It's a philosophical argument. There's a great Radiolab about this (if you can tolerate their banter). Man is acting weird and offensive. People treat him as you'd expect. Then it is discovered that he has a tumor that is causing his behavior. Now he receives sympathy and treatment.

The point being that we all have different brain configurations which cause our behavior. Some we call tumors. Others are "normal". Your definition of "medical needs" is where the interesting meta-discussion takes place.