But what does suck is that the changable ticket usually costs more than the change fee would. Either way, you're screwed. Unless, of course, you fly an airline with a friendler policy, like WN, that at least lets you apply the full value of the ticket toward future travel. Change fees are far out of proportion to the cost to the airline to rebook and are, at bottom, just another source of revenue and reason #532 why the public hates the industry. In a case like that offered by the OP, there is no reason whatsover that a case of demonstrable incapacity to travel shouldn't be rebooked at no charge other than the greed of the airline. In fact, there's a sound public health reason to allow people to rebook when sick -- people fly all the time with colds and other ailments that are communicable in the small confines of an aircraft cabin because of these fees.