The real problem is the reason for our laws in the first place: some practitioners have differing opinions about what’s good for consumers. If we all decided to go overseas to sidestep U.S. law, it is likely that consumers overseas could get hurt and have no recourse. I suppose some U.S. practitioners would welcome that arrangement. But our ego-centrism has been a problem for many consumers, even in the U.S. (i.e., doctors saw fit to have sex with them in the US to “show” patients how to be more “functional.”)

Similarly, our ethnocentrism could be harmful overseas. The truth is that overseas practice is more complex than one would imagine at first blush. How many of us studied multi-cultural mixed-marriage issues related to Croatia? adoption or step families in Sri Lanka? alcoholism in Bolivia? How many of us know about Hindu religious/sexual practices in Pakistan? Or gay issues in Nigeria? Many people live in different cultures and speak English differently than we do. We can’t understand everyone who approaches us online.

What if these people speak English reasonably well, and lie to us about their geographical location, just to get service from an American doctor? What if they aren’t aware of the level of detail we need before rendering ethical services. Just as we are not supposed to do therapy with African American, Hispanic or any other group without multi-cultural training if we aren’t from that same group, we have an ethical duty to know the linguistic, cultural and religious issues before we offer treatment to anyone.

It is daunting to stop and think of the possible ramifications of our actions when we deviate from the standard of care and practice internationally. That’s why we have laws and ethics codes to guide us. But if you are 100% sure you will “do no harm” then you make a good point. Lawyers are quite expensive. Contact your own licensing board first, and let us know what they said, ok?