Well said, E.
AVMED's recent decision-making is one of the starkest examples of decision-making that is not based on objective evidence or objective risk. It is based primarily on AVMED's messianic belief that they are carrying the primary burden of aviation safety because, according to the erstwhile PMO, a pilot’s licence goes on forever, but it is the medical certificate which enables the person to use the licence. All of the other so-called specialists and experts can have their opinions, but it is ultimately AVMED who bear the terrible burden of allowing a pilot to fly. And if that burden has been imposed on AVMED, it must surely follow that AVMED knows better that everyone else.
Amazingly, the pilots who have been allowed to fly for decades without NAA medical certificates have not caused carnage as a consequence of their sudden incapacitation. Amazingly, the pilots who do have NAA medical certificates suffer the same rate of sudden incapacity as the general population.
The current regime has little grasp on what causes the substantial risks to aviation safety, or how to mitigate them. If they did have that grasp, they'd realise they're a sideshow. They'd also realise that, as has been pointed out by people like Dr Liddell who do know, that all AVMED is now doing is encouraging pilots to take the risk of telling their DAME and AVMED as little as possible and not seeking medical advice about something that may turn out to be serious if not treated.
Unfortunately, AVMED has been allowed to get out of control and nobody with the power to get them back under control particularly cares.