Which, of course, raises the issue of whether the responsibility for his situation lay with himself or with somebody else.
If you can say no, and should say no, then it is up to the individual. The individual has clear responsibilities, as per his licence.
If you cannot say no, but should say no, then it is about the operator and the safety regulator. Everybody has responsibilities in this case, most especially the latter two.
The difference between both cases is the proper focus of an independent and non-hysterical examination.