**3.1 Principle of quality of life**

*Bioethics in Medicine and Society*

assistance policies.

oikos or "house."

**2. Method**

forms of competition for access to local public assistance services, and, finally, for

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

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

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

An integrated review of scientific literature was carried out which consists of constructing an analysis of the literature regarding discussions on research methods

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

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].

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

implication of health protection in Brazilian environmental licensing.

and results, as well as reflections on future studies [5].

content did not meet the research design.

generating overload and scarcity in local health systems [1].

**190**

**3. Result**

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 investigation [7].

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 the face of the advancement of technoscience.

#### **3.2 Bioethics and public health**

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 which interventions must promote the reduction of inequality.

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 drinking water as a public health problem.

#### **3.3 Bioethics and accountability**

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;


**193**

**Year** 2002

Lilacs

Bioethics, its development and importance for Life and Health Sciences [2].

To characterize the development of bioethics and its usefulness to face the problems that arise in research involving human beings, taking into account both the disciplinary and methodological requirements of bioethics and some needs of ethics.

**Base**

**Title**

**Purpose**

**Results**

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

Bioethics contributes to the State's accountability for the

provision of sanitation services, and, in particular, the provision

of good quality water. From a view of access to water as a right,

privatization policies in favor of public policies that aim to correct

situations of social injustice, protect the health of populations

and, in particular, of population groups constantly threatened, are

promoted, promoting conditions for a better quality of life.

It shows that, in the Age of Globalization, applied ethics, bioethics

and environmental ethics are in fact intertwined. This implies

conceptual, methodological, disciplinary, interdisciplinary and

transdisciplinary tools used by the three forms of thematization of

the ethos under examination in order to be able to account, at the

same time, for the identities and differences between these three

areas of knowledge and Ethics practices

2004

SciELO

Protection bioethics and the role

Examine unequal access to drinking water as a health

issue, analyzing the moral implications, primary needs,

situations of fragility and threat of population groups and

responsibilities for water supply.

of the State: moral problems

in unequal access to drinking

water [10].

2009

SciELO

Applied ethics, bioethics and

Analyze the issue of applied ethics, bioethics and

environmental ethics, identifying the possibility of

integration in research.

environmental ethics, possible

relationships: the case of global

Bioethics [1].

It establishes that bioethics is part of a context in which it coexists with the conflicting structures of human reality and attempts to build convergences of solutions, considered equidistant. Lato sensu bioethics corresponds to a planetary ethics concerned with responsibility for the harmful effects that can result from human acts on individual human life, social and cultural life, the biosphere and the ecosphere. Thus, the concept of lato sensu bioethics encompasses and is adapted to complex situations, being a theoretical and practical tool for understanding (analyzing) conflicts; converge the proposed solutions (prescribe better solutions); protect individuals and populations (provide means of protection). Bioethics is the thematization of ethos, taking into account human practices that can have irreversible effects on other humans, living beings in general and the environment.


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

*Bioethics in Medicine and Society*

**192**

**Year** 1995 1997

SciELO

The ecological question:

Analyze important elements in the formation of

technoscientific culture—techno-industrial model—and

developments in the field of Ecological Science and related

social movements.

between science and ideology/

utopia of an era [8].

SciELO

The third margin of health:

"natural" ethics

**Base**

**Title**

**Purpose** Discuss the relevance of a complex natural ethics for the

health field escaping the main disjunctions of the subject/

object, public/private, value in itself/value in itself.

**Results**

Points out the centrality of ethical reasons in the field of health that

imply the need to outline a practical-discursive universe of ethics

capable of articulating technoscientific knowledge with ethical

principles of justice, equity and general well-being in the context

of available resources and priorities each concrete situation. This

universe includes reflections on duties towards the environment;

the rights of present generations linked to future generations.

Health ethics is conceived as a field of links and possibilities

between the bioecological dimension of the life of individuals and

populations in a territory and its socio-cultural dimension.

It establishes the need for an ethics that enables dialogs on

ecological issues in which politics takes a strategic place for making

democratic decisions in the context of advancing technoscience.

