The topic of who decides was in a recent ranger report from Rainier in the Alpine Clubs yearly Accidents in North America. While discussing HAPE and HACE cases they mentioned the problem of ( especially the) inexperienced parties failing to recognize the problem that they or members of their party were in. This happens with hypothermia , as well as altitude-only issues. Dull brains. I do not mean only insufficient knowledge or experience to begin with , but a separate functional inability brought on by the hypoxia, hypothermia or whatever. Again, my term dull brains. The other problem arises when that person has enough "personality" left to reject your help.