I've had:
'Your'e not fatigued, your roster pattern doesn't 'score' as fatiguing so you are just tired'
And, more of a worry, from a CRM instructor:
'You can still fly when you are fatigued as long as it doesn't impact the safety of the operation'
When pushed if you could make this judgement when fatigued, he replied:
'well you are meant to be a professional'
I would love to live on a planet where you can ring up when actually fatigued (which I have) and feel no pressure or influence to change you mind because you are just tired. Fact of the matter is though that there will always be skepticism from crewing officers etc as they have been told to keep the show on the road at any cost.
As for the Muppet who complained about paying to see the doctor, are you really saying you would go to work when not fit so as to avoid a $30 doctors bill. Now that is a worry.