In 1971, renowned American photographer W. Eugene Smith journeyed to Minamata, Japan, to capture the devastating effects of a slow-building environmental catastrophe, what became known as Minamata disease.
Smith’s series of photographs brought global attention to the industrial pollution crisis, but one image stood out above the rest: Tomoko Uemura in Her Bath. This poignant black-and-white photograph shows a mother, Ryoko Uemura, gently bathing her daughter, Tomoko, who had been born with severe deformities caused by mercury poisoning.
The image, published in the June 2, 1972, edition of Life magazine, quickly gained worldwide recognition as a symbol of love amidst tragedy and the environmental destruction caused by corporate greed. It became a focal point of international attention, shining a light on the Kamimura family, who initially welcomed the spotlight, hoping it would help their fight for justice and it would aid in their struggle against pollution. However, the increasing attention brought unintended consequences. Rumors circulated that the Kamimuras were profiting from the publicity, and the local community—many of whom depended on the Chisso Corporation for their livelihood—resented their advocacy efforts. The family faced immense pressure, and their daily lives were made increasingly difficult by persistent rumors and animosity.
Tomoko passed away in 1977 at the age of 21. Years later, in 1997, when a French television company sought to feature Smith’s photograph in a documentary about iconic images of the 20th century, Yoshio Kamimura refused. By then, he felt it was time for his daughter to rest in peace, stating that he no longer wanted Tomoko’s image to be exploited.
At this point, Aileen Mioko Smith, W. Eugene Smith’s wife and co-photographer during the Minamata project, as well as the custodian of his photographs after his death in 1978, took an unprecedented step. Hearing of the Kamimura family’s wishes, Aileen traveled to Japan in 1998 to meet with the family. Rather than asserting her legal rights, she made the remarkable decision to transfer full control of the photograph to the Kamimura family. She recognized the deep emotional burden the photograph carried for them and believed that their authority over Tomoko’s image was more significant than the legal ownership she had inherited. “This photograph would mean nothing if it did not honor Tomoko,” Aileen said. “It would be a profanity if it continued to be issued against the will of her family. This photograph must honor her life, and through it, her death.”
Aileen’s empathetic decision raises critical questions about the boundaries of consent and the role of photographers in honoring the dignity of their subjects. While legal consent has evolved over the years—especially when compared to the looser standards during the mid-20th century when Life magazine was at its peak—Aileen’s actions reflect a deeper understanding of the emotional and ethical complexities that consent alone cannot address. Her choice reminds us that even with consent, the weight of an image’s legacy requires ongoing ethical consideration, especially when it involves sensitive and vulnerable subjects.
The incident involving W. Eugene Smith and the Kamimura family underscores the profound ethical questions that continue to shape photography today. Issues of consent, power, and representation remain as pertinent in the digital age as they were during the analog era. With the ease of replication and distribution in today’s digital world, the stakes are even higher, and the lines between empathy, consent, and exploitation are frequently tested.
To photograph is to appropriate the thing photographed. […] There is an aggression implicit in every use of the camera.
On Photography, Susan Sontag (1977)
Sontag’s words highlight the inherent power imbalance in photography and raise the question: can informed consent ever fully address the complexities of this dynamic? The story of Smith, the Kamimuras, and Aileen’s decision reminds us that empathy and ongoing ethical engagement are vital in the practice of photography, far beyond the confines of legal consent.
Informed Consent: A Shield or a Form of Control?
In photography, consent typically refers to obtaining a subject’s permission to take their photograph, but this is often where the engagement ends. The subject may not fully understand how their image will be used, where it will appear, or who will have access to it. This is where the concept of informed consent becomes crucial. Unlike basic consent, informed consent requires that the subject is provided with a clear understanding of the potential uses of their image—whether it will be published online, featured in an exhibition, or used for commercial or advocacy purposes. This process is supposed to ensure the subject can make a knowledgeable and voluntary decision about their participation. The distinction between consent and informed consent lies in the depth of understanding—the former offers only basic permission, while the latter requires transparency and communication about the image’s future use.
As both a trained medical photographer and a practicing global public health photographer, I have experienced firsthand the implications of informed consent in both areas. In medical photography, informed consent serves as a cornerstone of ethical practice. Patients are often photographed in highly vulnerable conditions—within controlled environments and confined spaces such as surgeries, treatments, or examinations—where images are primarily used for medical record as an adjunct to clinical care, students and other audiences in medical educational settings, and/or published in medical journals or other media as part of medical research. The reasoning behind consent in these cases is straightforward: it safeguards the patient’s autonomy, ensures their privacy, and grants them control over how their images are used, often with the options to make specific choices. In medical contexts, consent operates within a larger ethical framework that is crucial to preserving the trust between healthcare providers and their patients. In fact, a quick internet search for the term ‘informed consent’ primarily brings up results related to clinical settings, including its use in medical photography.
