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MixedNuts comments on Ego syntonic thoughts and values - Less Wrong
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I'm not sure what's surprising you here. You don't think John would feel more guilty if he had to beg Lisa for an antidote that she also wanted, than if Lisa said "I gave it to you this morning in your coffee, the decision was never in your hands"?
You can find more on what I think of guilt here.
As for your voice - did it sound more like an intrusive thought? Or did it sound like an external person talking, heard exactly as loudly and clearly as if it were your mother or your friend talking to you? Was it your own voice, the voice of someone you knew, or a stranger?
I'm pointing out that guilt as a signal you won't (can't) defect is made useless by having a system to remove guilt.
That one voice sounded like an intrusive thought, yeah. I get other voices of this type (thoughts in my head, and compulsion to write down things I can't (much) predict), but they don't want to grab me and direct me to do stuff, though they may advise (the most coherent ones are usually religious figures telling me religious stuff I should do; they're accompanied with emotions, usually serenity or awe). I also get regular auditory hallucinations, but if they're voices they just tend to call my name or whatever.
It's not like John is removing his own guilt for breaking Lisa's neck and taking the antidote by making himself believe that what really happened is that she actually gave it to him in his coffee and then died of poisoning. Here, guilt is removed sort of from the outside, by the society, which actually seems to make sense from the point of view of removing false (from the society's point of view) positives, while keeping all the social benefits of guilt. But, true, this mechanism can be exploited via making up imaginary friends.