not morally responsible for it. His conduct under the circumstances may
denote a brave or a cowardly disposition, or it may indicate habits of
self-command or the absence of them. His prayers or curses while thus
unconscious are no doubt the effects of acquired virtues or vices; yet,
in as far as his will has no share in the present acts, they are not
free or human acts. He deserves praise or blame for his former acts, by
which he acquired such habits, but not for his unconscious acts as such.

From this principle it follows that a physician is not responsible to
God or man for such evil consequences of his prescriptions or surgical
operations as are entirely beyond his will and therefore independent of
his control. If, however, 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