his mistakes arise from his ignorance or want
of skill, he is blamable in as far as he is the wilful cause of such
ignorance; he should have known better; or, not knowing better, he
should not have undertaken the case for which he knew he was not
qualified.

But it often happens that the best informed and most skilful
practitioner, even when acting with his utmost care, causes real harm to
his patients; he is the accidental, not the wilful, cause of that harm,
and therefore he is free from all responsibility in the matter.

The practical lessons, however, which all of you must lay to heart on
this subject are: 1st. That you are in duty bound to acquire sound
knowledge and great skill in your profession; since the consequences
involved are of the greatest moment, your obligation is of a most
serious nature. 2d. That in your future practice you will be obliged on
all occasions to use all reasonable care for the benefit of your
patients. 3d. That you cannot in conscience undertake the management of
cases of unusual difficulty unless you possess the special knowledge
required, or avail yourselves of the best counsel that can reasonably be
obtained.

5. A second principle of Ethics in medical practice, gentlemen, is this,
that many human acts may be highly criminal of which, however, human
laws and courts take no notice whatsoever. In this matter I am not
finding fault with human legislation. The laws of the land, considering
the end and the nature of civil government, need take no cognizance of
any but overt acts; a man's heart may be a very cesspool of vice, envy,
malice, impurity, pride, hatred, etc., yet human law does not and ought
not to punish him for this, as long as his actions do not disturb the
public peace nor trench upon the happiness of his neighbor. Even his
open outward acts which injure only himself, such as gluttony,
blasphemy, impiety, private drunkenness, self-abuse, even seduction and
fornication, are not usually legislated against or punished in our
courts. Does it follow that they are innocent acts and lawful before
God? No man in his right senses will say so.

The goodness and the evil of human acts is not dependent on human
legislation alone; in many cases the moral good or evil is so intrinsic
to the very nature of the acts that God Himself could not change the
radical difference between them. Thus justice, obedience to lawful
authority, gratitude to benefactors, are essentially good; while
inj