Moral Principles and Medical Practice | Page 5

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 injustice,

disobedience, and ingratitude are essentially evil. Our reason informs
us of this difference; and our reason is nothing else than our very nature
as intelligent beings capable of knowing truth. The voice of our reason
or conscience is the voice of God Himself, who speaks through the
rational nature that He has made. Through our reason God not only
tells us of the difference between good and evil acts, but He also
commands us to do good and avoid evil;--to do certain acts because
they are proper, right, orderly, suitable to the end for which we are
created; and to avoid other acts because they are improper, wrong,
disorderly, unsuitable to the end of our existence. There is a third class
of acts, which, in themselves, are indifferent, i.e., neither good nor evil,
neither necessary for our end nor interfering with its attainment. These
we are free to do or to omit as we prefer; but even these become good
and even obligatory when they are commanded by proper authority,
and they become evil when forbidden. In themselves, they are
indifferent acts.
6. These explanations are not mere abstractions, gentlemen, or mere
philosophical speculations. True, my subject is philosophical; but it is
the philosophy of every-day life; we are dealing with live issues which
give rise to the gravest discussions of your medical journals; issues on
which practically depend the lives of thousands of human beings every
year, issues which regard physicians more than any other class of men,
and for the proper consideration of which Doctors are responsible to
their conscience, to human society, and to their God. To show you how
we are dealing with present live issues, let me give you an example of a
case in point. In the "Medical Record," an estimable weekly, now in
almost the fiftieth year of its existence, there was lately carried on a
lengthy and, in some of its parts, a learned discussion, regarding the
truth of the principles which I have just now explained, namely, the
intrinsic difference between right and wrong, independently of the
ruling of law courts and of any human legislation. The subject of the
discussion was the lawfulness in any case at all of performing
craniotomy, or of directly destroying the life of the child by any
process whatever, at the time of parturition, with the intention of saving
the life of the mother.

I will not examine this important matter in all its bearings at present; I
mean to take it up later on in our course, and to lay before you the
teachings of science on this subject, together with the principles on
which they are based. For the present I will confine myself to the point
we are treating just now, namely, the existence of a higher law than that
of human tribunals, the superiority of the claims of natural to those of
legal justice. Some might think, at first sight, that this needs no proof.
In fact we are all convinced that human laws are often unjust, or, at