精神疾患觸法者與監護處分的再思考－兼論設立司法精神病院的爭議

精神疾病犯罪者在現行法律制度下面臨監護處分的問題及社會輿論的不友善，此不啻加劇應報式正義與修復式正義的衝突，而司法從業人員與專業精神鑑定者在相關判決中，對鑑定報告採信的程度亦不一致，雖從醫學科學角度，僅能事前或事後推斷，以判斷精神疾病犯罪者是否符合刑法第19條。因此，本文探討的方向：首先，如何判斷精神疾病犯罪者在犯罪時的精神狀態符合減刑要件；其次，對精神疾病犯罪者施行的監護處分，是否有修正的可能、爭議或未來政策之建議；最後，司法精神病院存在討論空間，例如人、物力的欠缺或相關人權議題考量等。研究方法以文獻回顧、比較法，援引相關判決與醫學文獻，並在文末總結提供本文對監護處分制度與設立司法精神病院之建議，做為本文研究發現。

關鍵字

精神疾病患者；社會安全；監護處分；司法精神病院

並列摘要

Criminals with mental illness face the issue of guardianship and unfriendly public opinion under the current legal system, which intensifies the conflict between retributive justice and restorative justice. The degree of acceptance of the appraisal report is also inconsistent, although from the perspective of medical science, it can only be inferred beforehand or afterwards to judge whether a criminal with mental illness complies with Article 19 of the Criminal Law. Therefore, the research direction of this paper is: first, how to judge the mental state of criminals with mental illnesses at the time of committing a crime, which meets the requirements for commutation; secondly, whether there is any possibility of revision, controversy or future policy suggestions for the guardianship punishment imposed on criminals with mental illnesses; Finally, there is room for discussion in judicial psychiatric hospitals, such as the lack of human and material resources or the consideration of related human rights issues. The research method uses literature review and comparative method, citing relevant judgments and medical literature, and at the end of the article, summarizes and provides suggestions for the guardianship system and the establishment of judicial psychiatric hospitals, as the research findings of this article.