Ethical Issues in Mandatory Community Treatment

強制社區治療之倫理問題

吳建昌(Kevin Chien-Chang Wu) ； 宋維村(Wei-Tsuen Soong)

《台灣精神醫學》 22卷2期 (2008/06) Pp. 84-95

https://doi.org/10.29478/TJP.200806.0002

摘要

台灣最新修訂之精神衛生法於2007年7月4日通過，將於2008年7月4日施行。特別不同於以往的是，新修訂精神衛生法引進強制社區治療之制度，希望能達到尊重個人自主、保護個人於社區生活、以及提升公共精神衛生之目的。為使強制社區治療能夠合乎倫理地進行，台灣精神衛生從業人員必須要強制社區治療之倫理議題及相關實證資料。因此，作者藉本文回顧強制社區治療之相關倫理議題。在第一節，本文探討強制社區治療之概念及分類，這些分類與倫理正當性之基本論述有關。在第二節，作者介紹在強制社區治療之倫理論述中可使用之思維架構。第三節中，作者簡短地回顧強制社區治療效果之實證研究。第四節中，作者描繪出對於強制社區治療之正反倫理論述，並引介與這些論述相關之實證研究。作者的結論是，我們應該從操做中學習並持續進行管制影響評估，盡全力使強制社區治療能夠有效並降低其潛在之可能傷害。

關鍵字

強制社區治療 ； 倫理 ； 精神衛生 ； 台灣

並列摘要

Objective: Taiwan's newly revised Mental Health Act was released on July 4, 2007 and will come into effect on July 4, 2008. Mandatory community treatment (MCT) is introduced in order to substantiate individual autonomy and personal protection in community and to enhance preventive mental health. To make MCT work ethically, it is necessary for Taiwan's mental health practitioners to understand ethical issues and empirical data about MCT. The authors intend to review current arguments on the issues and address their implications for Taiwan. The first section of the paper explores the concept of MCT and classifies the types of MCT as they are related to MCT's justifications. The second section sketches frameworks for ethics debates on MCT. The third section is a brief review of the effectiveness of MCT in enhancing care of persons with mental illness in community. The fourth section delineates the arguments for and against MCT and introduces relevant empirical findings. The final section concludes that through learning by doing and continuous regulation impact assessment, we have to do our best to make MCT work and reduce its potential harms.

並列關鍵字

mandatory community treatment ； ethics ； mental health ； Taiwan

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