公共衛生監測之規範問題研究──以美國法及我國現況為中心

Legal Issues of Public Health Surveillance- Focusing on the U.S. Laws and Current Situation in Taiwan

公共衛生監測(public health surveillance)是一國基礎的公共衛生建設；是一種持續、系統性的蒐集、分析、解釋健康相關資訊的措施，以計畫、執行與評估公共衛生實務；經過緊密的整合、適時的傳遞資訊與需要者使用，並且將這些資訊適用於防範與控制。我國目前有眾多的公共衛生監測系統存在，衛生主管機關，透過醫療院所等的通報，蒐集、利用並保存無數民眾可辨識身分的健康個人資料。這些公共衛生監測系統大部分經法律規定，但其內容細節均由主管機關自行設計，包括蒐集項目與使用方式等。我國雖有個人資料保護法宣示對個人資料的保護與尊重，但對公務機關蒐集、處理、利用特種個人資料的規範寬鬆，不足以對公共衛生監測所面對的規範問題提出有效的對策。本文首先介紹公共衛生監測，使讀者瞭解措施之目的與功能，次分析規範議題與美國法上之討論，最後就台灣目前之規範情況提出評論與立法建議。本文以為，公共衛生監測之規範，首應嚴格要求於母法中明示蒐集個人資料的特定目的，以利日後判斷蒐集項目與資料的使用是否有助達成目的、對人民權利的最小限制與均衡性。其次，就公共衛生監測系統應遵守之規範以專法規定之，以妥適保護人民的健康資訊隱私。

Public health surveillance is defined by the Centers for Disease Control and Prevention in the United States as an “ongoing systematic collection, analysis, and interpretation of health related data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know. The final link in the surveillance chain is the application of these data to prevention and control.” Currently, there are numerous public health surveillance systems in Taiwan. Public health agencies acquire, use and store innumerable identifiable health information from medical professionals and health care entities. Most of the public health surveillance systems are authorized by laws; however, details are designed by public health agencies. Personal Information Protection Act was enacted in 2010; however, it does not provide enough regulation for government agencies’ collecting, processing and using identifiable information rega rding an individual’s health status. This article first introduces the background knowledge of public health surveillance systems, including goals and functions. Second, this article analyzes the issues of regulating public health surveillance and introduces related discussions and laws in the U.S.. Third, this article analyzes current legal situation of public health surveillance in Taiwan and provides suggestions. The author suggests the court should require the authorizing law of public health surveillance to state the policy goal specifically and clearly. Such requirement helps to examine whether collected items and future use match policy goals. In addition, this article proposes an act governing public health surveillance to regulate related issues in order to protect people’s health information privacy.