Lots of stick and no carrot.
VP I admire your optimism. As with all official communications from above, especially amendments to the F.O.M there are a number of ways to interpret them. Nowhere in the FCI does it say that once the crew member has had a chat to the FDM and a doctor (should he be able to schedule an appointment) the Absent day will be reverted.
There is a reason for it not being more specific and that is because it is a thinly veiled threat of punitive action should a pilot have the temerity to report sick less than four hours prior to duty. The past self certification rules have been in place for more than 11 years so what has happened to bring about the need to change the policy?
What happens for example if the pilot in the scenario wakes up with a blinding headache which eases only after the sign on time. Doctor says "Can't find anything wrong with you mate take a panadol or two next time it happens" Do you think the guy is going to get the AB reversed. I think not.
Muttley I agree entirely with you that going to work when physically impaired is irresponsible yet both the company and the crew share responsibility in this regard. It is the companies responsibility to ensure that a crew member is not intimidated in any way and feels free to remove himself from a flight at any time should he feel unfit to fulfill his duties and responsibilities.
It appears to me that the current flight ops management are desperately trying to patch up the leaks in the reservoir whilst still pouring water into it. The result of this sort of thing normally ends with the dam bursting at some point. A well led, motivated, and rewarded workforce does not require threats to get the job done but therein lies the problem.