Not a 'medical issue an individuals mental issue
Its the Pilot's decision, made in the air or on the ground prior to departure, and since its in/from the pilots head, CAsA has NO control over it.
And they really HATE that which they cannot CONTROL
Therein lies the problem, accidents will always happen because individuals will make decisions that lead to consequences, fatal or otherwise and THAT cannot ever be regulated away.
BUt our esteemed regulator sure is trying hard to get there ! "safety" is all whatever the cost, reality or perception