I know a lad with Aspbergers who is naturally empathetic.
Have you discussed this with your GP. It sounds as if he needs assessing - although I can't quit eunderstand how he has got to this age without any assessments. All these things would have sent out warning signals at school. The reading/spelling thing, together with poor handwriting could well indicate dyslexia. Has he had no help with diagnosis and ungoing support from the hospitals he has been in?
He needs to get professional help, and the first port of call would be his GP.