Appendix E - Permanent Human-Judgment Boundary Policy Template
This appendix provides the template for the permanent human-judgment boundary policy referenced in Chapter 20: The Escalation Surface. One policy document should exist per domain in which the organization deploys consequential automation. The policy governs all executors in that domain and is the authoritative source for governance-based escalation categories across all authority grants in the domain.
The policy is a model-level decision instrument. It is set and revised at the CTO and executive level, not through the recalibration process. Filing it in the ACG governance library and referencing it in every authority grant scope boundaries field is what makes the permanent boundary visible, consistent, and defensible.
Part 1 — Policy Header
Complete once per domain. This section establishes who set the policy, at what level, and how it can be revised.
| Domain | Name of the decision domain this policy governs — e.g. Consumer credit decisions, Clinical triage, Employment screening |
|---|---|
| Policy reference | Unique identifier for this policy — e.g. CC-PHJB-001 |
| Policy version | Version number and date — increment with each revision |
| Policy set by | Named CTO and domain executive who jointly established this policy |
| Organizational level | The level at which this policy was set and at which revisions must be approved |
| Review cadence | How often the policy is reviewed regardless of trigger events — e.g. Annual |
| Scope | Which executors are governed by this policy — e.g. All executors authorized to make [domain] decisions, regardless of executor type or execution mode |
| Revision process | The specific steps required to revise this policy: who must approve, what documentation is required, who is notified, what timeline applies to governance owner updates, and how revisions are distinguished from recalibrations |
| ACG library ref. | Reference number in ACG governance library |
Part 2 — Decision Classes Requiring Permanent Human Judgment
Complete one row per decision class. Add rows as needed. There is no correct number — the list should reflect all decisions in this domain where the organization has determined that human judgment must be present as a matter of policy, not capability.
| Decision class | Criterion | Boundary definition | Capability exception |
|---|---|---|---|
Decision class Name and description of decisions requiring permanent human judgment | Criterion Irreversible consequence / Human accountability required / Regulatory mandate / Precedent-setting | Boundary definition Specific conditions that trigger human review — in organizational consequence terms | Capability exception The specific condition under which this boundary may be reviewed for policy revision — or 'None' |
Decision class Name and description of decisions requiring permanent human judgment | Criterion Irreversible consequence / Human accountability required / Regulatory mandate / Precedent-setting | Boundary definition Specific conditions that trigger human review — in organizational consequence terms | Capability exception The specific condition under which this boundary may be reviewed for policy revision — or 'None' |
Decision class Name and description of decisions requiring permanent human judgment | Criterion Irreversible consequence / Human accountability required / Regulatory mandate / Precedent-setting | Boundary definition Specific conditions that trigger human review — in organizational consequence terms | Capability exception The specific condition under which this boundary may be reviewed for policy revision — or 'None' |
Decision class Name and description of decisions requiring permanent human judgment | Criterion Irreversible consequence / Human accountability required / Regulatory mandate / Precedent-setting | Boundary definition Specific conditions that trigger human review — in organizational consequence terms | Capability exception The specific condition under which this boundary may be reviewed for policy revision — or 'None' |