Proposes an ethics of solidarity based on an open dialog of

pluralist and interdisciplinary confrontation; regulatory ethics;

in pragmatism; in the non-exclusion of feeling—the affective

expression of judgment—of the set of elements that cooperate in

making ethical decisions; in the ethics of ambivalence, in the sense

that this is a choice, not a logical conclusion, or a mechanical result;

evolutionary ethics and reversibility of principles; in the ethics of

co-responsibility; integrate efforts to overcome conflicts, become

aware of responsibilities so that action can be taken accordingly.

It is considered that although relevant to clinical bioethics,

principlism is not applicable to public health dilemmas, since it is

based on the morality of doctor-patient relationships. They propose

to link Jonas's ontological concern and the transcendental Levinas,

through the protection principle that would be more adequate to

the purposes of a public health ethics, allowing to clearly identify

the objectives and the actors involved in the implementation of

morally correct and pragmatically effective public policies.

2001

SciELO

Bioethical principles in

Characterize the specificity of moral problems in public

health and analyze the applicability of principlism as a

standard for resolving conflicts in this field.

public health: limitations and

proposals [9].


**195**

use mass of automobiles.

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

and work to make way to the interests of a globalized elite.

and banning of human behavior.

of these movements.

(**Table 1**).

**4. Discussion**

of health protection in environmental licensing.

sibilities of finding points of convergence [11].

**4.1 Bioethical problems addressed**

**3.4 Bioethics and biopolitics**

that is: (a) the description and understanding (in the double sense of "representing" and "presenting") of the conflicts that exist in the ethos; and (b) the prescription

Assumpção and Schramm [11] studied the urban transformations in the city of Rio de Janeiro related to major world events—Olympics and World Cup—in the light of the elements for a bioethical analysis. It is an important contribution in pointing the State as an agent that produces vulnerability in the context of economic globalization and the civilizing process that produces gentrification under the discourse of environmental revitalization, expelling people from their places of life

These authors show that there is an ethic of resistance on the part of human groups vulnerable by the State, and that bioethics has elements that contribute to the strengthening of the struggle of these groups that come together to interact in social movements. For this reason, bioethics needs to return, more and more, its analytical focus to processes of production of subjectivity, autonomy and resistance

Schramm [12] analyzed the concepts of liberalism, paternalism, biopolitics and bioethics, establishing dialectical relations among themselves and opening spaces for forms of resistance to threats to the quality of life of people and populations resulting from questionable actions. In this study, bioethics is rightly seen as a form of resistance that includes the analysis of macroproblems and collective conflicts through the previous theoretical deconstruction of categories, an ethical criticism and a concrete political opposition to an unjustified annexation of bioethics to biopolitics, when, in fact, it is possible to consider bioethics as a form of resistance to biopolitics. It is a liberating alternative to biopolitical practices as it mediates normative issues involved in the relations of organic life (zoe), practical life (bios) and these with politics (polis), enabling the empowerment of citizens

The selected and described articles address theoretical, conceptual and practical aspects related to elements of protection bioethics that contribute to the implication

Although they do not attempt to analyze, specifically, environmental licensing, it is evident that this problem is implicated with the bioethical problems addressed, which are discussed below. Global capitalism, local development and the environmental issue Initially, it is worth considering that the implantation of large enterprises in Brazil must be understood in relation to economic globalization, inscribed in the aspects of technological and biotechnological advances that intensify social relations in a global dimension, as well as in conflicts and, in principle, in the pos-

Similarly, the oil refining process is located in the environmental problem because of its local impacts that become global, such as, for example, the production of greenhouse gases, both by the emission of industrial pollutants, and by the

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

*Bioethics in Medicine and Society*

**194**

**Year** 2010 2012

Redalyc

Elements for a bioethical

Identify elements for a bioethical analysis of conflicts

related to urban transformations in the city of Rio de

Janeiro related to major world events—Olympics and

World Cup—inscribed in the phenomenon of globalization

and the social consequences of the removal of inhabitants

from slums and occupations.

analysis of recent urban

transformations in Rio de

Janeiro from the perspective of

globalization [11].

