"Practicing medicine without a license" is a serious charge that can result in years of jail time, that could, in theory, be leveled against body artists performing implants, tongue splitting, subincision, and similar body modification procedures. Cutters have been successfully prosecuted under these sorts of laws after castrations and labial removals reached the eyes of local authorities.
Technically speaking, the laws are usually worded something like this (these examples are from Michigan):
An individual who practices or holds himself out as practicing a health profession subject to regulation without a license or registration or under a suspended, revoked, lapsed, void, or fraudulently obtained license or registration, or outside the provisions of a limited license or registration, or who uses as his own the license or registration of another person, is guilty of a felony. For the purpose of the offense of practicing medicine without a license, the "practice of medicine" means the diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these acts.
As you can see, the problem is that even when put in legal-speak, "medicine" is not that clearly defined, and the definition changes regularly, depending on what the mainstream medical community feels is "medicine" (for example, until the 1960s or so, elective cosmetic surgery was not widely considered to be medicine). In some countries, chiropractors have been arrested for this, and in others, cult-like religious organizations have been charged with it (for "psychiatry"). Others have accused the government of this charge for forced vaccinations and other issues.
While these sorts of charges are very clear cut in the case of estheticians performing silicone injections or liposuction, or unlicensed doctors (often recent immigrants from other countries whose MDs are not recognized in the West) performing surgery at reduced prices in their basements, when it comes to procedures that are not widely offered by the medical community (such as tongue splitting or genital bisection), it is much less clear whether a crime has actually been committed or not.
In these cases, people have chosen to defend themselves on a number of different grounds (these are just a few ideas):
- Religion—A mohel, for example,is allowed to perform circumcisions without being a doctor because the Jewish faith makes a case for its religious need. That said, even though, in theory, the legal system provides them with equivalent protection under the law, non-mainstream religious have not been successful in this area (Others, of course, raise the point that if a procedure isn't curing a disease, and isn't being offered by doctors, then it's not medicine. That is, "you can charge me with assault if you want, but not medicine!" — although the success of this defense likely boils down to the amount of money you have to spend on your lawyer. The majority of people choose to plead out.
- Art&mdsah;Since the 1970s, a great deal of legal protection has been afforded to artists (including performance artists doing heavy body modification and body rites) and the definition of "art" under US law tends to boil down to "it's art because I say it's art". By being very clear that the procedure is not a medical procedure but a commissioned work of art, additional protections are procured.
- Consensual Sex—Some procedures can be seen as falling into the realm of heavy SM sex play, and, depending on the relationship of those involved, may be protected depending on the country's laws.
My strong advice to any practitioner performing procedures that fall into grey zones is to consult and retain a lawyer, both to advise as to the legality of procedures and potentially defend you, but also to help you draft consent forms and releases that will go a long way to protecting you should you have to face the courts.