So that means a pilot with a history of heart attacks, dizzy spells, class 1 diabetes can happily take 5 people at his mercy in a complex twin ???
Pace
The best form of medical is a natural sense of self preservation. People are best able to assess their own obvious medical limitations and to live their lives and act in a manner to minimise any risk to themselves and others accordingly.
No one who wants to have a decent chance of remaining alive will take undue risks, and those who want to die will not be prevented from doing so because they have a medical certificate.