Unfortunately, EMS in the US will never be dual pilot, unless it is civil service and not profit-based. The aircraft we are currently using just won't accommodate the extra 200 lbs and no one can afford a 139.
I've been doing this job more than just a minute and I look at the medical crew issue a different way. If I think we can go, but there's a chance of diversions and IFR and ground legs and the crew just doesn't want to go, we all just go back to bed. That's bad how?
It doesn't hurt my ego if I'm not able to do every request. It's a huge safety liability to be invested that way.
I've worked with these crews a long time and they're very comfortable with me, in fact, they'd let me fly them into a mountainside some night they're so comfortable. Occasionally in briefings, I remind them to keep an eye on me. Don't always assume I'm catching every little detail. Crews have spotted the invisible wire before, which I hadn't seen. I'm tired and distracted too and every so often complacent. Everyone needs their butt kicked once in a while.
Checks and balances work best when the opposing parties have different priorities and strengths. To prove that, you can look back over 100 years of flight crash data where the first officer was too reluctant to question the captain.
Just my opinion