We have decided some brain quirks are disorders (and get accommodations, as is compassionate), whilst others are flaws (and get slurs). But no one picks their hardware. You cannot earn a better prefrontal cortex or deserve a calmer amygdala. Nor does one get to pick the environment they are born in, which will inform their choices later in life. Even the capacity to “learn better” is a roll of the dice, some brains start the race with sprinting shoes, others with lead weights.
So when we call someone stupid, lazy or insane we are not describing a choice, but simply announcing which kinds of unlucky we’ve decided are worthy of scorn.
Oh but there certainly are people who wield every one of those insults against another with the intent to describe the core of their being. The difference between calling someone stupid, and calling someone’s action stupid is a vast one. I am glad you see it, but many do not.