When I was a kid, if you died with a mortal sin on your soul, you went to hell. Knowingly eating meat on Holy Friday would have been a mortal sin. BUT—in 1966, eating meat on Friday was, overnight, suddenly deemed OK, so no longer any kind of sin, let alone a mortal one.

So, on one Friday, some kid knowingly ate a fried baloney sandwich (well done, toasted bread, with ketchup, I would hope), walked outside, got hit by a Greyhound bus, and went straight to hell, because it was a mortal sin. However, the following Friday, some other kid ate a cheeseburger at the bowling alley (grilled onions, extra ketchup, sweet relish if you have it), and it was no longer a problem in the eyes of God.

That’s messed up. I was 13 in 1966, when the Second Vatican Council decided eating meat on Friday was no longer a sin. That ended my amicable relationship with Catholicism, and probably with most rule-makers and regulatory bodies in the land, and on the planet

Even at that young age, I deeply knew—“You can’t do shit like that.”

Which leads me to the Practice of Psychology, Counseling, Social Work, Art Therapy, and so on.

It was not long ago (say 5-6 years?) that an insurance company would not approve my offering remote services to a client in Albuquerque when I was in Santa Fe. The client was agoraphobic, and could not yet leave the house. Hello.

The justification of course was something along the lines of “It would not be efficacious to work with a client remotely”, and/or that “That would be unethical.”

Reality: “You’re an insurance company, and your goal is to write as few checks every day as possible.” The “Ethics” crap was gaslighting, lying, being cheap-ass at their policy-holders expense. Flat out.

Many of these arguments were and still are often framed as “Ethical Dilemmas” when in fact they are not. When they say we can’t see a client with NM insurance if they are visiting in Colorado, that is NOT actually necessarily an Ethics-Based principle, nor one related to clinical efficacy. It is states wanting control and money. Nothing less. They have the right, of course. It’s their ball. That is not the issue. But call it what it is. You don’t want somebody practicing in your state until they have paid the local piper.

All of the business of needing to be IN the state and the client needing to be IN the state is often bullshit, as far as true Ethics go. (These statements are all according to me, not like “TRUTH”.)  Now with tele, we can see somebody anywhere in the random mythical borders of a state. (New Mexico was not always “New Mexico.” Hawai’i was a Kingdom until 1893, under the rule of Queen Lili’uokalani. The borders of countries and states are in large part random as hell. Go two feet that-a-way across the literal Texas line with no Texas license, and that is now “unethical”? Yeah, whatever…)

But now, in 2023, it is somehow no longer a problem to “see” somebody in Silver City while sitting in your back yard in Santa Fe. Just don’t do therapy with a client driving in their truck over the Raton Pass, because the second they pass into Colorado, that conversation is against the rules!!!  (Don’t you love the 3D world?)

It used to be (I’ve been in some kind of clinical practice since 1987, and licensed in 5 states, so I forget exactly when and where) that supervisors of practitioners who did not have an independent license had to be IN THE BUILDING. Not at the Weed Dispensary, not at the Starbucks drive-through. It would be “unethical” otherwise. So when did the ethicality of THAT change? And why?  All bullshit, if that was being called an “ethics” issue. It was against some rule made downtown. Calling it ethics does not make it ethics.

Speaking of weed, people were put in prison for weed, which is now dispensed and sold and taxed by the government. What happened to Weed being Satan? Fact is, it never was, but some idiots out there threw people in prison as if it were. (I am the farthest thing you could imagine from being a Weed Guy, by the way. Nor am I a Conspiracy Guy. Far from that, too.)

Now many of us have licenses from all over creation, from sea to shining sea, and beyond (I have a Hawai’i license.) We can live in Truth or Consequences, see a client in Bangor at 9 and a client in Kauai at 10. As long as you are licensed in those 3 places, nobody cares. You DO need the license, but it is no longer being framed falsely as an ethical dilemma. They do want to know if you are licensed there, and where the client’s insurance is. These are business questions, no longer “ethical.” (Or so it seems to me, for the most part. I am not an expert in this stuff, let me say. But I am not a moron. At least most of the time.)

Psypact and the Counseling equivalent will make it possible for people to practice in lots and lots of places, as long as you pay the pipers all along the way. “Ethics” seems to have fallen to a lower level concern.

Then there are also “Temporary Practice” licenses, which basically say “it is OK to practice in our state without a license”, which they would never do if such a practice were TRULY considered unethical or dangerous. Under that circumstance, it is not being viewed as an ethical decision, but only a business and regulatory one.

Some stuff that was framed as “Unethical” for many years was, in reality, only against the rules. There was often no “moral reprehensibility” or behavioral impropriety—it was just against the rules, or against the laws. There is nothing fundamentally wrong with that, but I really do not like that so often these things come up as so-called ethical dilemmas, when they often are not. They are just a matter of Rules.

There is stuff that is legal, but ethically dubious.

There is stuff that is illegal, but not (at average to high sociomoral levels) ethically dubious.

Sometimes stuff that is illegal is even morally and ethically superior.

And don’t get me wrong. I understand that some clinical presentations are not really a good idea for remote treatment at all. This piece is not about “which clinical presentations lend themselves to tele.”  I am not anywhere near smart enough to present on that. Though I distinctly remember many professionals coming down HARD on how you could NOT do, for example, EMDR, remotely. This was at the beginning of Covid, when we were trying to figure out, well, everything. And now it seems EMDR can be done from outer space, if you have a Temporary License from Jupiter.

OH! And college students from any state or country whatsoever can go see Psychlogists and Counselors at the University Counseling Center. There’s that. Nobody gripin’ ’bout dat.

So money is money, laws is laws, rules is rules, ethics is ethics, moral dubiosities is moral dubiosities. They ain’t all the same thing.

Call ‘em as they are.

(Which reminds me of an old story. They asked 3 umpires how they called balls and strikes. First ump says “I calls ‘em as I sees ‘em!”  Second ump says “I calls ‘em as they is!”  Third ump says “They ain’t nothin’ till I calls ‘em!”)

I think I stole that from Carl Rogers. Now THAT probably is a felony. Stealing from Carl Rogers.

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