Choice or Sickness: The Morality Debate

That's a really tough question. I think intention does matter. But I know we're all limited by our neurobiology, so our actions might come across different than we intended. It's really hard to know if someone is intending harm or selfishness, or if they can't help it appearing that way. But then in a relationship scenario, people tell me intention doesn't matter if it hurts you. But isn't that discriminatory against people with neurological or mental differences?