精神病患強制住院治療法制與實務：臺灣與德國之比較研究

The Legal Framework and Practices of Compulsory Admission and Treatment for Mental Patients: Comparative Study Between Taiwan and Germany

臺灣精神衛生法於2022年12月14日修正公布，新法就精神疾病患者強制住院治療改採法官保留，並以使相關規定更符合CRPD意旨為修法目的。基此背景，本文主要探討以下議題：強制住院在CRPD下之容許性；在繼續保留強制住院制度的前提下，精神衛生法如何朝向CRPD精神邁進，及法院為強制住院裁定時如何進行審酌，並以德國法為比較法例開展論述。第貳部分介紹CRPD與強制住院有關的規定，同時分析德國與我國就強制住院與CRPD相容性之討論。第參部分說明德國法制與實務，包括德國公法安置在該國法體系之定位、運作法制框架與實體要件，實體要件部分尤其聚焦討論公法安置脈絡下「危險」的概念內涵，和適格作為受保護之法益。第肆部分分析我國精神病患強制住院治療之功能與定性、運作法制框架與實體要件，並借鏡德國法制與實務評析我國新法規定，及新法施行後法院為裁定應留意的面向。因新法採行「專家參審模式」，由醫療專家、病權團體代表及職業法官共同組成合議庭進行審理，故本文亦分析專家參審制如何運作始能落實新法採取法官保留以完善保障病人權益之意旨。最後，綜整全文研究提出結論和展望。

The Mental Health Act in Taiwan was amended and promulgated on December 14, 2022. The amendment adopts a prior judicial order mechanism for the compulsory admission and treatment of mental patients, aiming to better align relevant provisions with the principles of the Convention on the Rights of Persons with Disabilities (CRPD). Considering the aforementioned background, this paper, by comparing with German law, aims to examine the compulsory psychiatric admission compatibility with CRPD and on the premise of maintaining compulsory psychiatric admission, how mental health act can move towards achieving CRPD compliance, as well as how the courts should adjudicate such cases. This article first summarizes the current understanding and literature around Article 12 and Article 14 of the CRPD. Meanwhile, it explores the debate within Germany and Taiwan whether compulsory psychiatric admission violates CRPD articles. Secondly, the paper will address the positioning of public law placement within the German legal framework and present its legal framework and substantive criteria, particularly focusing on the conceptual understanding of ''danger'' within the context of public law placement and the eligible protected legal interests. Subsequently, the analysis will shift to Taiwan's approach to the compulsory admission and treatment of mental patients, discussing its functions and characterization, legal framework and substantive criteria. By drawing comparisons with German legal systems and practices, the paper will evaluate the new provisions of Taiwan's Mental Health Act and highlight aspects that courts should consider when making rulings under the new law. Given the adoption of the ''experts lay judge system'' in the new law, where a collegial panel comprising medical experts, representatives of patient rights groups, and professional judges conduct hearings, the paper will also analyze how the experts lay judge system can effectively implement the prior judicial order mechanism to better safeguard patient rights. Finally, the paper will consolidate the research findings and present conclusions and prospects.