However, the dynamics change significantly when we shift to development sector photography. In these fields, images are not captured for educational or research purposes but often for advocacy, awareness-raising, or fundraising efforts. The intent is different: photographs serve as powerful storytelling tools to draw attention to issues like poverty, disease, or climate change. It’s more about the community than the individual. Here, the act of photography is no longer confined to a clinical space; it becomes part of a global narrative that can amplify voices but also exploit them.
Informed consent is often sought in these settings, but its effectiveness is frequently diminished, becoming more of a legal safeguard for organizations than a meaningful engagement with the subjects. This is particularly problematic in regions like the Indian subcontinent, where consent frameworks are typically derived from Western models and are not adapted to local cultural, linguistic, or social contexts. Such frameworks often impose complex, bureaucratic language that is detached from the realities of rural or marginalized populations, creating significant barriers to understanding. For informed consent to be effective in India, it must be adapted to the cultural and social realities of its communities, factoring in literacy levels, regional languages, and cultural sensitivities, especially in a country with 22 official languages and over 1,600 regional dialects that fall under Indo-Aryan, Dravidian, Tibeto-Burman, and Austroasiatic languages. Additionally, the concept of consent may need to be reinterpreted in communities where decision-making is collective rather than individual, as Western notions of consent often fail to align with local practices of participation and autonomy.
Photographers working in the development sector often face these challenges firsthand. Typically, their assignments are short-term, without much time to build rapport and trust among the communities they photograph. These photographers often arrive with a tool of power—their camera—along with the representation of the organization they work for. In these moments, they must navigate a delicate balance between the fear of offending and the politeness of the subjects, who may feel obligated to sign consent forms despite not fully understanding their implications. Frequently, photographers are brought in at the end of a multi-year program, with only a few days—sometimes just hours—to capture images and visually narrate the entire project. The tight schedules leave little time to properly explain the meaning of consent or to ensure that subjects are fully aware of how their images might be used after the project ends.
The camera doesn’t rape, or even possess, though it may presume, intrude, trespass, distort, exploit, and at the farthest reach of metaphor, assassinate-all activities that, unlike the sexual push and shove, can be conducted from a distance, and with some detachment.
On Photography, Susan Sontag (1977)
This time pressure, combined with the need to fulfill the visual requirements of an organization, makes true consent difficult to achieve in practice. And Sontag’s words resonate with the reality of many development photographers: despite their best intentions, the speed and nature of their work mean that consent often becomes a superficial formality conducted from a distance with some detachment, rather than a genuine dialogue with the communities they document.
The Illusion of Consent and its Impact on Equity and Inclusivity
Informed consent, particularly in development sector photography, not only serves as an imperfect safeguard but also jeopardizes equity and inclusivity. The process of consent itself often reinforces existing power structures and prejudices, limiting the agency of marginalized groups. Consent in these contexts can become a mechanism that masks deeper ethical concerns rather than addressing the true dynamics of power and inclusion.
For example, in many communities, there are unspoken power hierarchies that complicate the process of consent. A photographer from an international organization—often seen as an authority figure—may not fully grasp the local dynamics that inform the interaction. The subject, particularly someone from a marginalized background, may feel compelled to comply with the request to be photographed, not out of genuine consen but out of a fear of offending or disrespecting the photographer or organization. This imbalance of power ultimately undermines the ideals of equity and inclusivity.
Prejudice and bias can also seep into the photographic process. Often, images of marginalized communities are captured either portraying hardship, poverty, or, conversely, overly optimistic scenes of smiling faces, perpetuating stereotypes and offering a limited, one-dimensional portrayal of these populations. This is especially prevalent in the Indian subcontinent, where social divisions based on caste, gender, and economic status can skew the photographer’s perspective. Even when consent is obtained, the resulting images may reflect the photographer’s own biases rather than the true diversity and complexity of the community.
The camera doesn’t lie, but it can be an accessory to untruth.
Harold Evans
In these instances, consent does not effectively tackle the broader concerns of representation and narrative control. It enables photographers to assert ethical credibility while continuing to reinforce damaging stereotypes and unequal power dynamics, largely driven by organizational expectations. Rather than fostering inclusivity, this shallow consent process can exacerbate divisions and suppress marginalized voices by portraying them through external, often foreign, viewpoints.
This illusion of consent can be especially detrimental in the development sector, where the imagery created often defines public perceptions of entire communities. The reliance on images that depict suffering or hardship to generate sympathy and donations has the unintended effect of reducing people to their vulnerabilities rather than celebrating their resilience, culture, or strengths. This dynamic limits the subjects’ ability to control their own narratives and reinforces their marginalization.
Digital Photography: The Era of Endless Replication and Vulnerability
In the digital age, the question of consent becomes even more complicated due to the rapid and enormous distribution potential of photographs. Unlike the analog era, where a photograph existed in a physical form and was relatively contained, digital photographs are endlessly replicable and distributable. Once a photograph is uploaded to the internet, it can be downloaded, shared, and distorted countless times, often without the knowledge or consent of the subject. This vulnerability opens the door to misrepresentation, exploitation, and unintended uses far beyond the initial context in which the image was created.
