臺日精神疾病之職業災害補償與賠償比較研究

摘要根據世界衛生組織（WHO）關於健康之定義，健康係指生理（肉體）與心理（精神）之完整性，遠離疾病、殘缺，健康權即用以保障生理心理之完整性，更可分為控制自己健康之權利與不受歧視地享受健康保護體制，以達成最高健康標準之權利。從而對於職場上所受之精神疾病與精神不健康，應可認為乃是健康權之侵害，國家對此更應負有照護之責，將精神疾病列入職業災害補償制度一環，以保障勞工之基本人權與人性尊嚴。勞動階層投入大量時間於勞工場所，承受責任制等加班壓力，長期鬱積於高壓之工作環境，導致其身心俱疲，進而罹患精神疾病。礙於我國實務見解向來認定職業災害給付之原因受限於物理上、生理上之災害，而未承認因業務因素所致之精神疾病，使得我國勞動基準法保護之主體無法完善受保護。又因職業災害精神疾病之診斷涉及疾病與業務之關聯性判斷，勞工於請求職業災害給付恐因個案舉證能力，而左右其職業病之判定。我國以日本之《心理的負荷による精神障害の認定基準》為參考標準，並於二○○九年起訂定《工作相關心理壓力事件引起精神疾病認定參考指引》，考量法制參考之延續性，本文旨在比較臺日之差異與分析我國現行制度上之缺失。

關鍵字

健康權；職業災害；精神疾病；心理的負荷による精神障害の認定基準；工作相關心理壓力事件引起精神疾病認定參考指引

並列摘要

Abstract 　　Health, defined by the World Health Organization (WHO), is a “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. The Right to health should be one’s freedom to manage one’s health and be protected by a non-discriminatory healthcare system. Mental illnesses resulting from occupational accidents are an infringement to one’s Right to health. The Government is responsible for ensuring employees those who should protected from mental illness as the right to health is enshrined in international human rights law. Overworking will result in fatigue, which could lead to mental illnesses. Taiwan defines occupational accidents as physical injuries however, it neglects mental illness caused by overworking. As a result, the Labor Law is unable to provide comprehensive protection for employees. In addition, the diagnosis of mental illnesses by overworking is often very subjective because of causation issues. In 2009, Taiwan set out “The Guideline of Identifying Work-Related Stress-Included Mental Diseases”, which was based on Japan’s “心理的負荷による精神障害の認定基準”, to examines and analyzes the deficiency in Taiwan’s existing healthcare system by comparing with Japan. This paper aims to compare the compensation structure for mental illnesses caused by occupational accidents between Taiwan and Japan.