Photo essay prompts huge response.

Publication of a 39-image photographic essay in last month's Kai Tiaki Nursing New Zealand, featuring the work of caregivers in two resthomes, has provoked a huge response within nursing and in the public arena.

The photographs, by professional photographer Alan Knowles, included a number of photos in which elderly residents were being showered and toileted and it is these images that have been the main focus of criticism. All those in the photographs consented to their publication in a variety of forums.

Kai Tiaki Nursing New Zealand has received an unprecedented number of letters from nurses, both expressing opposition to and support for publication of the essay. The deluge of letters has meant this issue is the largest Kai Tiaki Nursing New Zealand ever published. Editorial comment in a range of media publications has generally been supportive.

NZNO's Gerontology Section has lodged an official complaint with NZNO's chief executive Geoff Annals over publication of the photographic essay. Its opposition centres on what members see as an abuse of elderly people's right to dignity and privacy (see letters p3). Other complaints have been lodged with NZNO's board of directors.

The New Zealand Association of Gerontology has written to Health and Disability Commissioner Ron Paterson asking him to investigate "the matter and take action to ensure that people in residential care everywhere in New Zealand are protected from such ill-considered photography and publicity in future".

The letter, signed by association president Verna Schofield, who is senior research fellow at Canterbury University's Department of Social Work, stated that a number of the images were "extremely offensive in theft intrusion on the privacy and dignity of vulnerable older people". It lists a range of issues the publication raises, including consent, and calls on the Commissioner to use his powers "to prevent such a regrettable incident ever being repeated". Age Concern's chief executive Ann Martin sam she was concerned that in the debate over the photographic essay, older people were being portrayed as a group incapable of thinking for themselves. "It's true many older people are physically disabled, especially those in residential care, but many are not and if they are, the physical limitations don't make them disabled in their thinking. Many are very sharp with valid opinions and views on a range of matters, just like any group of people."

Age Concern respected the views and decisions of older people. "If some decided they wanted to become involved in an activity to support their carers by being photographed, then we concur in principle. They have as much right as anyone else," Martin said.

NZNO chief executive Geoff Annals, who was out of the country when the media storm over the essay broke, said he did not believe publication of the photos exploited the subjects or diminished the dignity of the individuals who chose to participate. If the individuals who were the subject of the essay gave meaningful consent and were not harmed by the publication, no nurse could be said to have acted improperly in relation to the matter.

"In provoking us all to reflect on our attitudes and disposition towards the dependent elderly members of our society, I suggest the essay has served an important purpose and is consistent with the best traditions of nursing and journalism," he said.

Co-editors Anne Manchester and Teresa O'Connor said they had expected the photo essay would provoke some controversy within nursing, as it was breaking new ground. But they were surprised at the vehemence of some nurses' responses and at how quickly the debate entered the public arena and the interest it aroused (see p2).

COMPLAINTS TO BE INVESTIGATED

In a statement on the photographic essay, NZNO's chief executive Geoff Annals said that all the complaints received would be fully investigated and acted on as appropriate.