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The only way I can separate how to break up "surgery" and "body modification" is by examining the tools that are being used and in what way they're being used.
Needles: When used for piercing or tattooing, their function is very easy to identify. The lines get blurred when substances begin to get injected. It's more than obvious that the vast majority of practitioners do not know the first thing about anesthetics or injectables. While some practitioners are skilled enough to safely administer anesthetics when needed, laws need to apply to the whole and can't exclude people - else they're fundamentally flawed. Therefore I feel that injectables shouldn't be offered to the public except by a medical practitioner.
I'm also adding beading into the "needle" category assuming it's done with a "beading tool" which is effectively a multi-part needle.
Dermal Punching: Again, one really needs to examine the way in which this tool is being used. In a hospital, they're generally used for biopsies. Though they've been adapted (rather successfully) in the piercing studio as well. Personally, I don't see any problem with a cartilage punch or even using them in other parts of the body. Simply put, sometimes they're the better tool for the job and beat out a needle hands-down. Unfortunately, legislation has a hard time looking past the fact that a dermal punch removes a portion of the body while piercing needles do not. The "removal of flesh" is the line that a lot of legislation draw between "practicing medicine" and "body modification".
Cautery & Strike Branding: Branding, in a medical sense, rather "safe". If done properly, it's purely dermal and shouldn't damage the nervous system, muscles or tendons. It's the aesthetics and "pain factor" of branding that generally causes most people to feel uneasy around the subject. I don't see any reason why a practitioner shouldn't be allowed to brand clients as long as they're properly trained, though the real problem is how to efficiently gauge an artist's "talent" in a subject way. But since the earliest days of man, we have been tied inexplicably with fire - there's no reason to change that now.
Scalpeling: Scalpeling is the body mod practice probably most easily associated with doctors and surgery. While some procedures such as a lobe lengthening are "generally" simple in the hands of a practitioner with practice, other advanced procedures involving scalpels, such as implants, in my opinion, cross the line into surgery.
After the lines are drawn between what services are legal for body art practitioners to perform, we're faced with the penalties for breaking the law. For the sake of this argument, I'm going to assume that for a shop to operate, both the shop and the artist are licensed with the local government to practice body modification (we can dream, can't we?).
One of the better methods for penalization is to impose a series of increasing fines for concurrent violations and after an arbitrary amount of penalties, the loss of the license of the practitioner and potentially the shop pending severity. I know that sounds harsh, but who are we really trying to protect first? The public or the practitioners? Hopefully - you said public. And by doing so, we're keeping the practitioners out of risk by not allowing them to do "medical" procedures. If anyone's aware of how "big business" medical malpractice suits are, then applying this to body artists that cross the line into "practicing medicine" will be a great legal risk!
Optimally, the "medical community" will end up offering procedures such as meatotomies, subincisions and advanced implants. When you look at plastic surgery as it stands right now - these procedures are extremely simple and carry so fewer risks than these other highly invasive surgeries. Step one is to convince the medical community that there's a desire for these procedures to be done. The next step is to convince them (and the general public) that it's a totally sane desire that some people have!
It looks as if there's, at the very least, a few years before we'll see uniform regulations that define the line between body modification and surgery. Until then, it's a tenuous line to walk for those practitioners that are in unregulated areas or that are pushing the envelope between body modification and practicing medicine. There's already one case in the court system in the US, and undoubtedly more to come. These next years will set some heavy precedents for this issue and it's all of our job to be as responsible and receptive to it.
First of all, I believe it's important to differentiate between what a person should be allowed to do to themselves or their partners, and what a practitioner should be allowed to perform on the public. My feeling is that a person has full control over their own bodies and we have little right to tell a person what they can and can't do to themselves or their intimate partners. However, we must balance this with society's right to protect its members both from themselves and others.
I will answer this question assuming you are asking what procedures should be permissable in a body modification (ie. piercing/tattoo) studio operating on the general public. If I was to answer the question as it applies on a more personal level, I would answer very differently.
