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Possible failure modes of Public Universal Friendship

(Minor spoilers for Time to Orbit: Unknown. If I haven't said, it's really good and worth a read.)

Time to Orbit: Unknown features a doctor who's a Public Universal Friend. He's volunteered for surgery to cause brain damage so that he no longer feels attachment to specific other people. The intention is for them to act truly in the service of "the greater good" and, roughly speaking, always choose the greater number of lives saved in a trolley problem, to always act in other people's long-term and big-picture best interest. They only undergo this surgery voluntarily* and only after years of hard training with their organization.

(*As the story points out, it's ambiguous how how to interpret "volunteering" here—most people including the protagonist see the Public Universal Friends as a cult. Can you really call it volunteering if a proto-Friend has been cut off from friends and family and everyone who might support them or who might think this surgery is a bad idea? That's all real and true but separate from what I'm wondering about today.)

We haven't directly seen it, but this seems like this specific approach to brain damage should have some failure modes:

  1. You might get a Friend who is committed to the idea that people are better off dead or not born. How they behave will probably not match up with the ideals we expect a Friend to act on.
  2. The Friend can cut off their attachment to specific other people, but they cannot cut off other people's attachment to them.

The latter point is especially clear with this story. Aspen, the protagonist, cares about the doctor Friend. I care about the doctor Friend. Other members of the crew I think also care about the doctor Friend. If he died, they would be upset. From a Friendly perspective this isn't a direct problem, but it might affect their ability to keep up the ship and endanger the colonists and crew that way. In the early arcs/chapters, at least, the doctor Friend doesn't seem ready to factor this into their thinking.

I wonder if that counts as a failure mode of the Public Universal Friend surgery—that they have a hard time connecting to and understanding the public that they serve and work with in service.