It is only when company culture (management and pilot attitudes) accept that early and decisive action can avoid the (probably not inevitable – making this a difficult call) consequence without recrimination (from management or from other pilots) and effect on personal reputation and ego, will the required change on attitudes be achieved....
JimL,
Add in the Hospital Management and Med Crews (Customer)....and I would call that a nearly perfect statement.
Along with visual cues being lost....the distinction between Customer/Crew gets all murky as well in the EMS world. Part 135 and reality are oft times too separate concepts regards that issue.
Med crews not employed by the Operator are not Crew ever....under the rules....but are passengers. Hence some built in conflict.