Yes, he is a documented malignant narcissist with sadistic tendencies--well known.
But, he likewise has evidence of a loss of filter--that which gave him excuse for all kinds of disgusting behavior in the past. That loss of self-filter is, along with many other aspects of his behavior and neurological presentation (gait issues (ataxia), intermittent facial droop and paresis on the right, frequent use of made-up words (or real ones) that sound like another (paraphasia), increasingly simplistic language overall and many other aspects, are not only documented but worsening.
Ignorant? (and willfully so?) Check
Malignant Narcissist? Check
Power obsessed? Check
Sadistic tendencies? Check
Progressive neurological dysfunction? Check
Simplistic cognitive function? Check
Does this mean he is not acting willfully and purposely--at least in general? Hell no. But, there is a lot going on with his pathology beyond him just being a disgusting and willfully nasty human being.
No simplistic dichotomies, please. We are smarter and far more analytic than that--whoever the hell D. Earl Stephens is.