Google clearly has the AI know-how to label when videos are important medical videos. They could skip ads and skip forced sign-in, but they don't care enough. There was a viral tweet once about somebody's grandma choking on a fishbone where YouTube responded telling them to buy YouTube Premium, so they're probably aware, but don't care enough. And they're implementing more measures like the forced sign-in for scraping prevention that happen to disproportionately affect public networks at restaurants and hotels. That's negligence.
Why's it so unreasonable?
https://support.google.com/youtube/answer/2475463?hl=en "YouTube may also place ads on videos in channels not in the YouTube Partner Program."
If you become eligible and join the YouTube partner program I believe there may be a toggle then, but for non partners it's completely up to YouTube.
And the forced sign-in of course never was controllable by creators.
YouTube is the most creator friendly social media platform that exists now. Creators choose when to include ads and receive a large amount of the revenue.
[0] https://i.imgur.com/8SDKRkZ.png