I've had an interesting email exchange with a reader that led to me writing this response regarding God's judgment:
A developmentally disabled person is not going to face the same judgment that you and I will, and so a true psychopath that is constitutionally incapable of differentiating between right and wrong would face a criteria that would take into account his ability or inability to make decisions. I don't know enough to say that a psychopath can be entirely held blameless, but we can also take another factor into account.
The Orthodox Church specifies that the Last Judgment occurs at a much later point than death, and that death itself is a process in which the conscience is examined without the salves we generally use to avoid reconciling with our consciences. However, the ultimate governing factor is whether a psychopath, released from his suffering flesh that has impaired his decision-making (that's how we define organic mental disorders), would accept or reject eternity in Christ once he is restored to wholeness.
There are plenty of organic problems that can impair function in this life, but the General Resurrection assumes that one is whole and restored... and so this is the real matter. Would you want to be whole and perfected in the presence of the Almighty? That's why we should always withhold our condemnation of others, because that's not an easy question for anyone.
Now, the respondent (who made a lot of very good points in our discussion) was asking about how God judges us. If we are going to examine our consciences in the process of recovery, and use the notion of being 'weighed' by God, how will we know He is fair? He will, as Christ teaches, reward us for our deeds, as St. Peter wrote,
And if you invoke as Father him who judges each one impartially according to his deeds, conduct yourselves with fear throughout the time of your exile. (1Pe 1:17)
What is this fear? Well, the 'fear' that Christ taught was not about moral perfection, but rather humility and reticence to condemn others. If we refuse to condemn others, should we also be hesitant about condemning God for being unjust when we are not sure what He will do?
Even if we think He is unfair, would it matter? No, there is nothing we could do about it. However, we should also remember that God is, first and foremost, the God Who is Love. We are measured by His love and judged by how we respond to it in our condition.
Ultimately, God gives us an easy out on our sins, called 'repentance.' If we drop the sins and embrace Him, then we can enjoy profound blessings. In fact, He even gives us the gift FIRST... we are resurrected, then judged. It is like the offer companies make, "Try it for free, and if you don't like it, send it back." Of course, we cannot really 'send back' the resurrection, and so the eternal torment really is a rejection of being resurrected.
But if we ultimately encounter God in the resurrection, without all the biological and situational problems we now face, especially those that drove us to make bad decisions (like a biological psychopath, let's say, or someone with a brain condition that made him violent), here we are still given an opportunity to repent.
In the parable of the Judgement in Matthew 25, the 'goats' do not repent, but rather make an excuse (as in "Gee, when did we see You hungry or thirsty or naked...?"). Those who are 'sheep' also give the same response, but it is one of humility because they actually did these things. If we repent and say, "Yes, I am guilty and I should have done these things because I had been warned and did nothing," or we say, "Yes, I did none of these things and I am sorry," then we have truly repented. God can and will accept this repentance. Had the goats said, "Have mercy on us!" then they would no longer be goats.
Now, some will argue, "But, the dead cannot repent." The question is, if you are resurrected at the general resurrection, are you still dead? It is true that the Old Testament teaches the dead are cut off from God and cannot repent, but the resurrected are alive (c.f. Mark 12:26-27), as are those who are at rest with Him. Otherwise, how could He say to the thief, "Truly, I say to you, today you will be with me in Paradise." Is death Paradise, or can Paradise be a place without prayer to God? Of course not!
The dead cannot repent, but those who die are not condemned to remain as such. They can choose to emerge from Hades by following Christ, even if they have great sins, so long as they want to with their true, complete will.
This is why the general resurrection must take place first, so that all those who would have otherwise not done what they did in this broken life may have that one experience of unimpeded life to finally repent. In any other court, a man may change his plea before he is sentenced, and the same is true of this court.
So, when we examine our consciences, we must take into account that God's love and forgiveness are greater than our sins. He loves and forgives even the worst offender, because He will give justice to those we wronged through the resurrection and eternal blessings if those we wronged will receive these things from Him.
God is not less merciful than us, but more so. He will not hold accountable those who did evil in a way that they could not control, because He even lets us off the hook when we do these things with full knowledge! We are not judged by our impaired selves, but our true selves that is often obscured by pain and fallenness. We are judged by our resurrected life and will, made whole and complete.
With it, we can indeed make the final decision to repent or not. The ultimate judgment of our deeds is not necessarily of our sins, but our willingness to repent. If we were measured without this, then all of us are goats.