There are two things that I think we can take for granted. The first is that we as humans have thousands, if not tens of thousands of years of experience performing piercings, tattoos, scarification, and certain forms of genital cuttings and implants, all done by amateurs. The second is that as long as we stay in the first few layers of skin, our bodies will survive almost any injury we can give it, so these things are relatively harmless physically.
To me, operating on common sense, that says that we as apprenticed "amateurs" (in that there is no recognized medical training involved) have every right to perform the following:
1. Piercings, with the exception of certain deep piercings. My feeling is that as long as a piercing doesn't open a channel of infection that bypasses the body's defense systems (for example, transscrotal piercings or under-the-collarbone piercings) it should be permitted.
2. Tattoos. Obviously. Good luck coming up with an argument against tattoos; they're probably the most harmless modification you can get (ignoring social implications, which I don't believe should be legislated).
3. Traditional scarification (cutting, branding, etc.). I'm not convinced that some modern techniques (skin removal, electrocautery, certain types of mechanical dermabrasion scarring) are ready to be unleashed on the general public though, as they carry much higher risks. But, if I had to choose, I'd leave them on the legal side.
I can't imagine that any reasonable person would argue against any of the above. Not only are these mods clearly safe, but there is significant precedent for their application. I believe that genital beading probably falls into this class as well.
Then we get to male circumcision, subincision, and analogous female modifications. While they are relatively safe, and also have historical precedent, they do start crossing into territory that is dangerous when misapplied, usually by young kids that misguidedly see these modifications as a way to make a name for themselves. Unfortunately these modifications are not currently readily accessible via the medical industry, leaving us in a difficult position. I don't think that these should be offered by amateurs to the general public, and as soon as the medical industry offers these mods, I'll gladly start referring people. Until then though, I'm glad that there are practitioners offering the procedures to people who need them.
As far as the heavier procedures such as implants, tongue splitting, castration, and similar procedures, these carry significant medical risk, including death (it has happened, and it will happen again). In addition, the risks are complex enough that they're difficult to assess without years of medical experience, and complications can be very dangerous. I do not feel that these procedures should be offered by amateurs on the general public. I do support the "oldschool" cutters, and I salute the much needed service they provide. However, they are a very different breed, and operate in a highly discrete by-definition unregulatable sphere ("outside the law") and, perhaps more importantly, "are not a problem" as they almost universally operate responsibly.
So, to give a short summary of this rambling reply, I think piercing, tattoos, and scarification should be permitted to be offered in public access studios. I do not believe that anything past that should be offered in public access studios by relatively untrained practitioners.
I think the legal situation of body modification as it stands is untenable. There does seem to be an air of 'consequence free' experimentation, leading to ever more daring procedures, and I fear this will mean that when the law does catch up with body modification, the bad aspects will seem more visible than would otherwise be the case.
I worry also that when the laws are put in place, they will be written and implemented by people with no involvement in the scene. For this reason, I hope that the body modification community continues to be self-regulating as long as possible. For this to be the case, I feel that the community must not expose itself to the mainstream media, and realise that what might be seen as a harmless fashion fad today may tomorrow be reviled as symptomatic of any number of social problems.
Some legal safeguards are however necessary, and I believe it is right to limit the sale of anaesthetics to qualified medical staff. Further than this, I am not sure how viable the option of getting procedures done by doctors is in practice. Doctors have a licence to lose, and several test cases have proved that the law does not look favourably on things like voluntary amputation. I am sure the same would be true for implanting, scalpelling and tongue splitting, were they to come to court.
In short, the issue of legal restraints is a tough and possibly insoluble issue, for the balance must be struck between allowing those responsible enough freedom of expression through their bodies, and protecting those who would damage themselves. I am not sure anybody, and particularly something as general as the law, can really distinguish between the two groups.
As somebody who is not directly involved in the industry, I find this question a little bit tricky to answer.
