There is a thoughtful essay on the ethics of photographing patients over at the Literature, Arts and Medicine Blog. Ana Bhlom raises a number of interesting issues, not only about privacy but about intellectual ownership and the dissolving of boundaries between fictionalisation and integrity.
She says: 'The ethical question in writing fiction, non-fiction, and creative non-fiction, is not necessarily about the propriety of using your patients as inspiration for artistic work–it has more to do with the subsequent dissemination of your aesthetic output. The issue becomes one of privacy and of authorship. If privacy is protected by changing recognizable facts, then at what point are the particulars altered so much that the distinction between fiction and non-fiction becomes absurd? If the fiction is tinted with the hue of a real interaction, then is the physician-writer guilty of thieving from her patients for the benefit of her characters?'
It's a good question, and good to see awareness being raised of this important issue. Sometimes anonymising patients and fictionalising details is disempowering in its appropriation of patients' stories. Yet, the uses to which images are put is increasingly difficult to control in a cut-and-paste world, and the meaning of image is dependent far more on its context than its content. Conversations about the way both stories and images are used need to be had, if possible, at the bedside. Bhlom's collaborative approach suggests a good way forward in negotiating the murky waters of documenting the patient encounter outside of a strictly medical environment.
Jo Spence (pictured) pointed out that the kinds of family snapshots we take tend to be present a very partial view of our lives. Family albums are filled with 'say cheese' type pictures. Illness is often a life-transforming experience and perhaps ought to be acknowledged in family histories more than it tends to be at the moment. How lovely that Ana Bhlom's patients often choose to display her photographs on their walls.