Theory and practice of informed consent in the Czech Republic

Abstract

The large-scale change of Czech society since 1989 has involved the democratic transformation of the health system. To empower the patient was one important goal of the healthcare reform launched immediately after the Velvet Revolution. The process has been enhanced by the accession of the Czech Republic to the European Union and the adoption of important European conventions regulating the area. The concept of informed consent and a culture of negotiation are being inserted into a traditionally paternalistic culture. Our article describes the current situation on the issue of the communication of information on state of health and treatment, and on the question of the participation of the patient in decisions on treatment. We present empirical results of a public opinion survey on this issue. The results show a still prevailing submissive attitude towards the physicians, despite the fact that the concept of informed consent has become more and more publicly familiar (42% of respondents gave the completely correct answer regarding informed consent). The impact of age, education and sex on answers to the questionnaire was analysed. Men, younger and more educated respondents were more likely to show the autonomous attitude, whereas women, older and less educated people tended to show the traditional submissive attitude. Further, our article raises the question of the cultural and historical background within which the current ethically and legally binding norms (products of western democracies, in fact) are interpreted. The question is how far cultural modifications are tolerable in the practical implementation of universal ethical constructs (informed consent).

Limited family members/staff communication in intensive care units in the Czech and Slovak Republics considerably increases anxiety in patients ́ relatives – the DEPRESS study

“…Family members clearly preferred an extended educational style interview over receiving written information. This finding seems to mirror findings in a study focused on informed consent in the Czech Republic that reflected “an unquestioning willingness, of a significant proportion of citizens, to accept, in cases of illness, all decisions made by doctors during the course of treatment” [ 19 ].…”

Are physician-patient communication practices slowly changing in Croatia? – a cross-sectional questionnaire study

“…In transitional countries, there is often a discrepancy between the actual legal provisions and situation in health care system because of poor implementation of legal standards (10,11). Transitional countries also often display specific cultural patterns of physician-patient communication (12-14), such as the lack of the information exchange and a paternalistic approach to patients (10,12,14). To the best of our knowledge, these issues have not been systematically studied in hospitals in transitional countries of Central and Southeast Europe, except in Slovakia (15).…”

Public and private surgeon attitude towards informed consent

“…37 In a study that was conducted in the Czech Republic, younger, highly educated men participants were likely to show the autonomy than older, less educated women. 38 On the other hand, another study supported the idea that women tend to be more information-seeking than men in health settings and tend to read the consent forms to alleviate uncertainty and trust concerns. 39 Also, in a previous study that was conducted to assess the role of educational status in informed consent, the author stated that poorly educated patients also want to be informed.…”