精神鑑定的特殊議題：智能障礙者之性自主

Special Issue of Forensic Psychiatry: Sexual Autonomy of the Persons with Mental Retardation (Intellectual Disabilities)

楊添圍(Tien-Wei Yang)

《台灣法醫學誌》 5卷1期 (2013/06) Pp. 41-46

https://doi.org/10.6134/tjfm.2013.0501.04

摘要

以往各國對於兒童與少年之性自主，基於保護與限制之立場，都對與兒童或少年發生性行為加以禁止而處罰。在類似考量下，與智能障礙或精神障礙之人，發生之性行為也加以禁止且處罰。晚近，智能障礙之性自主被視為基本人權而加以倡導，繼而，智能障礙者是否應有性自主？其性自主又如何看待？等等議題，不僅是觀念與假設，也涉及性侵害罪行之實務認定，如我國加重強制性交與乘機性交罪之認定。由於智能表現，行為能力要件，性自主能力，各具有不同的內涵，以心智年齡或行為能力年齡來認定智能障礙者性自主的方法，似乎無法解決實務的困境。本文回顧美國與英國對於智能障礙性自主的概念、法院的裁判與爭議等，歸納各種不同性自主能力的條件有兩大部份，一是性自主的認知條件：對於性行為的生理或身體以及後果的認知；再者是，性自主的意向與同意條件：對於可以表達拒絕與身體自主的認知，具備表達拒絕的能力，以及對於權勢、情境影響性自主的選擇自由。在法界尚未對智能障礙者性自主能力達共識與一致性前，作者建議這些項鑑定的判準，仍有助於司法官形成心證以為裁判之依據。

關鍵字

智能障礙 ； 性自主 ； 精神鑑定

並列摘要

Formerly, based on protection and restriction, various states had penal punishments to sexual encounters with children and juveniles. According similar considerations, sexual encounters with those mentally disorders and mentally retarded were also punished. Lately, advocating of sexual autonomy for the people with mental retardation as basic human right become prevalent. The issues, where there is sexual autonomy for the people with mental retardation and how to assess the sexual autonomy, raised frequently and involve not only concept and assumption but also practical verification of sexual offense.There are different levels and aspects of capacities for the intellectual performance, capacities for competence or sexual autonomy. Therefore, delineation based on mental age or age of competence seems not to solve the predicament. After reviewed ideas about the sexual autonomy for the people with mental retardation and several arguments in various jurisdictions of US and UK, the article summarized different criteria about sexual autonomy as followings. First, the cognitive part of sexual autonomy includes the understanding of the sexual act and potential consequences. Second, the volitional or consensual part of sexual autonomy embraces the understanding of one's right to refusal and control of one's body, the ability to expression of one's opinion and the freedom of choice (involved the vulnerable situation and power relationship).The author suggested that assessment and clarification the different criteria of capacity would be much helpful for the magistrate to judge the quality and nature of offenses before there is a consensus about sexual autonomy of the mentally retarded persons in various jurisdictions.

並列關鍵字

Mental retardation (intellectual disability) ； Sexual autonomy ； Forensic assessment

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