Ok. I presume there is a way of determining which it is but obviously we cannot judge from here.
Of course not. I am merely offering my personal opinion/judgement, based on both public and private interactions with him, that he probably
does have the ability to change, but chooses not to.
Well, I suppose that is true but if they choose not to then they can't (choose not to), can they?
I'm not quite sure what you're saying but, since we actually seem to agree, I suspect it's another confusion resulting from the (my) words!
Is there a difference (and is it quantifiable) between someone with tourette's and someone who just shouts "f**k" every now and then?
As I wrote earlier, it is difficult (impossible) to define borderlines in these situations. You could just as easily ask the same thing about physical things - the diagnosis of things like diabetes, hypertension, obesity etc. are based on at least partially arbitrary borderlines in things (blood sugar, blood presser, weight/BMI in thsoe cases) which show fairly wide variation throughout the population, including those regarded as 'normal'/not-diseased.
I suppose it's like when serial killers are judged not to be insane - but is the judgement correct?
Exactly, these things are all judg(e)ments [**]. At the extremes, there's clearly a difference between someone who commits repeated murders in order, say, to further their criminal 'career' (e.g. 'disposing of competitors'!) and another who commits repeated murders because 'voices are telling them to' and who do not understand that killing is wrong. However, somewhere between those extremes is a big grey area - and neither individuals nor Courts are ever going to be in complete agreement about that.
[** since words seem to be a topic close to your heart, this is an interesting. In terms of everyday English, "judgement" has an 'e' in the middle - but I understand that Court "judgments" do not! It's therefore not absolutely clear as to what spelling you should have used
]
Kind Regards, John