Synopsis: The Enterprise runs into a pre-warp modern civilization thats already had a bit of contact that beg them for medical help. There's another more primitive race as well who are rapidly evolving and are being patronised/stifled by the older race. Phlox figures out that they are at a genetic dead end and will die out within two centuries, and refuses to treat them.

Moral Dillema: The species had prior contact to outside sources, and asked for help, and Phlox/Archer told them to screw off. They also refuse to give them warp technology. Note that this episode is pre-prime directive.

What....the...****!?!
This one actually made me fling the remote.