As I stated, the pitcher’s intent is irrelevant. All that matters is the result: if the ball hits the skull, the penalty is automatic.
Players being seriously injured by a pitch are extremely rare. There is a better chance of serious injury being hit by a line drive since the fielders aren't wearing helmets.
Being an official at the higher of highest level in theee sports I have become impressed at how great athletes can literally move in ways to thwart the system. I have zero doubt that a major league pitcher hirs the spot he throws at. If someone get plunked on the head it probably was intentional. But I also have no doubt that so batter would find a way to take one on the noggin a la happy Gilmore in the batting cage to book four bases.
My question — did someone get decapitated today that brings this subject up?