UPDATE ARTICLE

Applying precaution and prevention in the workplace

Eloá Carneiro Carvalho^I; Helena Maria Scherlowski Leal David^II

^INurse. Ph.D. student. Assistant Professor at the Nursing School of the University of Rio de Janeiro State. E-mail: eloagrossi@uol.com.br
^IINurse. Associate Professor at the Nursing School of the University of Rio de Janeiro State. Pro scientist. E-mail: helena.david@uol.com.br

DOI: http://dx.doi.org/10.12957/reuerj.2016.26180

ABSTRACT

Objective: to strengthen the debate on the subject in the field of health and nursing, in social practices that contribute to defending a democratic project of civilization and a social order resting on justice and equity. Method: Theoretical and conceptual essay on the right to life, health and autonomy in the light of recent legal arguments, considering the concepts of environment, prevention and precaution, and linking them to the world of work. Results: these are times of judicialization, a much discussed form of judicial activism which to some constitutes an affront to the principle of the separation of powers. Conclusion: this position should be relativized, considering that for many it is the only way to gain access to health care, and to guarantee life and human dignity.

Keywords: work environment; precaution; nursing work; judicialization.

INTRODUCTION

Workers´ health, the struggle of the working class for better conditions in the workplace, for a fair working day and their health are topics discussed for centuries. Marx, in his work The Capital, discusses the relations established between capital and labor, showing that the greatest objective in this model of accumulation is the exploitation of workers through surplus value and surplus labor. He points out that excessive capital tends to usurp all workers´ time, putting their health in the background. Nevertheless, at that time, workers worked in unhealthy places until they fell ill and died, including children and women¹.

Some centuries later, there are still working conditions that demand the need of workers´ defense, despite the historical struggles aimed at acquiring rights. For example, some authors defend the importance of the application of the worker model in the evaluation of the occupational and environmental risks, due to the persistence of bad conditions of the occupational environment in general. A methodology that proposes the analysis of risks and health damages, from the reconstruction of the work process, with the participation of the worker².

Recently, in the history of workers´ health, the field of social medicine brings the perspective that the health-disease process is not only biopsychic but a social process. There is a need to assess occupational conditions and end the devastating conditions of the work environment in the health of the worker. This social approach seeks to break with the hegemonic medical model and seeks to identify the historicity of human biological and psychic processes. Thus, the biopsychic nexus will no longer be thought based on the health-disease concept, but rather related to "ways of walking the life"^2:399.

In this perspective, the objective of this study was to strengthen the debate on the topic, in the health and nursing area, social practices that contribute to the defense of a democratic project and a social order based on justice and equity.

Regarding the methodology, this article is a theoretical-conceptual essay on the right to life and health, based on the recent legal arguments, considering the concepts of environment, prevention, precaution and autonomy by linking them to the world of work.

SOCIAL PRODUCTION OF HEALTH

Considering that the worker´s health area in Brazil is situated within this approach of the Social Production of Health, it is understood that there is the subsumption of the biological to the social - the environment is a social product since the ways of walking the life are collective and not individual. This new object of study points to the relation work process, and the biopsychic nexus needs to be studied in the collectivities. Therefore, analyzing the health of workers occurs in the field of struggle between the antagonistic forces between capital and labor, and this struggle translates into the struggle for surplus value and how to generate it, that is, how to use the labor force³.

Bringing the discussion of workers´ health to the present, it is noticed that despite many changes, issues and problems persist mainly in the field of the work environment, risks and damages to the health of the worker. Among the main challenges, the contemporary world has the protection of the human being, the environment, and the development of the civilizing process, so that social inequalities can be mitigated at the international and national levels, which are presented so clearly, through hunger and misery³.

Implementing the protection of the human being and the environment requires a conceptual enrichment of the international juridical universe, through the in-depth analysis and eventual consecration of emerging principles, that is, those of common concern of mankind or humankind, basic human needs, sustainable development, human development, intergenerational equity and rights of future generations, a global equitable partnership, among others⁴.

