The Southwest Airlines policy for larger passengers is fair. For those pax who are large and cannot fit within one seat (ie not occupying part of seat next to him/her) the airline has a policy that is fair to the large traveler and those sitting next to the individual. Knowing this in advance leaves little for confusion and allows larger pax to plan accordingly as to guarantee space on confirmed flights. Many legacy carriers here in the US have similar policies yet do not make them well known for fear of bad publicity.
In this case, too many people made assumptions and did nothing to plan the trip home for this individual given his condition nor did the airline properly handle it.
Here is the policy for Continental Airlines (found on the net, assumed to be legit)
Customers Requiring Extra Seating
A customer flying in the economy cabin who is not able to safely and comfortably fit in a single seat is required to purchase an additional seat for each leg of their itinerary. The second seat may be purchased for the same fare as the original seat, provided it is purchased at the same time. A customer who does not purchase an extra seat in advance may be required to do so on the day of departure for the fare level available on the day of departure. The customer may instead choose to purchase a ticket for First Class/Business/BusinessFirst®, or elect to pay for an upgrade to the front cabin if there is availability to do so. Continental Airlines is not required to provide additional seats or upgrades free of charge.
A customer is required to purchase an additional seat or upgrade if they do not meet one of the following criteria:
The customer must be able to properly attach, buckle and wear the seatbelt, with one extension* if necessary, whenever the seatbelt sign is illuminated or as instructed by a crew member.
The customer must be able to remain seated with the seat armrest(s) down for the entirety of the flight.
The customer must not significantly encroach upon the adjacent seating space. See our seat maps.
Continental Airlines will not board a customer who declines to purchase a ticket for an additional seat or upgrade for each leg of their itinerary when required.
*The average length of the seatbelt extension is approximately 25 inches. As the seat designs on our aircraft vary, it is possible that the seatbelt extension presented on your flight provides less than 25 inches of additional coverage. Regardless of the actual additional length the extension provides, if you do not meet criteria #1 listed above when using the extension provided on your flight, it will be necessary for you to purchase an additional seat or an upgrade, where available.
Additional Procedures
The additional seat must be available without downgrading or unseating another customer. If an additional seat is not available on the flight for which the customer is confirmed, he or she is required to rebook on the next Continental Airlines flight with seats available for accommodation. Continental will waive penalties or fees that may otherwise apply to this change.
If the customer is away from his or her domicile and must rebook for a flight the following day, amenities including applicable meals and hotel accommodations for one night will be provided as appropriate. When the customer is able to rebook for a later flight on the same day as originally scheduled, amenities will not be provided.
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I also found these tidbits from CO's COntract of Carriage:
RULE 21 REFUSAL TO TRANSPORT
CO shall have the right to refuse to transport or shall have the right to remove from the aircraft at any point, any
Passenger for the following reasons:
……………..
H) Safety – Whenever refusal or removal of a Passenger may be necessary for the safety of such Passenger or other
Passengers or members of the crew, including, but not limited to:
………………..
6) Persons who are unable to sit in a single seat with the seat belt properly secured, unless they comply with
Rule 6 I); (see below)
I) Passengers Occupying Two Seats
Upon request, or if determined necessary by CO, and given availability, a Passenger will be permitted to the
exclusive use of two seats subject to the payment of two applicable fares for the points between which the two
seats will be used. A Ticket will be issued for each seat and the normal free baggage allowance will apply in
connection with each such Ticket presented to CO.