結核病隔離治療法制之檢討：實證研究與合憲性分析

Examining the Tuberculosis Isolation Law and Policy: An Empirical and Constitutional Analysis

本文以結核病隔離治療之法規內容及執行實況為素材，探討以傳染病防治法第44、45條為法源依據之結核病隔離治療法制合憲性。本文發現：第一，隔離治療之要件過於概括，未以病人對公眾健康的具體風險為依據，且實際運用上逾越法律授權範圍，混淆不同目的之拘禁手段；第二，衛生人員可能因法律上欠缺對其他侵害較小手段之授權及醫療、社會支持措施，逕以隔離治療作為解決病人經濟、社會問題之方法，未全然符合較小侵害原則；第三，病人的社經地位潛在地成為影響衛生人員隔離治療決定之重要因素；第四，欠缺重要程序保障機制，包括適當的法官保留與及時法院救濟。為使結核病隔離治療法制符合憲法第8條第1項剝奪人身自由應經正當法律程序之要求，傳染病防治法應依不同目的，區別不同拘禁手段之要件，揚棄「必要時」此種空洞的實體要件，改以具體行為風險為標準，提供病人健康、安全的環境以達成拘禁目的，並依最近司法院就非刑事被告拘禁之程序保障所作成之解釋意旨，強化程序保障內涵，提供病人及時法院救濟及法院定期審查。

This article analyzes how Taiwan’s tuberculosis isolation regulatory scheme authorized under Article 44 and 45 of the Communicable Disease Control Act (Act) was implmented to check the constitutionality of the isolation power. It finds that: first, the requirements for TB isolation are too general, not based on specific risk to public health posed by patients; its implmentation might have gone beyond the scope of legal authorization since the authorities confused different powers of detention; second, the use of isolation power was not completely in line with the least restrictive means principle; due to unavailability of legally authorized less restricitve means and lack of medical and social support system, public health officials had little choice but to use isolation as a temporary relief to the patients’ economic and social problems; third, socio-economic status of patients potentially became an important factor for isolation decisions; fourth, the isolation regulatory scheme are short of significant procedural safeguard mechanism, including appropriate and timely judicial review. To comply with the requirements of article 8, paragraph 1 of the Constitution, the Act should authorize different detention powers based on different purposes of confinement; the “when necessary” limit on isolation is too vague and should be abadoned; the isolation power agasinst TB patients should be justified by assessment of patients’ risk behavior; patients have a right to healthy and safe environments for detention and are entitled to procedural protections provided to non-criminal detainees, i.e. timely court remedies and periodic review held in recent Judicial Yuan Explanations.