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國際人權法與心理健康權

International Human Rights Law and the Right to Mental Health

摘要


研究目的:有鑑於「離開了心理健康就不能稱之為健康」的普世概念,以及回應我國組織再造理應成立「心理健康司」,卻被政治運作與不了解心理健康真諦,導致成為將口腔併入專司之不恰當結果。提出本文,目的在於分析心理健康作為人權之基本要求與規範內涵,考量其應與生理健康齊重,而不得以資源限制為由,恣意併入其他醫學專業變成應急的大雜燴般的設計,供作心理健康界、精神醫療界、法界參考之出發點。研究方法:透過國際法律文件及國際組織相關宣言之闡釋及分析,將聯合國成立以來從人權宣言開始到其他幾個重大與特定對象的國際人權公約,了解這些相關的公約中對心理健康的詮釋,釐清心理健康作為人權之依據和內涵。研究結果:發現心理健康無論依其定義或要件,都與個人的尊嚴、生活方式及生活條件密切相關。做為個人發展的基礎,不論生理或心理的健康之維繫和保障更是一直以來為國際人權法所承認的基本人權之一,從《世界人權宣言》到《經濟社會文化權利國際公約》中的「健康權」,以及《世界衛生組織憲章》,再再都強調了健康的概念繫於一個「全人觀點」,而心理安適的狀態係其中不可或缺的要素之一。證明心理健康係國際人權法所承認之基本權利,並應用「健康與人權」的理論探討心理健康權與其他人權間互相依賴且不可分割的關係。研究結論:建議國家實踐上,若不從人權的角度出發,心理健康很容易在政府制訂健康或福利政策時被邊緣化,並使得政府容易忽略各項國際法下之義務。自立法院於2009年批准兩公約並通過施行法,政府從未認真思考過人民之心理健康權應如何滿足,而心理衛生界或精神醫學界除針對汙名化和強制醫療等議題外,亦鮮少從國際人權法的角度來看心理健康之本質,故本文之探討因此更顯重要,期收拋磚引玉之效。

並列摘要


Purpose: Why did the WHO claim that there is "no health without mental health"? In its reform of the Ministry of Health and Welfare (MOHW), why did the Taiwan government add oral health into the Department of Mental Health? This paper explores normative accounts for the right to health which include physical and mental health as a highest state for everyone. Challenge the government should not excuse for inadequate resource to add oral to Department of mental health. Methods: We apply an analysis of international human rights law and international conventions to justify how mental health is a human right. Results: The right to the highest attainable standard of health is enshrined in the Universal Declaration of Human Rights, the International Covenant on Economic, Social, and Cultural Rights, as well as the constitution of the World Health Organization. A person's state of health is conceptualized with a holistic perspective. Mental health, by definition and elements, is critical to an individual's personal dignity, lifestyle, and living condition. Thus, as the fundamental basis of personal development and functioning, physical and mental health are recognized as a human right in international human rights law. The governments need to take responsibilities to build a mental healthy environment to their people. Conclusions: We found that in practice, governments (including Taiwan) often ignore people's mental health needs when initiating health or welfare policies, especially if mental health is not regarded as a human right by the government. In fact, some governments refuse to honor mental health as a right although it is a legal obligation under international law. We urge Taiwan's government to return the structure of the MOHW back to include an independent Department of Mental Health. To influence governmental policies, a change is needed in the research community, because researchers and practitioners in mental health and psychiatry still rarely view mental health from an international human rights perspective as well as for all public not disease oriented. We hope to initiate a review of the basic requirements of the right to mental health in terms of its positive, rather than negative, aspects.

參考文獻


UN Committee on Economic, Social and Cultural Rights. (1994). General Comment No. 5: Persons with Disabilities (E/1995/22). Retrieved September 28, 2015, from http://www.refworld.org/docid/4538838f0.html.
UN Committee on Economic, Social and Cultural Rights. (2000). General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12) (E/C.12/2000/4). Retrieved September 28, 2015, from http://www.refworld.org/docid/4538838d0.html.
(1993).Vienna Declaration and Programme of Action (VDPA).the World Conference on Human Rights.(the World Conference on Human Rights).:
World Health Organization. (n.d.). Linkages between Health and Human Rights. Retrieved July 25, 2014, from http://www.who.int/hhr/HHR%20linkages.pdf.
World Health Organization. (2003). Mental Health Legislation and Human Rights. Retrieved March 8, 2013, from http://www.who.int/mental_health/resources/en/Legislation.pdf.

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