Very sad to see these accidents lately. As a EMS helicopter pilot for 8 years in a mountainus region and a gomer pilot before that I have seen a lot of things. I believe the biggest problem starts in the cockpit with the pilot you have to know when to say NO. There is tremendous presure to accept a flights in EMS  now days due to increased competition and expected flight numbers. There have been numerious flights I have turned down for weather that my competetiors have flown and I always hear about how company  XYZ completed the flight who cares I do not. I am still here after flying since 1976. It is hard on some newer pilots ego not mine. My idea of a hero is a sandwich. I feel there are three  things that could be done;

1) Raise the minunums and raise the pay you pay peanuts you get monkeys think about how much money an airline pilot gets paid with 20 years experience compared to a helicopter pilots with 20 years experience. I feel if you took an airline pilot on a typical night scene flight in the mountains at minunums dodging powerlines trees vehicles and over excited first responders on the ground he would tell us we were nuts for doing this for truck driver wages. 

2) More  IIMC training and better equiped helicopters (Auto pilot glass cockpit ect) 2 pilot IFR would be nice but not very practical at this time BTW didnt a ERA 2 pilot IFR ship fly into the water a few years ago. Due to pilot error

3) Mentally screen pilots I have had friends that work in sales and they take a personality profile test to see if they have the aggresive personality the company is looking for. How about screening pilots the same way and send the aggresive heros down the road.

Just my 2 cents

BTW I know my spelling sucks I am in In  my 60's and cannot figure out how to use spell checker on my post.   

But how does what you wrote resolve the issues at hand? Or was your post just all about you, for you? Jeesh!

No doubt experience in your area.

what you said. I did some stupid things along the way. Mostly early on. I survived 46 years of flying (so far) 43 of them in rotor, most of those years in EMS. Thing is I was lucky enough to live through it, some d/t being in a dual Pilot cockpit early on. Anyway, as you say, the setup for profit and competition is obviously a formula for disaster. We'll keep killing people until something makes it all change. Obviously that hasn't happened yet. There are some knukleheads on shift today, and coming on shift tonight and next week that will slam into the ground before long. Then we'll say nic ethings about them at their memorial service and move on.

In a couple of months...Feel your pain!

doesn't equate to being illiterate and being proud of it.  Ever wonder why Airline pilots get paid more than Helicopter Pilots and truck drivers?  For starters, when they go through the resumes, they can pick out the individual with intelligence and education.

LOL, and if you're a dud when you show up for the interview,,,,,, say no more.

Company says “Safety first! We will never push you to fly, always be safe”

Pilot says “cool, the company has my back, I’ll turn down these flights because it’s not safe”

Med Crew says “Our competition is taking these flights, our jobs are at stake!”

Company says “You can’t question the pilot on weather”

Med Crew says “Fine we will figure something else out, like claim he’s flying too low or that we once got too close to a tower”

Pilot says “That’s not true”

Company says “Its their word against yours, pack your bags. But remember: the company never pressured you to fly, even though we harbor a system that allows a roundabout way to pressure you to fly. Happy job hunting.”

Pilot says ”....”

you did a very good job of summing up the pressure to fly my company would never push us to fly or even show us the monthly flight numbers, however you could look in the aircraft log book and know how much the base was flying you had a pretty good idea at what volume a base would close but this was never discussed openly by managment. As far as the med crew is concerned I agree they would never directly say anything about the flight you declined but during the next day or two you would hear who flew the flight how the patient did and wondered why couldnt we could not make the flight. When I was in the GOM years ago we were under unbelivable pressure to push the weather. The company I fly for now in EMS never pressures me to fly and has a very strong safety culture but the pressure is still there in a very  subtle way.

pilots continuing the flights into weather?

It doesn't matter if the minimums are clear, blue and 22 if pilots continue to fly into whatever unsuitable conditions they encounter.

The idea that one should descend to maintain visual contact kills people, especially at night.  CFIT accidents outnumber failure to maintain control in IMC by a significant number, and the half hour, hour one gets at recurrent is not enough for IFR proficiency- does it result in the mistaken impression that an emergency IFR recovery has a higher probability of success than exists?

Why don't the accident pilots divert, abort or just land?  Because those options are not trained, or not part of the culture?

Well, if the forcasts and weather when you plan the flight are that ceilings are 1200 and visibility 9 miles, and you encounter decreasing ceilings enroute, a descent is sometimes the better tactical option considering climbing takes you into ICING conditions IIMC.

When you need to make a decision, you do so at the moment, and base it on weighted threats.   If the reason for the descent was indeed lower ceilings, a decision to climb into it with certain icing in an aircraft not rated for icing would be a bad decision.    Suppose that was the option the pilot took, then iced up badly excuting an intentional decision to go IIMC, and crashed as a result of that icing; what would you're criticisms be then?   Let me guess.... why did the pilot climb into icing!

What would have been most helpful was that pilot's company OCC providing timely and accurate information, and offering alternative plan's of action!

CFIT will kill you. Make the best choice of those unpleasant options.

Ice isn't as easy to find as you suggest. Besides, plenty of helicopter pilots have seen varying degrees of ice and lived to tell the tale. It might not be as scary as you imagine.

icing be damned then!

Icing will kill you also, if it gets heavy enough.    So, pilots generally opt for the generally safer solution.   Not ever descent to stay below the clouds ends in CFIT!

And, we have no idea this was the reason for the descent here either.   Maybe it was a purposful descent looking for a place to land?   Maybe it was already icing?   Maybe it was some mechanical?   Maybe it was a birdstrike?   Maybe it was something got jammed in the flight controls?   Maybe it was a distraction when their OCC called on the SATCOM to tell the pilot to cancel?

Lots of helicopter pilot have "I ducked below the cloud" stories to tell too!

Doesn't negated the fact that she had already passed the point of good judgement, if that were the case.

If she was incapable of landing, then she was already below the Part 135 prescribed miniumums. Based on your suggested hypothesis- not any known facts.

Abort early, or leave it parked on the pad (or in the hangar) to begin with. Profit margins and base stats be damned!

What is that term for turning around once you perceive a need to to get lower, or slower, than a certain prescribed parameter?

Wishing and hoping, then praying and crying (or dying) aren't the way to proceed in a VFR helicopter in marginal weather conditions.

§135.619   Operations control centers.

(a) Operations control center. After April 22, 2016, certificate holders authorized to conduct helicopter air ambulance operations, with 10 or more helicopter air ambulances assigned to the certificate holder's operations specifications, must have an operations control center. The operations control center must be staffed by operations control specialists who, at a minimum—

(1) Provide two-way communications with pilots;

(2) Provide pilots with weather briefings, to include current and forecasted weather along the planned route of flight;

(3) Monitor the progress of the flight; and

(4) Participate in the preflight risk analysis required under §135.617 to include the following:

(i) Ensure the pilot has completed all required items on the preflight risk analysis worksheet;

(ii) Confirm and verify all entries on the preflight risk analysis worksheet;

(iii) Assist the pilot in mitigating any identified risk prior to takeoff; and

(iv) Acknowledge in writing, specifying the date and time, that the preflight risk analysis worksheet has been accurately completed and that, according to their professional judgment, the flight can be conducted safely.

(b) Operations control center staffing. Each certificate holder conducting helicopter air ambulance operations must provide enough operations control specialists at each operations control center to ensure the certificate holder maintains operational control of each flight.

Some new added "safety" regs don't help out the situation either.  The required risk assessment only adds another item to "rush" before you lift.  Pretty sure the RA has never been the deciding go/no go factor that the pilot would otherwise take without  the RA