Original Message

The guy in your scenerio is the customer.   The customer is calling the certificate holder to fly him to the Super Bowl because the certificate holder holds out to the public to provide 1st class helicoper service from point A to point B, complete with a cabin attendant who will polish his shoes and serve him a fine Latte.  The rich customer hires the certificate holder for that 1st class service because the certificate holder's 2nd tiered operational control person (the pilot) determined the flight could be completed.   Then, the cabin attendant decides they don't want to go because they have a hot date later and call a NO for the flight, cancelling the flight the real customer contracted for.

You have the customer wrong in your example.   The rich guy is the requesting hospital, not the medical crewmember.  

Therefore, your perspective is very blurry and way out of focus!