The ease with which digital images can be manipulated only intensifies the problem. A photograph taken with ethical intentions can be appropriated and altered for purposes far beyond the control of the original photographer. As Susan Sontag observes, there is an inherent aggression in photography, and in the digital age, this extends to photographers losing control over how their images are used, often by the organizations they represent. Additionally, since photographers sign consent forms on behalf of the organizations they represent, this creates a potential loophole where the photographer could be held legally accountable if issues arise later. In this context, informed consent provides limited protection against the vast potential for the replication and misuse of digital photographs.
Photography is not objective. It is deeply subjective—my photography is consistent ideologically and ethically with the person I am. […] I don’t believe a person has a style. What people have is a way of photographing what is inside them. What is there comes out. […] You photograph with all your ideology.
Sebastião Salgado
Salgado’s recognition of photography’s subjectivity highlights the limitations of consent in the digital world. A subject’s consent to have their photograph taken does not account for the photograph’s life beyond the moment of capture—where it might be shared, manipulated, or reused for unintended purposes. Therefore, the responsibility does not rest solely with the photographer but also with the organizations that ultimately control how these images are used. Freelance photographers, in particular, often lose oversight of their work once it is handed over, leaving the images vulnerable to misuse or exploitation beyond their intent.
Integrating Empathy into Photography Practices
In a world where images travel faster than ever, integrating empathy into photography practices is essential. Empathy asks photographers to step beyond their role as detached observers and to build deeper relationships with the people they photograph. This requires a shift in mindset—moving from capturing images to sharing stories with mutual respect and understanding.
The camera is an instrument that teaches people how to see without a camera.
Dorothea Lange’s insight suggests that empathy lies not just in what the photographer sees but in how the subject is portrayed and how their story is told. This is particularly important in development photography, where cultural differences and socio-economic divides can obscure the humanity of the subject.
In diverse cultural contexts, empathy means recognizing and respecting the cultural norms, values, and emotional landscapes of the subjects. It involves asking questions like: How will this image affect the people I photograph? What are the long-term implications of capturing this moment? How can I ensure that the dignity of my subjects is preserved, not just in the moment, but in the narrative that my photographs create?
Photography for me is not looking, it’s feeling. If you can’t feel what you’re looking at, then you’re never going to get others to feel anything when they look at your pictures.
Photographer Don McCullin, known for his war photography, often spoke about the burden that comes with documenting human suffering. McCullin’s reflection highlights the emotional labor involved in ethical photography—the importance of feeling with the subjects, not just looking at them.
Building Trust Between Photographers and Subjects
In sensitive settings, where the power dynamics between photographer and subject are heightened, trust is essential. Building trust involves time, transparency, and active listening. It is not enough to simply ask for consent; photographers must and should be allowed to engage with their subjects as collaborators in the storytelling process. This means explaining the intent behind the image, being transparent about where and how the image will be used, and, crucially, being open to feedback from the subjects themselves.
If I could tell the story in words, I wouldn’t need to lug a camera.
Hine’s commitment to telling the stories of marginalized workers highlights the importance of not just taking a photograph but engaging with the subjects in a way that honors their experiences.
One effective strategy for building trust is to involve the subjects in the creative process. Instead of merely taking a photograph, invite them to co-create the narrative. This could mean discussing the framing, asking for input on the context of the image, or sharing the final product before it is published. This collaborative approach shifts the photographer from a position of authority to one of partnership, and it’s a practice that organizations should also prioritize.
In some cases, returning to the subjects with printed copies of the photographs, explaining their significance, and asking for continued consent before publishing can reinforce the relationship and trust. Sebastião Salgado is known for spending significant time with the communities he documents, earning their trust through patience and respect before ever picking up his camera. This approach ensures that the subject’s voice and dignity remain central to the final image.
Towards an Ethical Visual Culture
The incident with W. Eugene Smith and the Uemura family remains a crucial example of how even the most well-intentioned photography can have unintended consequences. It highlights the limitations of consent and the importance of ongoing ethical engagement with the subjects of photographs. In the digital era, where images can be replicated, distorted, and shared across vast networks with little control, the responsibility and ethical obligations of both photographers and organizations have become even more critical.
As we move forward, it is clear that empathy and trust-building must be at the heart of photography in sensitive settings. In the Indian subcontinent, where power imbalances and cultural complexities abound, these values are particularly important. Organizations must move beyond the superficiality of consent and towards a more human approach that prioritizes the dignity, agency, and emotional well-being of the people they photograph.
To photograph is to appropriate the thing photographed.
On Photography, Susan Sontag (1977)
It is only by recognizing the weight of this appropriation—and by working to mitigate its potential harm—that photographers and organizations can contribute to a more ethical visual culture.