Photos were potentially abusive.

The members of NZNO's National Gerontology Section committee are outraged at the images of older people in care, published in the photographic essay in the May edition of Kai Tiaki Nursing New Zealand.

A number of the images depict frail and dependent order people in a state of undress, on the toilet or being dressed. We believe the manner in which they are portrayed removes their right to dignity and privacy and infringes the Hearth and Disability Code of Rights and Human Rights legislation.

We question the motives for printing these photographs at this time. The essay is obviously being used in the industrial campaign "Fair Share for Aged Care". This logo appears on the bottom of the fast page and undoubtedly confirms this. We believe it is unethical and potentially abusive of the dependent and vulnerable status of the residents concerned, to use these photographs in a campaign to get better conditions for caregivers. As a group we strongly support better conditions for caregivers but do not condone using vulnerable residents for this purpose. We also have issues with informed choice and consent being obtained from the residents. Consent may have been gained as stated, but was it fully informed consent? From whom was consent gained for each resident and to whom was it given? Is there documented evidence to support this? Frail, dependent residents are in a powerless position. Did these people have the cognitive capacity to make an informed choice? We believe it is inappropriate to even consider asking them to consent in this situation.

There are also important ethical and moral issues at stake here. The NZNO Code of Ethics (2001) supports the underlying values of non maleficience (protecting the rights of clients in order to minimise or prevent harm), justice (respecting the rights of individual people, their dignity, needs and values), confidentiality (safeguarding the physical, emotional and social rights of unwanted intrusion) and being professional (providing nursing practice which meets standards developed by the profession). As registered nurses we expect our professional organisation adheres to its own ethical code. As the section specialising in gerontology, why were we not consulted about the contents of this essay or shown the photographs prior to publication? Thirty-five thousand copies of this so-called professional journal have gone out. The resulting adverse publicity will undo years of hard work by nurses and caregivers in their efforts to represent aged care positively within both the nursing profession and the wider public domain.

There are many more positive ways in which caregiver work can be presented and celebrated. This committee believes the essay gives an unbalanced view and devalues the work caregivers do.

Beth Kelly, Lyneta Russell, Christine Davies, Juliet Kenworthy, Dorothy Moore, Gillianne Meek, Lois Waugh, Annette Senton, Sally Fleming and Gillianne Meek, National Gerontology Section (NZNO) committee members

Co-editors note: The issues and questions raised in this letter and the following ones, on last month's photographic essay, are answered in the editorial on p2 and a viewpoint by photographer Alan Knowles on p10.