This is an odd one for me... I'd only just realised a connection to some real life examples in my profession.
The most recent was a guy who'd killed someone in a nursing home accidently. It's very different case, no experimental drugs involved, but he had mental problems which made him lose control and accidentally kill someone. He wasn't charged as he wasn't under control of his faculties and wasn't able to stop himself.
Another, more extreme case, was a guy who killed his family two years ago. A very pleasant man by all accounts, but over the years he had become heavily brain damaged to the point where he was paranoid and delusional. He killed his wife, child and them - possibly out of remorse, but we'll never know for sure - killed himself the following day.
Ever since then the fandom was split into two camps. One who'd disown him for being an evil man who did an evil thing. However I'm with the side who believes he wasn't an evil man and while he'd done something unforgivable I place the blame for those who were responsable for his health and pushed him into positions that caused the brain damage and used him to the point where he was no longer in control of himself.
I feel there that the fault was with those that caused his medica state. Much like Garak in this episode, the fault lies with the drug that altered him and made him lose control. In every day life he wouldn't go around killing people for sport, he's a very controlled individual. And thats the difference. For me at least...