Bioethical Implications and Major Infrastructure Works

*José Marcos da Silva*

## **Abstract**

Brazilian oil refineries' environmental licensing process has been criticized for lack of healthcare aspects. Therefore, this paper aims to identify elements of bioethics that contribute to healthcare in this process. Based on an integrative review of scientific literature and on the deconstructive method proposed by Derrida, the relevance and legitimacy of bioethics to justify the relationship between morality and the consequences for individuals', populations', and ecosystems' health is justified. We conclude that bioethics may contribute as a theoretical and practical tool to solve conflicts by describing existing struggles and moral dilemmas, through processes of criticism and justification and the establishment of morally acceptable measures for the protection of humans and environmental health.

**Keywords:** bioethics, licensure, public health, environmental health, collective health, environment

### **1. Introduction**

This work has as object of analysis the environmental licensing of large enterprises in Brazil—illustrated by the issuance of the term of reference (TR) by the environmental agencies, by the elaboration of the Environmental Impact Studies (EIA), by the undertakings, and the public hearings that precede the decision to implement or not the related production processes—and the problem of the absence of elements for the protection of health in the socioeconomic dimension. Such an object is inscribed in specific phenomena: (a) the development of globalization and its hegemonic economic front—global capitalism; (b) local economic development; (c) the impacts on health and the environment produced by polluting production processes that generate life-threatening situations.

This theme is considered, as well as the phenomena in which it is inscribed, as a legitimate object of bioethics, for the reasons described below. First, because bioethics can be understood as ethics applied to human actions that bring about transformations recognized as significant and irreversible in the vital world.

In this sense, the implantation of large enterprises in the territories, on the one hand, affects the environment, both in the implementation phase—the moment of the construction of infrastructure works—and in the operation phase—by the emission of environmental pollutants that contaminate air, water and soil; on the other hand, it affects the life and health of the people who live in these places, by expropriation and removal of housing, by social and cultural changes related to migratory processes, by issues related to the disordered occupation of the territory such as favelization by human exposure to environmental pollutants, for generating forms of competition for access to local public assistance services, and, finally, for generating overload and scarcity in local health systems [1].

Secondly, because bioethics aims to analyze and understand the morality of the actions of moral agents on moral patients. It is understood that the transformations related to the process of implantation, operation and uninstallation of productive processes in the territories start from the decision of a certain agent, the State, and have consequences for the moral patients (those who suffer from the effects of the decision) represented by the residents, workers and professionals working in local assistance policies.

These are not only susceptible and vulnerable to possible consequences resulting from the State's action, but concretely and vulnerable. Thus, if the impacts on health and the environment can, in principle, affect anyone in the areas of influence of the enterprises, the negative consequences are concentrated, in fact, on specific individuals who work in the production process, those who live at the same time. Around and health professionals who are responsible for health care [2]. Thirdly, because, in its origin, the word ethos means "den" or "abode" and has a semantic proximity to oikos or "house."

Understood as thematization of ethos [3] ethics has in its spectrum of concern and performance the purpose of protecting susceptible and vulnerable subjects [4]; therefore, it has a relationship with health protection in the environmental licensing process. There is, therefore, a legitimate object, but little treated in the field of bioethics. Thus, the objective is to indicate tools of bioethics that contribute to the implication of health protection in Brazilian environmental licensing.

### **2. Method**

An integrated review of scientific literature was carried out which consists of constructing an analysis of the literature regarding discussions on research methods and results, as well as reflections on future studies [5].

For this, the following steps were established: (1) structuring the research question—which tools of bioethics contribute to the implication of health protection in environmental licensing; (2) search for evidence in the databases SciELO (Scientific Eletronic Library Online), VHL—Virtual Health Library and Redalyc—Network of Scientific Journals of Latin America and the Caribbean, Spain and Portugal, through the search feature (licensing OR licensure OR concesión de licencias) AND (bioethics OR bioethics OR bioethics) AND (public health OR public Health OR public health); and (3) application of inclusion criteria—indexed articles, published between 1990 and 2016, in Portuguese, English and Spanish; relevant content for research in abstracts; and exclusion criteria—incomplete articles, articles whose content did not meet the research design.

With the perspective of justifying the relevance and legitimacy of bioethics to support the relationship between the morality involved in the environmental licensing process and the consequences for the health of individuals, populations and ecosystems, the deconstructive method is used, as presented by Derrida, which seeks to make evident in the text that which sought to command it from outside [6].

#### **3. Result**

In the initial search process, 71 articles were identified. When applying the inclusion and exclusion criteria, nine were selected. Chart 1 summarizes the integrated review of the scientific literature with articles located in the SciELO, Lilacs

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*Bioethical Implications and Major Infrastructure Works DOI: http://dx.doi.org/10.5772/intechopen.93410*

intervention on the environment has power over life.

the face of the advancement of technoscience.

drinking water as a public health problem.

**3.3 Bioethics and accountability**

which interventions must promote the reduction of inequality.

**3.2 Bioethics and public health**

**3.1 Principle of quality of life**

investigation [7].

Brazil.

and Redalyc databases, in the period 1990–2016, according to the database, title, objectives and results related to elements of protection bioethics which contribute to the implication of health protection in the licensing of large enterprises in

In an article published in 1995, Schramm reviews the relevance of a natural ethics that considers the complexity of the health field and considers that human

In view of this, the principle of quality of life becomes a fundamental tool in issues related to being together, equity, justice, and general well-being. It questions the supremacy of science, proposing dialog for the transformation of scientific knowledge into common sense committed to the norms and values of societies and for the translation of common sense into questions for scientific

In 1997, Silva and Schramm [8] analyzed the environmental problem in the context of scientific rationality, in which the conflict between the relationship between man and the natural environment is evident and gives rise to social movements that denounce the environmental impacts produced by the highly techno-industrial model polluter, consumer of natural resources and generator of global biosphere disorder. It highlights the need for an ethics of solidarity involved with dialog, regulation, action, inclusion, with the recognition of conflict, with co-responsibility in

Schramm and Kottow [9] characterize the moral problems in public health and consider that principlism a particular current, originating in the United States of America, which provided a bioethical model for biomedical practices, whose core are the principles of autonomy, beneficence, non-maleficence and justice—it is not suitable for this field because it does not effectively fulfill the principle of justice in

Thus, they propose the principle of protection, which would be more suitable for bioethical purposes in public health, in which protection should be directed to the subjects who actually need it, through the implementation of public policies, morally correct and effective from the point of view of technicians. In 2002, an article tried to characterize the development of bioethics and its potential to deal with problems related to research with human beings. It presents lato sensu bioethics as a planetary ethics that is concerned with responsibility for the damage produced by human action on the environment [2]. Pontes and Schramm [10] studied the bioethics of protection and the role of the State with regard to unequal access to

The authors consider that bioethics contributes to the State's accountability as a strategic protective agent in the construction of a just and equitable society, committed to the protection of the health of its members, as well as to the promotion of its legitimate personal development projects. Schramm [1] carried out an analysis of the problem of applied ethics, bioethics and environmental ethics. Identifying that the common denominator between them is in the reference of each to ethics and ethos, as well as by the common methods to construct their specific objects;

and Redalyc databases, in the period 1990–2016, according to the database, title, objectives and results related to elements of protection bioethics which contribute to the implication of health protection in the licensing of large enterprises in Brazil.

In an article published in 1995, Schramm reviews the relevance of a natural ethics that considers the complexity of the health field and considers that human intervention on the environment has power over life.
