Some good comments from some of the EMS pilots on this site.
I will give you my experience while flying EMS (Central Europe) at night.
We flew NVFR only, in a IFR equipped (less an autopilot), Bell 427. All pilots were given regular training, in a covered cockpit, on instruments and ILS captures.
There would always be 2 pilots (unless the 206LT was being used due to maintenance) with the Lead pilot for the shift making the go/no-go decision, with obvious input from the second pilot.
We had a 15 minute window to check weather along the route and to make sure that company minimums could be kept throughout the flight. The condition of the patient was not generally told to us, and even if so, was not relevant to the mission going ahead. The pilot’s decision was FINAL. He was backed 110% by the company management on this. Any medical personal pressuring a pilot would be removed from flight operations permanently.
We also only did inter-hospital transfers, or landings in to known areas at night. This is due to change with the introduction of NVG’s I believe. The weather minimums will remain the same however.
I don’t think NVFR is a big problem, but you have to pick your battles. If the weather is looking marginal just don’t go, it’s not worth it. You can’t save everyone.
This is a post from a while back where we said no, and another crew said yes, and died. It is well worth reading the entire thread. It all sounds depressingly similar.
http://www.pprune.org/rotorheads/204...terrain-2.html