I think that the types of procedures that are beyond the limit of what an artist should be permitted are those that either put the client's life in serious risk or those that could permanently disfigure or disable a person. I'll use a full leg amputation as an example of both.
Whatever laws are put in place need to be conducive to people getting their mods done in a safe environment. The more strict laws are, the more underground these types of procedures become. The dangerous part of this is that should any accident arise, proper medical attention may be avoided in order to protect the artist.
Ideally, the medical industry would come around and see that body modification is more than facelifts and liposuction. If the medical community were to perform extreme (and in this sense I use the word 'extreme' to describe procedurally dangerous mods) then perhaps this wouldn't be an issue.
Another complicating factor in all this is that there is no industry-recognized certification for people practicing mods. Let's say we look into whether an individual artist is negligent in his practice after a mod goes wrong. It is possible for a good artist to have bad luck or to make an unavoidable error, and it's possible for Jack the Ripper to never have anything go wrong his whole career. Since there is no "Bod-Mod Board" recognized by the industry or the government, it makes it difficult to define what malpractice means in regard to body modification.
Laws are supposed to be to protect people. In relation to body-modification there is some uncertainty as to what this means. To many people a leg amputation is harmful, and the person would need to be protected from himself. Our community knows better. However there are still cases where people need protection, especially from predatory bod-mod artists. I think that if an artist knowingly performs a procedure they are not capable of, or they do so in a negligent way, perhaps assault laws would apply.
Ultimately, it will be the government that decides what counts as "practicing medicine without a license" and what modification practitioners can do without breaking the law. And I think that judgement will continue to be quite conservative, granting licensed medical professionals access to many more procedures than mod practitioners. After all, there is a medical schooling and licensing system for a reason, and most people (legislators included) would consider a doctor much more qualified to perform any procedure on the human body than anyone else.
If I were given the choice of where to draw this line, I'd have a lot of trouble. I've encountered a lot of incompetent and close-minded doctors, and a bunch of skilled mod practitioners. With that in mind, I'd be inclined to grant mod practitioners a lot more freedom in procedures. On the other hand, I've also met some very competent and cool doctors, and scary modification hacks. Both sides are out there, and unless there is a regulated education and licensing system for body modification, both the good and bad practitioners will be doing procedures and representing all practitioners to the community and the government.
In the grand scheme of things, I'd much rather see doctors embrace and perform traditionally "mod" surgical procedures than see those procedures legalized for practitioners to perform. Overall, I do believe that a doctor is a safer and more skilled person to perform most surgical procedures. They are educated in anatomy, intimately familiar with the skills needed to perform procedures, able to get all sorts of tools and equipment, able to provide an operating suite, qualified to do follow-up care, and even sometimes included in insurance programs! If plastic surgeons were willing to do non-reconstructive implants, or subincisions, I think they'd be the obvious choice. I recognize that doctors may never be comfortable doing these procedures. If they were, though, I'd rather see the legal rights in their hands.
With things as they are, mod practitioners are the exclusive option for some "extreme" mods. We don't see doctors doing those implants and subincisions. It's very rare to see an oral surgeon doing a tongue splitting, or a doctor performing castration. But I don't feel that these procedures should be advertised and available to every person that walks into a bodyart studio off the street. I don't really think that surgical mods should be named and priced alongside piercings, tattoos, or even scarification. They carry much more serious risks and effects. And without strict education and regulation for practitioners, especially those who wish to perform such procedures, I can't see making them legal for any non-doctors to do.
I think that the more public nature of body modification demands a better definition of the law. The government will need to specify the procedures that have passed into the area of medicine. I'd say that the removal of tissue, and anything involving restricted or prescription-only products (like injectable anesthetics), is probably going to fit into this category. As for penalties, I'd rather see a hefty fine and revoking of a studio license than jail time. But if this is "practicing medicine without a license," then it is in the same category as many deadly situations. I would hope for flexible sentencing, and punishments varying by the level of the offense, but the penalties could still be high.