It is worth noting that the ecologically balanced environment in the democratic system of law is considered as a fundamental right of the human person. Thus, "history is a dialectical movement, the expansion of rights is not exhausted. New rights are being claimed; minorities become aware of their dignity [...]"^5:63.

In the same way that it is accepted that the debate on the environment and the right to life and health has brought to the juridical universe, the need to review and modernize concepts and principles is defended that there is the appropriation by health professionals that defend the health of workers, the main aspects that guide the legal field, expanding the capacity for understanding and uncompromising defense of the right to life and health as a universal good⁶.

The main aspects to be explored in the discussion of this theme, in the areas of health and nursing, should highlight its characteristics of social practices that contribute to the defense of a democratic project and a social order oriented by justice and equity⁷.

THE CONCEPT OF THE ENVIRONMENT

Human rights have varying characteristics since there are those that impose limits on state intervention: the right to life, the right to freedom from humiliation, freedom, and security of the person, freedom of thought, conscience, religion and opinion, movement and similar. On the other hand, there are those that require more effective state action: the right to work and a decent standard of living (food, shelter, and clothing); the right to health and social security; the right to organize unions; the right to education⁴.

It is important to note that art. 3^rd of the Universal Declaration of Human Rights, of 1948, says that every person has the right to life, liberty, and personal security. In the concept of "right to life" the ecologically balanced environment is inserted, since it is one of the essential ontological conditions of living in all its fullness and forms⁸.

In this sense, it is pertinent the lesson of a study, in which the term environment brings in its linguistic composition two synonymous words in a compound expression, but draws attention to the fact that the Portuguese language uses this resource to highlight or reinforce a term that has suffered wear and tear over time, or because it is desired to achieve greater comprehensiveness with the term reinforced, in the face of its acceptance and expressiveness in the native language⁶.

Also, environment is broadly conceptualized:

It is worth noting that the federal legislation, through the National Environmental Policy Law (Article 3, I, of Law 6.938/81), defines environment as "the set of conditions, laws, influences and interactions of physical, chemical, and biological, which allows, shelters and governs life in all its forms"⁹.

It is understood that the expression environment represents the idea of integration of the elements that constitute the environment in which they live, be they natural, artificial, or cultural, all interrelated by norms and principles that compose Environmental Law aiming the balance of life in all its forms.

In the face of the environmental concerns that we are facing today, it is worth reflecting on the following questions: Does Humanity go to a collective suicide or prepare its apotheosis? Subjected to successive movements: the age of iron, an agricultural revolution, three industrial revolutions, and having enormous powers of intervention over its most intimate biology, will it be driven to collective suicide, or to walk by a series of splendorous, and still invisible, creations for an apotheosis?¹²

The studies on the environment arose linked to the biological sciences, but they evolved and unfolded permeating other sciences, including legal sciences. In this context, the principles of precaution and prevention are relevant in this discussion.

CAUTION, PROTECTION, AND AUTONOMY

In the context of the environment, the precautionary principle ensures non-intervention until its protection is guaranteed. The thesis becomes particularly valid when it is considered that the environment should not be taken care as an end since it is treated in function of human life, which develops until reaching its maximum fullness.

On the other hand, acting for life implies abstaining from practices that can suppose its destruction, both from the physical and spiritual point of view. In doubt, abstention; it is proper to more civilization to know how to limit one's power, to dominate it, and to know how to say no. This is not a limitation to the right of freedom, but to a sublime exercise of freedom¹³.

This principle had its origin under a German law: its first antecedent was the government's environmental protection program of 1971. Since then, it has been incorporated into the legislation of several countries in search of greater security, given the potential risks inherent in increasing technological advance¹⁴.

