原住民族接近使用醫療服務權與國家保護健康權義務

Indigenous People’s Right of Access to Health Care Service and the Nation’s Obligation to Protect the Right of Health

本文以「接近使用醫療服務機會」（access to healthcare），結合健康權之國際人權法理，探討原住民族醫療可近性之憲法基礎與國家保護義務。透過國際健康權理論與德國法學見解，闡明健康權之規範內涵，並以「尊重、保護、履行」國家保護義務作為分析，說明國家對人民平等接近利用醫療服務之憲法責任。
其次，從中華民國憲法增修條文第10條第11項、第12項，論證原住民族健康保障具有憲法價值選擇與基本國策拘束力之意義，評析原住民族健康法之立法依據與規範密度。並主張原住民族健康法並非僅屬一般政策性法律，而具有準憲法高度之「憲法性」法律性質，屬制度性保障與國家保護義務理論之具體實踐。再者，本文指出原住民族醫療可近性面臨地理、經濟、文化語言及人口老化等多重障礙，強調國家有義務確保人民平等接近利用醫療服務及相關資訊，避免第三人限制健康權之實現。
整體而言，本文在國際法、比較法與我國憲法增修條文之架構下，建構原住民族醫療可近性之憲法理論基礎，補充我國學界對原住民族健康權憲法定位之討論不足，並深化國家保護義務之理論內涵。

This article takes“Access to Healthcare”as its analytical focus and, in light of the international human right framework of the right to health, examines the constitutional foundations of indigenous peoples’healthcare accessibility and the nation’s duty to protect. Drawing on international right-to-health theories and German legal scholarship, the article clarifies the normative content of the right to health and, through the tripartite framework of the nation’s obligation to respect, protect, and fulfil, elucidates the nation’s constitutional responsibility to secure equal access to and utilization of healthcare services.
The article further argues, on the basis of Article 10, Paragraphs 11 and 12 of the Additional Articles of the Constitution of the Republic of China, which the protection of indigenous health reflects both a constitutional value choice and the binding force of fundamental national policy. It also analyzes the legislative foundation and normative density of the Indigenous Peoples Health Act, contending that the Act should not be regarded merely as an ordinary policy-oriented statute. Rather, it should be understood as possessing a quasi-constitutional character, serving as a concrete embodiment of both the doctrine of institutional guarantee and the nation’s duty to protect.
In addition, the article identifies multiple barriers to indigenous peoples’access to healthcare, including geographic remoteness, economic constraints, cultural and linguistic differences, and population aging. It emphasizes that the nation is constitutionally obligated to ensure equal access to healthcare services and related information, and to prevent third party from interfering with the realization of the right to health.
Overall, by integrating the perspectives of international law, comparative law, and the Additional Articles of the Constitution of the Republic of China, this article constructs a constitutional theoretical framework for indigenous healthcare accessibility.
Therefore, it fills a gap in Taiwanese legal scholarship concerning the constitutional status of indigenous health rights and further enriches the theoretical understanding of the nation’s duty to protect.