Since Psychopathy and Sociopathy are ranges rather than absolutes, it's estimated that about 4% of humans are Psychopaths or Sociopaths and we're talking about the what's basically the handful of people in a universe of over 300 million who seeks and achieves positions at the top of the Power Duopoly in the US in a domain well know for it's cut-throating and backstabbing, I would say that the odds heavily favour the explanation of them being very high on the Sociopath (or Psychopath) - so called "well adjusted Sociopaths" - spectrum than them being normal people who are "relaxed about personally enabling the murder of tens of thousands of children".

The image of a Sociopaths or Psychopath who actively seeks to inflict horrible pain on others for their own pleasure is incredibly atypical and Hollywoodesque - being high on those scales just means having no empathy for others, including their suffering or joy, and the result is that a Sociopath or Psychopath simply does that which they think is better for themselves and they can get away with (they care about the consequences for themselves, not for others), with absolutely no consideration for how that makes others feel, hence harm or even death of others is fine since that has the same emotional resonance for them as breaking an inanimate object.