Luck always trumps Skill and often substitutes for the lack of Skill.
DB is right.....HEMS Go-No Go Decisions are not based upon the Patient's Condition, Prognosis, or Needs, Flight County, or Revenue generated......it is a simple (in theory) decision based upon the Weather and other Aviation related factors.....ONLY.
If the weather and related factors are within the published minima and crew capability....one departs.
If not...one does not depart.
In the USA...we strive to free the Pilot of the Patient Information as much as possible in an attempt to lessen the psychological pressure one might feel otherwise.
The hard part of the decision making process is when the weather is marginal and there appears to be no clear cut, easily defined set of factors that affords that straight forward easy decision...be it go or not to go.
If one launches in marginal weather over bad terrain or in the dark of night....or all of the above....and you guessed it wrong then you are in trouble.
Guess it right and everything goes well....you are the Base Hero for a while until someone else takes the honor.
The hardest word for an EMS Pilot to vocalize is....."NO!".
It should not be at all.....as there are occasions that is exactly the right response to a request for a flight.