EMS PLT REQUEST DENIED FOR ENTRY INTO CLASS D AIRSPACE UNLESS ON A SVFR RTE. ACFT HAD NO SUCH CHARTS ON BOARD. UNAUTH UNCOORD PENETRATION OF AIRSPACE OCCURS.

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I WAS RESPONDING TO AN AUTO ACCIDENT S OF XYZ ARPT ON HWY FROM A HOSPITAL N OF XYZ AT NIGHT IN IFR CONDITIONS. I IDENTED MYSELF AS 'EMS' AND REQUESTED SVFR THROUGH XYZ AIRSPACE. TWR CLRED ME VIA A PUBLISHED ARPT ARR AND DEP RTE. I SAID I WAS UNFAMILIAR WITH THE NAMED RTE AND REQUESTED ROUTING TO REMAIN W OF HWY; N TO S; AT 6300 FT MSL. THE CTLR TOLD ME HE COULD ONLY ALLOW ME INTO THE CLASS D AIRSPACE IF I ACCEPTED AND FLEW A 'PUBLISHED SVFR RTE.' AS I COULD NOT COMPLY; I TOLD HIM THAT I WOULD CIRCUMNAV THE CLASS D AIRSPACE. I FLEW W TO A POINT I THOUGHT WAS W OF THE AIRSPACE AND TURNED S. I WAS IN CONSTANT RADIO CONTACT WITH TWR AND RESPONDED TO INQUIRIES ABOUT MY LIGHTING AND LOCATION. AS I PROCEEDED S; TWR INFORMED ME I WAS IN CLASS D AIRSPACE. I TURNED W; THEN S AGAIN. WHEN I WAS FAR ENOUGH S (I THOUGHT) I TURNED SE TO RETURN TO HWY. DETERIORATING CONDITIONS REQUIRED THAT I TURN AROUND AND FLY NW. ONCE AGAIN; TWR TOLD ME I WAS 'ABOUT 3/4 MI' IN THEIR AIRSPACE. I REPOSITIONED TO THE W AND COORDINATED A REVISED PATIENT PICK-UP POINT WITH OUR DISPATCH. THE SELECTED LOCATION WAS IN XYZ'S AIRSPACE. THIS TIME; WHEN I SPOKE WITH A DIFFERENT CTLR; I WAS CLRED INTO THE CLASS D BY ROAD NAMES (A STREET TO HWY). I WAS CLRLY IN ERROR IF I WAS IN THE CLASS D AIRSPACE WITHOUT A SVFR CLRNC. I HAVE NO WAY OF KNOWING EXACTLY WHERE I WAS. I FEEL; HOWEVER; SOMEWHAT BETRAYED BY TWR IN SEVERAL WAYS: AS AN EMS ACFT RESPONDING TO AN EMER; I FEEL I SHOULD HAVE BEEN CLRED THROUGH THE CLASS D BY KNOWN GEOGRAPHIC CHKPOINTS. I DON'T BELIEVE TWR SHOULD USE LOA PUBLISHED ARR AND DEP RTES FOR THROUGH FLTS -- OR AS AN EXCUSE TO EXCLUDE SVFR FLTS. TWR RADAR SHOULD BE USED TO ALLOW ACFT IN COMS WITH TWR TO AVOID THE CLASS D (IF THAT IS THEIR DESIRE) NOT 'BUST THEM' WHEN THEY ARE ALREADY INSIDE.