And they do here as well.
My point is, they do not hop out of the ambulance, take one look at your bloody face and broken leg, and demand you sign it right off the bat.
They will do whatever they can to attend to you first. It is only as a last resort, after you refuse to be treated several times, that they will request you sign the form.
I do the same thing should I encounter a serious electrical problem. I will explain the danger, show the code book, and try to impart the impact it may have in the future.
I may say something like, "Well, I obviously cannot guarantee that the building will burn down, nor can I predict when it will if it does at all, but what I see here is a serious problem that should be corrected. However, should there be a fire and the building burns down, you can rest assured that both the fire marshal and your insurance company will get involved. If it is determined that this definceincy was the cause of the problem, you may be looking at an insurance carrier that refuses to pay. And if it can be proven that you knew about the problem and declined to correct it, criminal charges could be considered. Now, in order to protect me from any future lawuits that might arise should this worst-case scenario become a reality, I'll ask you to sign a waiver stating that I have indeed informed you of the issue as well as your refusal to permit me to correct it."
This is a far cry from sierrasparky's envisioned "Oh, my, well.... will you look at that. Damn, that's bad. I see hundreds of people dying tomorrow morning in a massive fire. It'll be on the six-o'clock news about how you allowed them to die needlessly in a fire you could have prevented. Oh well, no skin off my nose. However, I'm going to require you to sign this form right here and right now or else I'm going to call Vinnie and Bruno over to do things 'the old world way', if you know what I mean (wink wink)."