"The man in the story is obvioulsy ill."

Are you living in "The Least Convenient of Possible Worlds"? It is surely conceivable that the man rationally considered his alternatives, and decided that the best thing he could do for the world was to kill himself and give the money from the life insurance policy to charity. Sure, it's also possible that he was ill, and then the story changes, but that's not what the story says. Or do you think thought experiments are inherently irresponsible?

Assume that he is, indeed, suffering from depression, and attempts to treat it have not been particularly successful. Does that make a difference?