Ethical beliefs of RNS compromised.

The photographic essay has been subject to a major controversy in radio, the print media and was even raised during question time in Parliament. The photos showing people engaged in intimate and private bodily functions should not have been taken in the first instance, and certainty not published for a range of reasons including:

* No assurance was given in the May edition that the residents saw the actual photos and agreed to their publication in a nursing journal.

* It is not appropriate to ask a family member for consent for photos if the resident cannot.

* The photographer having access to private activities in the bathrooms and toilets of a resident's home raise questions about the staff's ability to advocate for residents and provide a safe, non-invasive and homely environment. I accept there are differing opinions on the value of the essay, and some support for publication, but it is very concerning that publication has caused distress for a significant number of people. I am a member of the journal's editorial review committee and I was also disappointed by the response of NZNO's spokesperson, acting chief executive Cee Payne-Harker, to media questions in relation to the role of the committee. On Radio New Zealand (Morning Report, May 18) Payne-Harker said: "I don't know how well this has been explained to people but Kai Tiakiis an independent part of our organisation and it has its own editorial review committee and it was the decision of Kai Tiaki to publish these photos." As is clearly described on the title page of journal, the editorial review committee reviews clinical articles (articles reviewed are clearly labeled within the journal). Committee members did not see the photos nor know of their existence before publication.

This situation provides the opportunity to learn from the issues that have arisen. Kai Tiaki Nursing New Zealand is a key publication for registered nurses (RNs). While I appreciate the journal also represents the interests of other health workers, it is really important the professional identity and ethical beliefs of many RNs are not compromised by our own publication. I believe it would be advisable to develop a more formal and collective content review process for the journal. One possibility is an editorial board with RN members who work with the co-editors determining suitable content, and who are then able to defend the publication from a professional and ethical perspective, if any issues arise.

Jean Gilmour, RN, BA, PhD, senior lecturer, Massey University, Wellington, and member of Kai Tiaki Nursing New Zealand's editorial review committee