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No one feels like they're selfish

Why do people break up with cocaine addicts? Or alcoholics?
When it comes to the final showdown and their partner walks out (if the addict is awake and aware), if they are told "I'm leaving because you love to snort more than you love me" what do these addicts feel like? Do they feel like "yeah"? No. They say, oh, it's a problem I'm dealing with (addiction is a psychiatrically recognised condition), of course I love you.
But why is that untrue? Because when people introspect, they never find themselves selfish, or loving cocaine more than their loved ones. Which is why this level of introspection is useless, actions speak the facts loud and clear.

Some people have kids, some have mentally disabled children, some have a bad back, some have diabetes, some have phobias. Everyone has issues in their lives.
When people apply for a job, there's always one question in the application form, "Do you have any personal conditions or illnesses that might affect your work?" If people have a kid who needs dropping off at school and can't have transport arranged, they shouldn't agree to being at work at 7 am. If they do, is there a difference between the lie they have told "I will be at work at 7am" and the person who goes out clubbing and is hungover and unable to wake up? No.

This is true of all relationships. If a "new" problem arises, we seek help from our colleagues/friends/family. But if a problem is becoming an issue that is going to affect us long term, no matter what the problem, we have to address it and inform others about how it's likely to affect us. If we don't that means we value our "need to avoid addressing the issue" more than we value others' need to know what they're doing with their lives.

The most fundamental sin in Islamic tradition is self-worship, or selfishness. The most fundamental deadly sin in Christian tradition is pride. The five cardinal sins of Buddhism are killing one's parents, harming/killing spiritual teachers and creating schism in society.
They all refer to the root of all evil, that "I" matter more than "you". That my "life" is more valuable. My "race" is more valuable etc.

People never feel like they're selfish. The most selfish person, when asked why they do selfish things, they always find justification. But the truth is no justification is ever acceptable for an issue unless the issue was "unknowable" when arrangements were being made. As the basic ethical tenet goes: one is responsible for the predictable consequences of one's actions.

If the task is picking up something heavy (say 150 kgs.) and four people promise to do it, then none can do it because one is petite, one has muscular dystrophy, one has severe chronic back pain and one decided to get drunk the day before, they are all equally "guilty" and "selfish" to not value the task-giver's time when making the promise.
Having a medical condition, does not justify selfishness. If one can't do a task, for any reason, they have to make it crystal clear. If they don't, it doesn't matter what the reason is. As long as the issue was foreseeable/predictable, it's their fault. And it is the person's responsibility when making an agreement with anyone, to make clear exactly what their limitations are.

When one does a bad deed such as breaking an agreement, their inability to do what they promised at the time is never excused by the severity of their issue. If a surgeon knows he faints if he hasn't drunk enough water and doesn't drink and goes into theatre and causes someone's death, he's committed manslaughter. Just like a drunk driver.

When new issues arise in our lives, we help our families/friends/colleagues when they need a helping hand. It's part of being moral, to treat others as we would like to be treated ourselves.

Evil people don't exist, people who do bad things do. Some do it because they can't stop the urge to enjoy/do something even though it harms others, some do it because they have been damaged psychologically and prefer doing the bad deed to quench some form of desire or aversion from phobia.
When anyone does anything bad, it is very hard to admit they have been selfish. The knee jerk reaction is to bring up the excuse. It takes courage and honesty to face one's selfishness and addressing it. But again, admitting this defies pride which is why few people are able to do.

Ethical people overcome their selfishness and value other people as much as themselves. Saints, those who value all others more than themselves, are a different story. A story that is trite to say, but life changing to behold.