To add to the debate...hopefully....as a former EMS pilot....I always took the position that I performed medical transportation flights. I and my medical crew provided a service that enhanced the quality of the medical care provided to the patient/casualty and did not "save" lives. One must remember that before helicopter EMS/rescue services existed.....and when existing services cannot perform the mission for whatever reason....patients and casualties suffer from that lack of service. They did so before the advent of these operations and shall continue to do so in the future.
At the operations I flew for, we attempted to deprive the pilot from knowing the nature of the flight beyond that he needed for planning purposes....ie...neonatal requiring isolette, lengthy ground time for preparing the patient, scene location for hazards, and location for fuel planning, etc. This was so that the pilot was making a business decision rather than an emotional decision. If you think emotion does not enter into it.....wait until you hear it is a small child with ugly injuries or burns and the weather is marginal.....those decisions were always gut wrenching.
We do the best we can....in as safe a manner as possible. We do no one any good if we crash an aircraft enroute to or from the scene or hospital. It is an unfortunate fact of life....people die in this life despite all of our best intentions and efforts. The loss of any rescue/ems aircraft and personnel due to any decision to push beyond the established policies and procedures is unwarranted and unprofessional. One must know when to back off and try it again another time.
For the trip under discussion....I missed any report of the vessel making max turns towards shore and the nearest medical facility. I can only assume that was done to alleviate the demands upon the helicopter.
If the window for successful reattachment of a severed hand is 4-6 hours....I fail to see how this flight really became a viable issue. Flight time alone exceeded the or matched the announced window of time....along with the preflight delay for planning and such and the post flight transport to the operating room....it makes the whole exercise seem fruitless. I hope to hear of the results of the surgery and recovery of the individual concerned. If it succeeds, then all this was a certified success and deserves our admiration and congratulations to all involved with it.