizing how strongly you believe an accusation that is obviously true signals nothing. Only controversial things get spread. A rape allegation will only be spread if it’s dubious enough to split people in half along lines corresponding to identity politics. This is why so much coverage [on rape allegations] focuses on the proposal that all accused rapists should be treated as guilty until proven innocent.

The Old World contains Rome and China. The New World contains Aztecs. Rome and China are very close to each other. Now what happens [if this was a game of Civilization V]?

Rome and China spend the Stone, Bronze, and Iron Ages hacking each other to bits. Aztecs spend those Ages building cities, researching technologies, and building unique Wonders of the World that provide powerful bonuses. In 1492, they discover Galleons and start crossing the ocean. The powerful and advanced Aztec empire crushes the exhausted axe-wielding Romans and Chinese.

This is another story about slack. The Aztecs had it – they were under no competitive pressure to do things that paid off next turn. The Romans and Chinese didn’t – they had to be at the top of their game every single turn, or their neighbor would conquer them. If there was an option that made you 10% weaker next turn in exchange for making you 100% stronger ten turns down the line, the Aztecs could take it without a second thought; the Romans and Chinese would probably have to pass.

Our attitudes toward people with marginal conditions mainly reflect a deontologist libertarian (libertarian as in “free will”, not as in “against government”) model of blame. In this concept, people make decisions using their free will, a spiritual entity operating free from biology or circumstance. People who make good decisions are intrinsically good people and deserve good treatment; people who make bad decisions are intrinsically bad people and deserve bad treatment.

But people who make bad decisions for reasons that are outside of their free will may not be intrinsically bad people, and may therefore be absolved from deserving bad treatment. For example, if a normally peaceful person has a brain tumor that affects areas involved in fear and aggression, they go on a crazy killing spree, and then they have their brain tumor removed and become a peaceful person again, many people would be willing to accept that the killing spree does not reflect negatively on them or open them up to deserving bad treatment, since it had biological and not spiritual causes.

Under this model, deciding whether a condition is biological or spiritual becomes very important, and the rationale for worrying over whether something “is a real disease” or not is plain to see. Without figuring out this extremely difficult question, we are at risk of either blaming people for things they don’t deserve, or else letting them off the hook when they commit a sin, both of which, to libertarian deontologists, would be terrible things. But determining whether marginal conditions like depression have a spiritual or biological cause is difficult, and no one knows how to do it reliably.