> Tbf in Postgres, you can declare FKs to be deferrable, so their existence is checked at transaction commit, rather than at insertion time.h further implies that you don’t have FK constraints, because the DB would disallow this.

I'm using EF core which hooks up these relationships and allows me to persist them in a single transaction using MSSQL server.

> If you don’t have the DB enforcing referential integrity

I'm building an electronic medical system. I'm well aware of the benefits of referential integrity.