「精神疾病強制鑑定審查會」運作之探討：以社工委員為例

Dilemma and Reflection on Social Workers in the Mandatory Hospitalization Review Committee for People with Serious Mental Illness

吳慧菁(Hui-Ching Wu) ； 林萬億(Wan-I Lin) ； 張莉馨(Li-Hsin Chang) ； 唐宜楨(I-Chen Tang)

《東吳社會工作學報》 23期 (2012/06) Pp. 9-45

https://doi.org/10.29734/SJSW.201206.0001

摘要

依據2007年所修訂的「精神衛生法」第四十一條規定，嚴重病人經評估後有全日住院治療的需要但不接受時，經由中央主管機關精神疾病強制鑑定審查會審查有全日住院治療之必要者，將強制住院治療。而2007年「精神衛生法」第十五條規定，精神疾病強制鑑定審查會成員（以下簡稱審查會）包括專科醫師、護理師、職能治療師、心理師、社會工作師、病人權益促進團體代表、法律專家及其他相關專業人士。由於此一審查會的設置，使得社工專業得以有一合法發言位置，表達社工專業考量。然而值得關注的是，在審查過程當中，權衡「嚴重病人」以及「自傷傷人之虞」的審查要件經常使得社工委員面臨違反案主自決等原則是可被接受的境況。因此，本文旨在了解社會工作委員在參與審查會過程中所面臨的倫理立場兩難、社工委員在跨專業團隊合作的審查會機制裡所扮演的專業角色以及精神疾患強制就醫實務面的省思，進一步對目前審查會的審查準則提供更完備的建議。

關鍵字

嚴重精神病患 ； 社會工作專業倫理 ； 人權 ； 審查會 ； 精神醫療社工

並列摘要

Involuntary admission and treatment for patients with severe mental illness is usually based on the dangerousness to oneself or others. According to Article 15 of Mental Health Act Amendment, 2007 in Taiwan, the decision regarding to involuntary placement of severe psychiatric patients is subjected to review by the Psychiatric Disease Mandatory Assessment and Community Care Review Committee (hereinafter the Review Committee). The committee members including seven specialists, namely psychiatrists, professional registered nurses, legal experts, occupational therapists, psychologists, psychiatric social workers, and caregiver representatives advocating for patients' rights are involved in this court-like body to check and ensure the criteria for involuntary placement is met.For verifying the responsibilities as a psychiatric social worker committee representative, the purpose of this research is to find out the roles of social worker in the Review Committee and their perspectives on involuntary admission and treatment of severe psychiatric patients. Despite the fact that decision-making process of involuntary psychiatric admission and treatment is a struggle since it is against the patient's will. This study would be important in finding social worker roles on contribution to a full-picture of psychosocial consideration for severe psychiatric patients in the Review Committee.

並列關鍵字

Human rights ； Social Work Ethics ； Psychiatric Disability ； Mental Health Social Worker ； Review Board

參考文獻

葛謹(2010)。Gillick 行為能力-最高法院95 年度台非字第115 號刑事叛決評譯。醫事法學。17(1)，34-40。

唐宜楨、陳心怡(2008)。從《身心障礙者權利公約》來探討身心障礙概念的新轉向。身心障礙研究。6(4)，238-251。

王金永(2008)。英國與台灣精神衛生法的變革。社會政策與社會工作學刊。12(1)，189-218。

陳淵渝、林志強、諶立中、楊斯年(2007)。經急診室收住院之精神分裂症病人的臨床特徵。台灣精神醫學。21(3)，167-175。

Adams, P.(2009).Code of duties or ideological club?.Journal of social work values and ethics.6(1)