論心智障礙者之強制治療和權利保障─以國際人權法下之自主原則為核心

Involuntary Treatment and Fundamental Rights Protection of Mental Disabled─The Principle of Autonomy under International Human Rights Law Perspective

吳宜亭(Yi-Ting Wu)

指導教授 ： 黃居正

國立清華大學/科技管理學院/科技法律研究所/碩士(2010年)

https://doi.org/10.6843/NTHU.2010.00608

摘要

由於心智障礙者的疾患行為，很可能會對他人或自身造成傷害，進而影響社會安全和公共秩序，就此，國家常以強制治療做為對心智障礙者社會控制的一種方式，但強制治療本身，無論在實質的治療方式和程序上，是否造成心智障礙者的基本權利侵害，不無疑義。某些治療方式，有可能會造成副作用，使心智障礙者的身心受到創傷。其次，關於強制治療的決定程序，部分並未針對心智障礙者本身的特殊狀況，設計適當的配套措施，充分行使訴訟程序權利，就此，人身自由之限制的保障是否健全，應有探討之餘地。
為了探求心智障礙者強制治療和權利保障之間的平衡，本文首先探討就強制治療立論基礎和目前各國相同法規範的爭議，主要將其區分實質面和程序面來討論。接著，再探討目前自主原則的學說理論發展，以找尋一最適合做為心智障礙者自主性之學派─關係式自主(Relational Autonomy)，做為強制治療下權利保障規範之檢視標準。其次，檢視目前國際人權法下，關於強制治療權利保障之法規範和實務見解發展，主要以聯合國人權系統、歐洲人權系統和美洲人權系統，做為探討國際人權法規範發展的核心，再以先前提到最適合自主原則學說做為評判標準，端視目前國際人權法針對強制治療的規範發展是否能保障心智障礙者之基本權利，防範強制治療時對其基本權利的過度侵害。
期望藉由關係式自主和整理目前國際人權法下對於心智障礙者在接受強制治療時，權利保障規範之發展現況，藉此提供給學界一個不一樣的觀點來看待心智障礙者接受強制治療的狀況，也提供國內法界目前國際人權法之發展趨勢現況，以做為國內精神衛生法修法的參考來源。

關鍵字

心智障礙 ； 強制治療 ； 國際人權法 ； 自主原則 ； 關係式自主 ； 告知後同意

並列摘要

Some mental disorders could cause the harm to others or self and the disturbance of public security. States take involuntary treatment as a measure of social control out of the reason. But, involuntary treatment may infringe on the fundamental rights of mental disabled in either chosen treatment methods or decisive procedure. Some treatments with side-effects bring about physical and mental injuries. Also, part of the decisive procedure of involuntary treatment cannot protect the liberty of persons with mental disabilities comprehensively due to the ignorance of behavioral nature of the symptoms and the lack of properly specialized measures for them to fully exercise the procedural rights.
To search the balance between involuntary treatment and rights protection, first, the article discussed the controversy of the involuntary treatment in substantial and procedural aspects. Next, the article outlined the development of theories of the principle of autonomy then found out the best one- Relational Autonomy, as the claim of autonomy for mental disabled. Finally, it analyzed the jurisprudence on involuntary treatment under international organization, mainly focused on the United Nations human rights system, European human rights system, and inter-American human rights system, then, concluded whether the current development of law for rights protection under involuntary treatment of international human rights is compatible with the standard on the basis of relational autonomy.
By proposition of relational autonomy and the analysis of current development of the jurisprudence under international human rights law, the article hopes to provide the different perspective to think about the psychiatric involuntary treatment issue and the reference to legislation of domestic Mental Health Law.

並列關鍵字

mental disabled ； involuntary treatment ； international human rights law ； principle of autonomy ； relational autonomy ； informed consent

參考文獻

25. WORLD HEALTH ORGANIZATION, INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY, AND HEALTH (2001)

1. American Convention on Human Rights, 18 July, 1978, O.A.S.T.S. No. 36, 1144 U.N.T.S. 123.

2. Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Art.1, G.A. Res. 39/46, annex, 39 U.N. GAOR Supp. (No. 51) at 197, U.N. Doc. A/39/51 (1984), 1465 U.N.T.S. 85.

3. Convention for the Protection of Human Rights and the Dignity of the Human Being with Regard to the Application of Biology and Medicine,4th Apr 1997, E.T.S 164.

4. Convention on the Right of Persons with Disabilities, G.A. Res. 61/106, U.N. Doc. A/ RES/61/106 (Dec. 13, 2006),.also see http://www.un.org/disabilities/