Downranking/blocking of domains should be customisable on a per-medium basis. For example, I should be able to block Pinterest only in All, allowing results to remain searchable in Images and/or Videos. In the example of Pinterest, this is especially relevant for Images results. I can also imagine wanting to see Amazon product photos but not links, so only wanting results to be present in Images and not All.
The option to do this should be available in the search interface and in the Personalised Results pane.