2014

Redalyc

Dialectic between liberalism,

Analyze the concepts of liberalism, paternalism,

biopolitics, bioethics, separately, and then relate them

dialectically to each other.

state paternalism and

biopolitics. Conceptual analysis,

bioethical and democratic

implications [12].

**Table 1.**

*implications of health protection in the licensing of large enterprises in Brazil.*

Redalyc

Bioethics as a form of resistance

to biopolitics and biopower [4].

**Base**

**Title**

**Purpose** Deconstruct the concepts of biopolitics and biopower and

create conditions for a correct performance of bioethics,

understood both as an analytical and normative tool for the

morality of biopolitics and biopower.

**Results**

It assumes that the concepts of biopolitics and biopower are

used inconsistently, which affects their power of intelligibility to

understand the profound transformations of contemporary society.

Discusses the proposals for biopolitical democracy and democratic

biopolitics, showing the need for bioethical control of biopolitics

as a practical application in the form of resistance and democratic

dissent in relation to morally questionable effects, resulting from

biopolitical practices and the inappropriate uses of such concepts to

They carry general aspects of the phenomenon of globalization

and its background—the civilizing process -, as well as its urban

implications. As an analytical focus for the bioethics produced in

Brazil—in particular the bioethics of protection and the bioethics

of intervention—they propose the resistance processes present in

urban conflicts over housing and urban housing. They approach

bioethics of protection and bioethics of intervention, in its

theoretical aspects, and criticizes the relevance they give to the

role of the State as the sole agent of transformation, indicating

that the analytical focus of bioethics turns to the autonomous and

self-managing processes of social movements.

The thesis is defended that the terms, as a whole, have a dialectical

relationship, since liberalism would take the place of thesis

and paternalism, that of antithesis, whose synthesis would be

represented by the moment of biopolitics, which would in turn

constitute a new thesis, initiating a new dialectical process in which

the place of antithesis would be represented by bioethics, both

of which would converge to a new synthesis, represented by the

empowerment of citizens, constitutive of democratic societies, or

that are intended to be such.

*Articles used in the SciELO, lilacs and Redalyc databases, from 1990 to 2016, according to the database, title, objectives and results related to elements of protection bioethics that contribute to the* 

carry them out.

that is: (a) the description and understanding (in the double sense of "representing" and "presenting") of the conflicts that exist in the ethos; and (b) the prescription and banning of human behavior.

Assumpção and Schramm [11] studied the urban transformations in the city of Rio de Janeiro related to major world events—Olympics and World Cup—in the light of the elements for a bioethical analysis. It is an important contribution in pointing the State as an agent that produces vulnerability in the context of economic globalization and the civilizing process that produces gentrification under the discourse of environmental revitalization, expelling people from their places of life and work to make way to the interests of a globalized elite.

These authors show that there is an ethic of resistance on the part of human groups vulnerable by the State, and that bioethics has elements that contribute to the strengthening of the struggle of these groups that come together to interact in social movements. For this reason, bioethics needs to return, more and more, its analytical focus to processes of production of subjectivity, autonomy and resistance of these movements.

### **3.4 Bioethics and biopolitics**

Schramm [12] analyzed the concepts of liberalism, paternalism, biopolitics and bioethics, establishing dialectical relations among themselves and opening spaces for forms of resistance to threats to the quality of life of people and populations resulting from questionable actions. In this study, bioethics is rightly seen as a form of resistance that includes the analysis of macroproblems and collective conflicts through the previous theoretical deconstruction of categories, an ethical criticism and a concrete political opposition to an unjustified annexation of bioethics to biopolitics, when, in fact, it is possible to consider bioethics as a form of resistance to biopolitics. It is a liberating alternative to biopolitical practices as it mediates normative issues involved in the relations of organic life (zoe), practical life (bios) and these with politics (polis), enabling the empowerment of citizens (**Table 1**).
