Subverted in Infamous, where despite the myriad of powers Cole has at that point in the game, he either can't think up or doesn't take a Third Option, and chooses either the six doctors or Trish in a Karma Moment. This Karma Moment could count as an Aversion instead though, because Trish dies no matter what you do - if you pick the 'wrong' / Bad Karma choice, the Trish you save turns out to be a decoy and the real Trish was among the six doctors you failed to save.