During the “A Most Extraordinary Specimen” Companion side quest in The Outer Worlds 2, you’ll have the objective to confront Grafting Doctor Giles Rasmussen. You’ll be faced with the option to either kill the Grafting Doctor, or spare him and take him back to Ethel’s Lab to continue research on the Graft. Here are the consequences for choosing both options, and the rewards you obtain during this side quest in The Outer Worlds 2.
What Happens if You Kill the Grafting Doctor?

If you choose to kill Grafting Doctor Giles Rasmussen, you’ll obtain one Augmentation Device, the Mechanical Augmentation, and Inez will be satisfied. With this route, you’ll get only one Augmentation Device. However, Inez will be happy with this decision since the quest is about confronting the Grafting Doctor for the crimes he committed.
Before you get the option to either kill or spare the Grafting Doctor, you’ll need to speak with him, which will begin the confrontation between him and Inez. You’ll find out that the Doctor was conducting grafting experiments on creatures, as well as Inez’s close friend, Trooper Ortiz, which led to him being killed due to his body rejecting the grafting process.
Inez will further pressure him on the ones the Doctor killed for the Grafting Program, and how he extracted data out of the people and the creatures who died during the Grafting process. At the end of the conversation, the Doctor will try to bribe Inez and offer her state of the art Grafting Parts in exchange for sparing his life. Inez will begin second-guessing her plan to kill the Doctor, and ask you if his work is truly worth saving.
Inez will want to spare the Grafting Doctor’s life to continue his research for the greater good, instead of exacting revenge for what he did to Ortiz so that she can be accepted at Auntie’s Choice again. Pick the “This is a personal choice, Inez. I’ll support whatever you decide.” dialogue option to kill the Grafting Doctor.
Inez will shoot the Doctor in his head, and you’ll be tasked with heading back to Ethel’s Lab at the Fairfields. Talk to Doctor Ethel Tinsley there to install the Mechanic Augmentation for Inez, and end the “A Most Extraordinary Specimen” companion quest in The Outer Worlds 2..
What Happens if You Spare the Grafting Doctor?

If you spare the Grafting Doctor, you’ll obtain two Grafts: the Mantiqueen Grafting Part and the Ursopod Grafting Part, out of which you can choose one to install on Inez. You need to have Speech Level 17 to choose this option. Inez will be satisfied with this choice as well, since she can now research to save more lives with the Doctor and Tinsley at Fairfields in The Outer Worlds 2.
At the end of the conversation with the Grafting Doctor and Inez, pick the “You can set the terms, Inez. If things work out, so many lives can be saved.” dialogue option to spare the Doctor. Make sure you have Speech Level 17; otherwise, this dialogue choice will be locked. Once you’re done with the conversation, return to Ethel’s Lab at the Fairfields to install either of the Grafts, and the side quest.
Best Choice: Spare the Grafting Doctor instead of killing him. This will allow Inez to save many more lives and avenge Ortiz in the process, and you’ll obtain two Grafts for free. Out of the two Grafts, you can choose only one to install on Inez. With this route, Inez will be happy and have a shot at redemption, and you’ll get more rewards, which makes this the best option.
That’s all you need to know about killing or sparing the Grafting Doctor in The Outer Worlds 2. For more comprehensive guides on Obsidian’s vast and dense RPG, check out the ones on How to Resolve the Personality Crisis and All Excogitation Audio Logs Guide.