I know that my views may meet a lot of opposition. I also know that the route I've proposed will keep many procedures illegal and underground. But backroom surgery carries a lot of risks, and I don't think the government should put a stamp of approval on it. An unqualified person performing an operation is dangerous with or without it being legal.
First, I'd like to say that there are many parts to this question. I'll do my best to answer them all.
"What types of laws and penalties should be put in place to draw a line between what bod mod practitioners can perform...." "...where should the line be drawn?"
I'd have to start off with a simple question. What would you consider a body mod? Sounds easy, however, it isn't that easy to define. While this is an exaggerated example, here is one: A body mod could be considered the removal of wisdom teeth, since it is a change to the body to make the person feel better (be it physically, emotionally, or spiritually). While I haven't heard of people going to a bod mod artist to have teeth removed, I'm sure that it is a possibility.
"What types of laws and penalties should be put in place...."
If any law were to be made, I'd suggest that it refer to proper sterilization of tools/area. If the bod mod artist is going to do more "hard core" things, such as implantation, castration, etc., I would suggest that the individual at least have a working knowlege of the anatomy to the point that they would know exactly what they were doing, how they were doing it, and fully disclose all information about the procedure (side effects, possible negative outcomes, the experience that practitioner has with said procedure, etc), so that the client could make a decision on whether or not the risks outweigh the desire to get the mod done.
As far as penalties...
A penalty should be issued if the client wasn't given full disclosure of the procedure and how it might affect the client. To me, full disclosure means that the practitioner explains how much experience has been acquired (apprenticing and doing the process on their own, knowledge of the body, positive/negative outcomes, and possible side effects from the procedure).
As for what type of penalty, I am not sure what would be appropriate, except that if the practitioner was grossly incompetant, the practitioner should not be allowed to do any more procedures unless they went through (and passed) a strict medical education. That sounds harsh, but if a practitioner acts with flagrant non reguard to a client, a strict medical education would be the least of their worries.
"...what should be done by the medical community..."
The medical community is mostly not mod-friendly. If people had to go to a medical professional to get a mod done, chances are that the individual would never be able to get the mod because the medical professional would lable the person "unstable" or something along that line. Either that, or the price for the mod would be so expensive that no one except the extremely rich would be able to afford it. (and then, you'd end up with body mod artists that worked in a backroom with probably less than a sterile environment, and probably a less than acceptable positive outcomes)
I'm not completly clear with how the laws are concerning piercing in the US and Canada since I live in Sweden but over here there are basically no real laws concerning body piercing. This basically means that any moron that can get hold of some needles and jewelry can open up a shop and call himself a piercer. He doesn't even have to know basic sterilization-procedures, own an autoclave or anything like that. Since the government don't know shit about this kind of thing they don't know what to check for so all they do is basically make sure that air flows through the studio in a correct way(?) and that it is "clean" i.e. no visible dirt. So the first thing that needs to be done over here is to put some laws in effect that at least require piercers to know and take care of proper sterilization and such. Once that has been done the discussion on where to draw the line can be taken care of.
I think a discussion with the medical community would be in order and get them to agree to do subincisions, tongue-splits, castrations and other obviously surgical modifications so that the people that really desire these mods don't have to go to "less qualified people", i.e. piercers and cutters that don't necessarily have the appropriate training. This would hopefully raise the quality of many procedures at least as far as sterility and such goes and would be good for both communities I think (both unmodded and modded people that is). Even if the medical community doesn't want to actively participate in these procedures I think at least that a kind understanding should be achieved and that they could possibly just assist bodmod-artists instead.
Where to draw the exact line is hard. One might wanna draw the line at where it is no longer a matter of placing a piece of jewelry through a hole as in a piercing. However, some of the large gauge scalpelled piercings are very invasive procedures and could certainly be lifethreatening if the scalpel-wielder didn't know what he was doing. So I'm not sure where to exactly draw the line.
