Wearing a BC which holds no air and is taking on water in 5-ft seas is not going to feel good. If the diver is low on air, does not have a snorkel on their mask and is tired from the dive and is without a buddy nearby and is contemplating dropping lead, then there is really very little question about what to do.
If a diver is in a situation where dropping lead will not cause some type of significant problem (for example an uncontrolled ascent) and is considering that option, then decisive action should not be delayed.
Problems at the surface when it is rough can spiral out of control in one instant if the diver inhales even a tiny amount of water and their throat locks up. This is one reason why removing the regulator and calling for help or notifying someone on the boat that you are having an issue can cause a serious problem. Should a diver delay immediately dropping lead in this type of situation, their future ability to do so (and function in a logical and effective manner) can be completely lost.
Sometimes I doubt that some people who make comments about the benefits of being "theoretically" neutral at the surface have ever been caught in a washing machine situation, behind a boat with their regulator out of their mouth.
Having trouble at the surface is often significantly more complex, dynamic and actually dangerous than dealing with a situation when submerged 20 feet. The psychological stress of being slammed around, waves breaking over your mouth, face and head can be significant. The diver (at least temporarily and repeatedly ) is losing the ability to see, hear and control their position and attitude in the water and if they decide to spit the regulator it can spiral downward in an instant. Even having a breaking wave loosen and partially flood a mask can be the straw that breaks the camel's back.
Of course if you are totally calm, not winded, in good shape and comfortable in rough conditions, then it might not be a big deal, but for most people, you throw in a leg cramp on top of all this and "Houston, we have a problem".
I think it is so important that people be mentally prepared and are physically capable of dropping lead if/when they THINK they need to. I hear people constantly repeating comforting phrases like "anyone can call a dive for any reason" - which is NOT really true if you are a dive professional BTW, yet seem hesitant to acknowledge some of the benefits of dropping lead.