論健康權與健康的社會決定因素——以蘇格蘭月經用品之給付法制為借鏡

健康與否取決於階級、性別等健康的社會決定因素，已然成為國際社會思考弭平健康不平等的切入點。本文先爬梳國際公約關於健康權之一般性意見，發現其在健康權的基本框架下，逐步納入社會決定因素的概念，接續聚焦於作為性與生育健康權利一環之月經用品，推導出國家有義務確保人們取用月經用品用品以及消除形成取用障礙之社會決定因素。為接軌我國憲法及國際公約，本文從健康權的內涵、功能及憲法依據開展，並找尋銜接社會決定因素之解釋途徑，接著，本文將討論範圍限縮於貧窮對於月經用品取用的影響，從健康權的給付功能以及基本國策推得國家於人民陷入貧窮之時提供月經用品之給付義務。為使國家義務具體實踐，本文借鑑蘇格蘭的月經用品給付法制，發現其普遍免費給付的政策，不僅可以緩解貧窮對於健康造成之不利影響，另可回應如性別權力關係等其他社會決定因素。經本文檢視我國在月經用品之政策，的確未合乎公約以及憲法之誡命，最後，本文建議我國法制之再建構可參考蘇格蘭，以構築健康平等的社會樣貌。

關鍵字

健康權；健康的社會決定因素；決定健康的基本要素；月經貧窮；月經用品

並列摘要

The social determinants of health, such as social class and gender, have become an entry point for the global community to consider how to address health inequalities. Firstly, this article examines how the international human rights treaties adopt the concept of social determinants of health within the fundamental human rights framework of the right to health. It then focuses on period products as part of the right to sexual and reproductive health. The article concludes that the state has the obligation to ensure access to these products and to address the social determinants of health that are the barriers to their access. In accordance with the Constitution and the international human rights treaties, this thesis begins with the content, function, and foundation of the right to health within the Constitution, exploring methods to interpret the social determinants of health in conformity with the Constitution. Next, this article focuses on the impact of poverty on access to period products. Based on the right to health and fundamental national policies, the state must ensure access to period products for people living in poverty. In order to put the law into practice, this article introduces the act and policy of access to free period products in Scotland. It suggests that a policy of universal free access not only mitigates the adverse health effects of poverty but also addresses other social determinants of health, such as gendered power inequalities. This article reviews the current policies regarding the provision of period products in Taiwan. It argues that these policies are not in compliance with the Constitution and the international human rights treaties. In sum, it highlights that the law system in Taiwan can be restructured to align with that of Scotland, aiming to establish a society with health equity.