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Is the idea here that all preferences are good? Because that's crazy. Obviously lots of people prefer to commit crimes, the fact crimes are bad doesn't mean those people are unable to chose otherwise or they have a disease. It just means they're choosing to do something bad.

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People who have had their consciousness commandeered by a flaw in their neurology can't choose anything. Without conscious control there is no choice.

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That's point. Somehow these people who supposedly have had "their consciousness commandeered by a flaw in their neurology" suddenly make different choices given the right incentives. There is no choice without conscious control, true. But that's the point. They do show control, just way after you or I would begin to behave because they prefer their behavior to the bad consequences.

What is hard for us to generally accept is why someone would behavior self-destructively. Do people actually prefer to be depressed, anxious, alcoholic, etc.? As onlookers, we can think through others situations without involving ourselves at all in the motivating feelings that are so crucial to action. It might be obvious to a everyone that a skinny guy needs to go to the gym if he wants to build muscle, but the skinny guy might prefer staying home more than doing what it takes to build muscle.

To analogize to depression, let's say that it is reasonable for a person to become depressed after being dumped. If they decide then that they find meeting new people intimidating and so cannot find another partner, how are they supposed to resolve their depression? Without change, they cannot. So functionally, they prefer depression. But if that person were offered 1 million dollars to find a partner in the next week, maybe they'd take their friends' advice and get their shit together.

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