> But guides and hotel staff ... tell them they are at risk of dying, that only immediate evacuation will save them.

I got Acute Mountain Sickness at just 11k feet. Headache, nausea, dizziness, fatigue. I passed out until hitting the ground woke me up. I was very disoriented and vulnerable. If someone had told me that I had to get to a hospital or I'd die they could have led me like a tame goat. And they could be right. If you have high-altitude cerebral or pulmonary edema it is life threatening.

A guide getting a kickback can make it a lot more likely just by cutting short the boring acclimatization time.

Ya that was a very serious situation for you. I knew when my dad was barely able to stand but insisted we hike the 1000ft back up to then get back down it was also serious. But when we got home I read how deadly altitude sickness is.