In a use case like this, AI would be less about a final diagnose and more about getting the doctor or patient pointed in the right direction, especially with rare cases that few doctors are aware of. You no longer need to visit a hundred specialists in the hope of finding the one person who's seen something similar to your case before.
Correctly implemented, a block system would allow them to see your comments but not reply. I think that's essentially the major part of what you're looking for?
What are you talking about? Nobody's disputing that. You seem to have lost the thread of the conversation, which is about preventing people you've blocked from seeing your posts. At that point you're not cutting BS out of your stuff, but other people's.
This approach is incredibly open to abuse. Reddit implemented this to a lesser degree and abuse already started happening. By blocking everybody who disagrees with you, you can start threads that are only visible to lurkers and your supporters, creating a warped perception of public opinion and false consensus.
nobody can respect that others are allowed to have different opinions.
It's the paradox of tolerance social contract. I will respect their right to an opinion as long as they uphold that contract. Unfortunately, many don't.
Or maybe there are already instances out there that don't defederate and leave it up to the individual?
It only takes one to defederate. Any large instances that stay neutral will eventually be defederated with by other instances, as per the beehaw example recently. So your best option would indeed be to host your own small instance.
I have to say that there's a level of irony in asking for bans and central controls on content on a platform that in its very nature decentralized and supposed to be empowering.
There isn't any irony. That's the whole point of the decentralization - it empowers everybody to be part of the communities they wish to be in, and not participate in those they disagree with. We have the power to leave any instance where we disagree with the admins and move to a new one.
Satire doesn't work as well on fedi when everybody has to check what instance they're on AND what instance you're posting from to figure out if you're serious