Part of the solution would in any event be for the "powers that be" to get involved and acknowledge that this isn't something that's going away and then enforce some kinds of laws that demand that anybody working with piercings and mods should have some form of training in order to weed out the money-grubbing hacks and minimize the amount of damage done to both communities by that kind of element.
As always, never a black and white issue. As a 'practitioner' of lighter mods (piercings and the like) who is very much interested in one day performing heavier modifications (branding and such), I really have no complaints with how the system is currently functioning. I should draw a line between myself and those less responsible, but for the most part I really have no problem with people experimenting on each other, as long as both parties are informed to the utmost extent, understand not only the procedure but the aftercare and social ramifications (up to and including legal prosecution), and have realistic expectations of the outcome.
Of course, I will always send a potential tongue-splitting client to a doctor first, however if the person is willing to take the risks associated with having the procedure done by a less skilled and less informed practitioner, I have some good references! In all seriousness, people are not as stupid as they seem, and if they understand what's best for them, they'll seek out appropriate measures. Appropriate is always a relative term, of course....
If, however, the government were to step in and sanction what can and cannot be done by non-medical practitioners, I don't think that action would stop what is already happening. Most procedures are grey-area illegal at best, and anybody performing something that they feel the need to keep quiet about is doing so for a reason. I really wouldn't like to see stiff penalties for body modification, because A) a practitioner isn't about to quit doing procedures once they pay off their fine or complete their jail time - this is not only a job for people, but a love and lifestyle for many; and B) there's no reason to! Again... if both parties are consenting, sane adults, there should be nothing holding them back.
As far as my philosophy goes, I am very conservative and will remain so. It's the people who haven't given any thought to their clients who worry me the most. As Shannon said, it's the "cool mod factor" or something like that. It is these people who will ruin it for the rest of us, if only for telling one too many people about a procedure that they didn't know how to perform properly. There are a lot of skilled artists out there, but most of them are fairly reserved and conservative in their practice.
I still haven't finished answering the question, have I? If I were to draw a line where a practitioner should not go, to begin with I would say that altering any internal organs would be a no-no...
A joke I read recently went something like "What's the difference between a piercer and a surgeon? The surgeon doesn't think he's a piercer!"
As far as I'm concerned, most of the surgical procedures being received by the modified community should be perfectly legal for body modification practitioners to perform. Things that include simple incisions (and sometimes sutures) are well within the abilities of many practitioners. Tongue splitting, meatotomy, subincision, hood splitting (basically any kind of splitting, and things like hood and labia removal) should be completely legal for practitioners to perform without a medical license.
Where it becomes a bit less clear is when you start discussing implants. I feel that transdermal implants should be done by practitioners, but subdermal implants should not. My reasoning for this is materials. Practitioners do not have legal access to suitable materials, or the training to carve them properly.
As far as laws and penalties go, I think we should be stricter with each offense. There should not, by any means, be a zero tolerance policy set on this. That would be incredibly damaging to the many people that are seeking these procedures. There should be regulation requiring proper sterilization and a certain degree of medical training (first aid, CPR, cross-contamination, etc; Nothing that you can't learn from Red Cross classes) in order to do these procedures. I don't feel the government needs to step in any more than that.
I consider bod mod and medical to be two different communities. However, the population as a whole most likely will not agree. I've heard a lot of problems both in the bod mod and the medical with faulty practitioners in my short but fruitful years. Over all, I feel there should be more practice and better knowledge gathered by all concerned about any form of treatment from tattoos to implants, and from piercing to setting bones.
No matter which category, practitioners are there enhancing and helping people, and absolutely need to be as up-to-date as they can for what their artistry happens to be.
As for laws and penalties, it will take a few tattooed congressmen to help correct the blurred line when it comes to the law itself. I'm not an authority on this, but I feel that if a person is really wishing to put the lives of others in their hands, they better know (or even better, are willing to learn from the start) what they are doing.
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