Conceptual integrity is to maintain the good initial ideas, even if it implies not making that many features. This is better than having lots of uncoordinated ideas.
Likewise, functionality and simplicity. Which is better? There have been software projects that have an outstanding performance in one of both. But we have to say that it’s a combination of simplicity and straightforwardness. Every part must use the same philosophies, same semantics and syntax and the, you have conceptual integrity.
And how, or more precisely, who will achieve that integrity? Either one mind (Surgical team), the equivalent to an aristocracy; or a handful of minds, with a division of architecture and implementation, the equivalent to a democracy.
And it’s no bad to desire a democracy, but it has several problems. The people in charge of the architecture should consider methods to implement their architecture; the implementers, when suggesting ideas must preserve the integrity of the architects.
That’s why at the end, the aristocracy (Surgical team) is better because as long as the design and implementation are clear in the surgeon’s mind, everything is ok. Or at least, an aristocracy of architects, who have a clear idea of how the system should behave, and they should decide how to maintain integrity, even if that means to leave the implementers with practically no voice, at the end, what must endure the most is the design, not the implementation.