For me it’s not about refactoring—a global rename is a global rename—it’s about ease of reading. When I see __MODULE__ I immediately think “local.” Seeing a fully-qualified self-referencing module name always causes a bit of a jarring pause where I have to go and confirm that it is indeed referencing itself. This is indeed on the minor end of readability issues and is not a hill I’d die on. I do, however, vehemently disagree with the advice in that guide to use an alias if you want “a prettier name” 
If it weren’t for the few legitimate uses cases it has, I wouldn’t be upset if the :as option for alias were removed from the language.
