1. If the word morality means anything, and health and well-being, sickness and suffering are things that can be quantified, then all one has to do, is look at the circumstances to judge. The only problem that we are faced with when making moral decisions is information.
Example, would it be immoral for me to cut off your hand? most people might answer yes, but some might say, "well that depends". So if you were bit by a snake, and you believed that it's venom would kill you if you didn't cut off your hand and you asked me to cut it off, would that be immoral? If you believe that intention matters, then if my intention is to save your life is my causing you suffering in order to prevent an even greater suffering immoral?
Now I take you to a doctor. I show the doc a pic of the snake that bit you and he tells us that the snake wasn't poisonous, is what I did, immoral in light of new information?
The point is a simple one, the problem of morality is that that almost any action can be deemed moral in the right context, the problem is always one of information.
So in order to determine the right or wrong of a situation we have to know the context of the situation that the people in it understood. Now that doesn't forgive outright ignorance. If you do something and you had an obligation to understand it and you chose not to, and it lead to the harm of others, that would, in most cases I can think of, be immoral.
What about people that derive pleasure from hurting themselves? Who am I to say that they are wrong. Again, if hurt and pain have any meaning, it's because they can lead to bad outcomes. if you subjectively feel pleasure causing yourself harm, than you are objectively causing yourself harm, then it is immoral.
Again, the same goes for someone deriving pleasure from causing others pain, logically, we prefer to avoid pain more than we wish to experience pleasure. My evidence? If a woman has a husband who treats her like a queen 29 days out of each month and spend the other day beating her for the entire day, would she call that "good"? Most healthy people would say no. There is plenty of evidence that demonstrates that avoiding pain is preferable to experiencing happiness, so my avoiding pain trumps another persons experiencing pleasure at my expense (again generally speaking)
You can ask who am I to say that these ideas are true. I would simply respond, that if the word moral, happiness and suffering have any meaning, the evidence to its truth speaks for itself independent of what I think about it.