I'm with you on what you've written. Perhaps I'm picky, but if you make a visible point you can see that there is a difference between what is specified and what Qgis does. In Qgis text above point is placed on the bottom of the ascent, while the specification places the point so the text is on the baseline. In Qgis text below point is placed with a gap between text and point, while the specification declares that the point should be on the top of the ascent. Is it a motivated design to place text like this in Qgis, as I see no reason why text placement isn't 100% compatible between software.

Good answer, but the "ideal" placements when using the "Cartographic" option seems not ideal. The attribute field that comes along with the shapefile sets to me an ideal placement for labels using quadrant placement. This is apparent when multiline text is presented using two separate points, one point with text for each line. Also a lot of text is sometimes really close to each other, and the attribute field has optimized this. As I've stated the shapefile contains a lot of points with text. Manually optimizing this would be tedious, and useless as these shapefiles are updated regularly.

Added some pictures. Yes, you you have understood my question correctly. Text placed above point should be placed so the point is at the baseline. Text placed below point should be placed so the point is at the top of the ascent.