精神醫療的十字路口──當強制治療面對人身自由

Psychiatry at the Crossroads: Compulsory Hospitalization Confronting Personal Freedom

本文以2022年精神衛生法修正前的社會情境與爭議為起點，討論所涉及的人身自由、社會安全衝突，並點出較少提及健康權及生命權。人身自由與社會安全的矛盾，更由於身心障礙者權利公約第12條及第14條及後續解釋，讓多數討論都聚焦於身心障礙者權利公約所反對的精神科強制治療一事。另方面，將社區支持和非醫療介入過度放大，而低估了強制治療作為減緩失能、維護嚴重精神疾病病人身心健康的目的，這正是其他國際人權委員會，主張保留強制治療的原因。
面對精神衛生法新制，作者主張維護嚴重精神疾病病人的權利，不應僅考慮人身自由限制，更應著眼於生命權及健康權的維護，方符合司法院釋字第785號維護國人身心健康權利的意旨。

This article starts from the social situation and controversy before the amendment of the Mental Health Law in 2022, discusses the conflicts involved in personal freedom and social security, and points out that we rarely mention the right to health and life. The contradiction between individual freedom and social security, following Articles 12 and 14 of the Convention on the Rights of Persons with Disabilities and subsequent interpretations, most discussions focus on the issue of compulsory psychiatric treatment that the Convention on the Rights of Persons with Disabilities opposes. On the other hand, community support and non-medical intervention are over-emphasized. Therefore, most discussions underestimate the purpose of compulsory treatment to alleviate disabilities and maintain the physical and mental health of patients with severe mental disorders. That is precisely why other international human rights committees advocate retaining compulsory treatment.
While facing the new mental health law, the author advocates that to protect the rights of patients with severe mental illness, we should not consider only the restriction of personal freedom but also focus on the protection of the right to life and health to comply with the Judicial Yuan Interpretation No. 785 on safeguarding the physical and mental health of the people as a constitutional right.