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Physician: The patient is suffering either from disease X or else from disease Y, but there is no available test for distinguishing X from Y. Therefore, since there is an effective treatment for Y but no treatment for X, we must act on the assumption that the patient has a case of Y.

The physician's reasoning could be based on which one of the following principles?

(A) In treating a patient who has one or the other of two diseases, it is more important to treat the diseases than to determine which of the two diseases the patient has - WORNG. The comparison isn't the case here. Also, knowing which disease it is out of context since the decision is already made with an assumption in the passage.

(B) If circumstances beyond a decision maker's control will affect the outcome of the decision maker's actions, the decision maker must assume that circumstances are unfavorable - WRONG. Unfavourability is out of context here. The decision is already made so knowing about the circumtances whether they are favourable or not is not required.

(C) When the soundness of a strategy depends on the truth of a certain assumption, the first step in putting the strategy into effect must be to test the truth of this assumption - WRONG. Again like above two choices this seems to divert in the direction that makes no sense.

(D) When success is possible only if a circumstance beyond one's control is favorable, then one's strategy must be based on the assumption that this circumstance is in fact favorable - CORRECT. Draws some essence from B but in the right direction.

(E) When only one strategy carries the possibility of success, circumstances must as much as possible be changed to fit this strategy - WRONG. There are no two strategy but just one based on which  a decision is made by physician. 

Answer D.
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