| The Practical Impossibility Argument | |||
| 1 | In hearing bad news patients are often anxious and hear selectively. | ||
| 2 | Patients are usually ignorant of medicine. | ||
| 3 | Diagnoses and Prognoses are often less than certain. | ||
| 4 | If [1, 2 and 3] then it is a practical impossibility to tell patients the truth, the whole truth, and nothing but the truth. | ||
| ∴ | 5 | It is a practical impossibility to tell patients the truth, the whole truth, and nothing but the truth. | 1,2,3&4 |
| 6 | If it is a practical impossibility to tell patients the truth, the whole truth, and nothing but the truth, then it is morally permissible for physicians to not tell the truth. | ||
| ∴ | 7 | It is morally permissible for physicians to not tell the truth. | 5&6 |
The troubling premise here is surely (6):
| An Argument for Premise (6) | |||
| 1 | If agent X has a moral obligation to perform action A, then it is possible for X to perform A. | ||
| 2 | It is a practical impossibility to tell patients the truth, the whole truth, and nothing but the truth. | ||
| 3 | If it is a practical impossibility to tell patients the truth, the whole truth, and nothing but the truth, then it is not possible for a physician to tell the truth. | ||
| ∴ | 4 | It is not possible for a physician to tell the truth. | 2&3 |
| ∴ | 5 | A physician does not have an obligation to tell the truth. | 1&4 |
| 6 | If a physician does not have an obligation to tell the truth, then it is morally permissible for physicians to not tell the truth. | ||
| ∴ | 7 | It is morally permissible for physicians to not tell the truth. | 5&6 |
| ∴ | 8 | If it is a practical impossibility to tell patients the truth, the whole truth, and nothing but the truth, then it is morally permissible for physicians to not tell the truth. | 2&7 |
The idea here is very simply that one cannot be morally obligated to do what one is incapable of doing. Since physicians are incapable of telling the truth, the whole truth, and nothing but the truth, it follows that physicians cannot be morally obligated to tell the truth.
The worrisome premise is (3). To say that something is a practical impossibility is to say anything from its inconvenient to it cannot be done to any reasonable degree. But surely we cannot conclude from this that it is impossible, simpliciter, for physicians to tell the truth.