In the situation of uncertainty about risk, it is valuable to distinguish between prevention and precaution, formulated in the following terms:

Based on the precautionary principle, where there is a risk of serious or unavoidable damage, due to the lack of absolute scientific certainty, effective action should be taken to prevent environmental degradation¹⁵. Thus, while prevention concerns certain and proven risks - hazard - precaution is simply linked to potential risks. In prevention, dangerousness is already established; the danger is, therefore, concrete. On the other hand, in precaution, there is an abstract danger - risk, due to the imprecision of scientific knowledge, incapable of measuring the damage, or even of providing certainty as to the occurrence, current or supervening, of damages¹⁶.

The Federal Constitution of 1988 (CF) adopted the principle of prevention when prescribing, in the caput of art. 225, the duty of the Government and the community to protect and preserve the environment for present and future generations¹⁷.

In Brazilian law, prevention is established in the art. 225, paragraph 1, item V of the CF, and through art. 54, paragraph 3, of Law 9,605, 1998, which criminalizes who fail to adopt precautionary measures required by the Government.

Not forgetting the lack of unanimity of criteria about the nature and scope of the precautionary principle - perhaps due to its rapid assimilation of normative and jurisprudential to the detriment of a clear delineation of its characteristics -, it is verified, at present, initial idea enlargement, both with regard to its scope of application - no longer limited to environmental protection, but also invoked in matters such as food safety and health protection - as well as in their degree of legal force¹⁴.

In this sense, this principle prescribed by the Wingspread Declaration, states that when an activity raises threats of harm to human health or the environment, precautionary measures should be adopted, although some cause and effect relationships are not fully established scientifically¹⁴.

We live in a society of risk, which shows two parallel and not contradictory moments: on the one hand, the development of technology drives real revolutions in the field of nature and solving social problems; on the other hand, there is fear or concern about undesirable results. Faced with this picture, risks increase more than solutions to problems, needing the evocation of the precautionary principle whenever the ecosystem, health, and human integrity are at risk¹⁸.

In this context, nursing work requires attention to these principles to reduce workplace risks. Based on these principles, the autonomy of nurses can contribute to improving the work environment.

Autonomy is a word derived from the Greek autonomy which means "ability to govern oneself"^19:78.

Thus, it can be understood as a right to rule by its laws. Alternatively, rather, "it is applied to indicate precisely the faculty of a certain person or institution, to draw up the norms of their behavior, without feeling restrictive impositions of a strange order"^20:175.

In a look of Kant, "it is a term that he claims to be the independence of will about any desire or object of desire and the ability to govern according to a law of its own"^21:428.

Entering within the scope of the activity of the nursing professional^22,23, the practice of autonomy means the comprehensiveness they possess regarding "knowledge, skills and competencies, and in this way, they form decisions and resolutions in their area of practice"^23:531.

CONCLUSION

Workers´ health continues to be a challenge today, after all, we live in a capitalist society that has undergone many changes over the centuries, yet it still contains many disguised, but still existing, features of Marxism. However, today we also have legal developments and the CF of 1988 brings some rights as guarantees and are considered as hard clauses, so we have some mechanisms to defend them. Thus, we protect the right to life, health, the health of the worker, the balanced environment, among others.

In the Constitution, there are several principles that must be used to ensure that the guarantees are respected. Also, if nothing is respected, the right to judicial protection is provided, that is, the individuals can seek help from the judiciary to guarantee their rights.

This is the hour of the much-discussed judicialization, which is a form of judicial activism; for some, it would characterize an affront to the principle of the separation of powers. However, this position must be relativized, considering that for many, it is the only way to achieve access to health, guarantee life and human dignity.

Lastly, carrying out his activities, the nurse is necessary to develop them with solid foundations of knowledge, combined with a specific knowledge of the profession. As seen, professional autonomy requires the use of precaution and prevention in work, reducing risks in the work environment and avoiding the judicialization. Also, he should demonstrate an accurate sense of responsibility, ethical knowledge and ability to act by the Law of Professional Nursing Practice.

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