我們與善與惡的距離──論思覺失調症之罪與罰

The Distance between Us and Good and Evil: On the Crime and Punishment of Schizophrenia

有關刑罰法律，基於無責任無處罰之憲法原則，人民僅因自己之刑事違法且有責行為而受刑事處罰，刑罰須與罪責相對應。是故，行為人於犯罪時是否處於病發狀態？其犯罪時係完全喪失識別能力及控制能力，或其仍有殘存之識別能力及控制能力，只是顯著減低，此皆有賴精神醫學之專業判斷。然因司法與醫學乃屬不同領域，目前司法精神鑑定報告是否能完全輔助法官對於事實之釐清，不無疑問。又精神疾病之精神狀態類似光譜，呈現漸層深淺的高低起伏，惟刑法第19條太過簡化精神疾病之病程及態樣，宜作更為精細之分級。再者，對於犯刑法第19條而受監護處分之人，如何避免其再犯，亦有重新檢討刑法第87條監護處分之必要。此外，就精神醫學角度，思覺失調症患者如有定期服藥，其治療效果相當良好，然若任其自行停藥，往往導致病情加重，甚且發生害人害己之重大悲劇。職是，本文基於保護思覺失調症患者之就醫權及公共利益之考量，以預防犯罪之立場，建議對於思覺失調症患者應強制定期接受門診或居家藥物治療，以免憾事一再發生。

"Based on the constitutional principle of nulla poena sine culpa (no culpability carries no penalty), a person shall be subject to criminal penalty only for criminal violations and culpable acts, and the punishment must correspond to the act. Therefore, was the offender in a state of mental illness when he committed a crime? Had the offender lose his ability to recognize and control when committing the crime? or the offender still had the remaining ability to recognize and control, but it was significantly reduced? It all depends on the professional judgment of psychiatry to decide. However, because Justice and Medicine belong to different fields, whether the current judicial psychiatry report can fully assist the judge in clarifying the facts is not without doubt. In addition, the mental state of mental illness is similar to the spectrum, presenting gradual depth fluctuations, while Article 19 of the Criminal Law over simplifies the course and type of mental illness, it is needed to make a more detailed classification. Furthermore, to prevent persons under custodial protection for violating Article 19 of the Criminal Law from repeating crimes, it is necessary to review Article 87 of the Criminal Law. Besides, from the perspective of psychiatry, if patients with schizophrenia take medicine regularly, the treatment result is extremely good, but if they stop taking the medicine without authorization, it often worsens the illness and even cause a major tragedy happened that harms others and themselves. Thus this article is based on the protection of schizophrenia patients’medical rights and public interest considerations, and from the standpoint of crime prevention, it is recommended that patients with schizophrenia should be forced to take regular outpatient follow-up or home medication treatment to prevent repeated regrets."