身家調查？揭露身分？──愛滋感染者接觸者追蹤之公衛權力界限與法制改革建議

Investigating Personal Data? Disclosing Identity?: The Power of HIV Contact Tracing and Recommendations for Legal Reform in Taiwan

伴侶告知是國際普遍的愛滋防治措施，但可能損及感染者維護資訊秘密的隱私利益，增加歧視風險。目前人類免疫缺乏病毒傳染防治及感染者權益保障條例第12條及第15條訂有感染者提供資訊、主管機關實施調查與通知檢查之法源，但手段定義不明、欠缺具體調查及揭露要件，且公衛人員迴避間接強制感染者提供資訊，存在蒐集、使用與揭露資訊權力界限不明的問題。本文釐清伴侶告知的三個面向，並以國際指引及美國紐約州與加州立法例為借鏡，檢討臺灣規範與執行上爭議，建議應尊重感染者參與接觸者追蹤之自願性，強化提供感染者告知服務，促進醫界對第三人保護義務之討論，明確化蒐集及運用資訊之主體、範圍與流程，平衡保護感染者之資訊秘密需求及伴侶知悉權。

Partner notification is one of the important strategies for controlling the spread of HIV after the discovery of a HIV-infected person. The purpose of partner notification is to find all possible infected persons related to the index patient for health education, to inform the risk, and provide testing and treatment. While it has significant public health benefits, the infected may face coercive pressure of revealing the names of their partners, lose their privacy interests in maintaining confidentiality, and become susceptible to discrimination in partner notification. Taiwan’s central health authorities is now combating HIV/AIDS by enforcing contact tracing, a legal power delegated by Article 12 of the Prevention and Treatment of HIV Infection and the Protection of the Rights and Interests of Infected Persons (hereinafter referred to as the AIDS Act). It prescribes that the infected person has the obligation to provide his/her source of infection or contact with the competent authorities; the public health authorities may carry out an investigation on the infected and his/her source, but the implementation of the investigation shall not infringe the personality and privacy of infected persons. However, the AIDS Act provides neither clear guidance on the definition, mode, and scope of such an investigation nor the duty of infected person to disclose and the duty of health care workers to warn, nor does it consider the limitations on information collection and utilization. All these shortcomings result in difficulties and deviations in implementation of contact tracing. This article first discusses the three implications of partner notification, then examines the international guidelines and New York State and California Legislation, reviews the regulatory structure and implementation of the Taiwan AIDS Act, and finally provides recommendations for reforming Taiwan’s AIDS law and public health policy.