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Joseph Fielding Smith Jr. (10th prophet):
Extreme care should be taken in the giving of patriarchal blessings. They should be given only in the spirit of prayer and humility. Patriarchs should sit down with the candidates for blessings and question them in relation to their lives, what they have done in the Church and otherwise. They should feel of their spirits, discover if they have been active or inactive in the Church, learn all about them that they can; then, relying on the Spirit of the Lord, patriarchs should give them conservative blessings.
Source: McConkie, Bruce R., ed. Doctrines of Salvation: Sermons and Writings of Joseph Fielding Smith, Vol. 3. 171. Salt Lake City: Bookcraft, 1954-1955.