我國精神衛生法之檢討

A Repercussion of the ROC Mental Health Law

我國精神衛生法於民國79年11月23日完成立法，同年12月7日頒布實施。為瞭解其可行性，研究者擬定精神衛生法意見調查表，郵寄給217位精神科專科醫師、507位心理衛生工作人員及325位病人家屬，共回收有效問卷302份，回收率28.8%。分析結果發現：1.除第11條、第32條及罰則之五條外，其餘各條均獲85%以上之同意率，顯示一般而言受調查者對精神衛生法尚稱滿意；2.不同意者超過5%的共有九條，其內容是有關家屬的定義，精神疾病防治審議委員會之組織與職掌，保護人之辭職，強制住院及其展延之手續，病人同意治療的權利，精神醫療補助，強制住院者免費醫療，及家屬同意者得免追究收容機構未送病人醫療之刑責；3.精神科醫師、心理衛生人員及病人家屬意見不一致的條文，可歸之於利益衝突、和過去的習慣不符、條文文義不清、或反應精神衛生法部份條文的不周延及執行時可能碰到的困難。根據上述發現、文獻、及心理衛生立法之世界趨勢，作者建議我國精神衛生法之中和強制住院、強制治療、病人權利、家屬的責任等有關的條文應予修訂。作者呼籲應有更多有關精神衛生法之研究，其結果可供改善我國精神醫療之參考。

The first Mental Health Law (MHL) of the Republic of China was promulgated and entered into force on 7 December 1990. To study the opinions toward the MHL, questionnaires were handed over or mailed to 217 specialist psychiatrists, 507 mental health workers, and 325 family members of patients. A total of 302 questionnaires returned for analysis. The major findings are summarized below. 1. Except Articles 11, 32 and five on chapter V (penalties), more than 85 % of the respondents agreed with all other articles. This indicated that they were satisfied with the MHL in general. 2. There were 9 articles which more than 5% of the respondents disagreed. They were related to the definition of family member, the composition and function of the Prevention and Deliberation Committee, the resignation of the protector, procedures of compulsory hospitalization and its extension, the procedure of consent to treatment by the patient, the subsidies for treatment by the government, the free treatment for compulsorily admitted patient, and the exemption of penalties to persons who fail to provide medical care or assist in seeking medical care arises from the consent of the family. 3. The differences among psychiatrists, mental health workers, and family members could be attributed to the conflicts of interests, the conflicts with previous practice pattern, the ambiguities of the articles, or the reflections of the professional opinions of the potential problems or weaknesses of the MHL. Based on the literature, the worldwide trend of mental health legislation, as well as the above findings, the authors argue that those articles related to the procedures of compulsory admission and treatment, the rights of the patient and the family roles should be considered for amendment. More researches in the area should be done and their results shall be the bases for further improvement of the mental health service in the country.