Informed consent in the Czech Republic

This paper describes the ethical practice of environmental epidemiology prior to the ‘velvet revolution’ at the end of 1989. The practice was essentially pragmatic. It was applied in a standard way in every central and eastern European country, with some modifications consistent with local conditions. The former Soviet model of national health care services used in these countries accentuated, both in theory and practice, the principle of prevention. As a result of the decades of pure pragmatism in resolving problems, however, there now exists a real risk from potential neglect of important ethical matters. Pragmatism has resulted in a potential incapacity to identify an ethical problem and to recognize its seriousness. It is a pervasive problem currently affecting all societies undergoing socio-political transformation, accompanied by troublesome and, sometimes, painful transitions. This process is evident to varying degrees in every country of central and eastern Europe.