It's difficult for me to respect/worship a god that would allow such permanent torment.
If it was caused by a tumor, is he awarded a Get Out of Hell Free pass? What about influences of childhood?
I have no trouble worshiping a God who allows people to choose, and who has since he created them.
If you are given a choice to get on a boat and leave an island on fire, but decide not to board, whose fault is that? The boat's? The Island's? Or yours?
The reason I said it is left to a higher Judge is just the concept that there may have been some factor such as a brain tumor rather than some intellectual, spiritual, or other decision on his part. Obviously we don't know what motivated this guy, we don't know him even superficially, much less what was going on inside his brain.
Don't we give those who are non compos mentis a reprieve from their guilt because they are not in their right mind? I would think that our Creator would make allowances for such malfunctions.