DAME has told me that even the Doctors in CASA are ruled by the lawyers, and they hate it.
What I can say anecdotally is that CASA AVMEDS practices make aviation much less safe because in view of the experiences of people like Inxs and GregP, pilots now go to great lengths to mask possible health conditions because of CASA AVMEDS disproportionate and unreasonable response to a possible abnormality.
Lest you think that this is about a few old fart GA pilots it includes line airline pilots. We used to joke about cabin crew going on the diuretics before a weigh in, but now there are alleged anecdotal reports of airline pilots going on the same before a medical to mask blood pressure issues*.
The DAME handbook now seems to be written to require that even the most remote, unusual and improbable side effects have to be ruled out before someone with a condition is allowed to return to flying - hence potentially life threatening conditions are not reported.
And of course AVMED is not there to in any way protect your health in a positive and timely manner. It is t here to protect CASA and AVMED from you. ...and of course once you have lost your medical they no longer have any interest in your health, do they?
* And that comes from the DAME of the owner of a C172RG who had a heck of a time keeping his medical with diabetes and blood pressure issues, so it is third hand.