從商業性言論自由之角度出發——再探醫療廣告應有之規範：兼評112年憲判字第17號判決

Revisiting the Regulation of Medical Advertising from the Perspective of Commercial Speech Freedom: A Commentary on Judicial Yuan Judgment No. 112-Hsien-Pan-17

言論自由，憲法所保障之重要基本權。其價值在於有助於真理的追求、深化多元的民主，以及落實個人自治與自我實現。在言論的分類下，商業性言論自由固然被認為係屬低價值之言論，但也仍受憲法一定之保障。然，即便其得受較多的規範、甚或限制，尤其基於公益維護之必要，仍不改其屬應受保障言論自由之本質。因此，當醫療法僅准允醫療機構得為醫療廣告，也就是完全地限制了醫師得從事商業性言論，這樣的限制，乃至於對於特定專業人就其本應享有憲法保障之基本權產生了根本的剝奪，是否可以再以所謂的醫師專業形象之維持、醫療行為商業化之避免，以及落實國民健康之確保，而取得前述限制之正當化理由？針對這樣的爭議，憲法法庭於民國112年做成了憲判字第17號判決，大法官們在本號解釋中，即針對醫療法第84條禁止醫師從事醫療廣告之規定，就其合憲法與否進行審查。固然多數意見站在應保障醫師商業性言論自由之立場，就前述規定予以違憲之宣告，相對於檢視不同意見又是如何提出其見解，更重要的當是在於，面對這樣的爭議，本號判決是否真真確確地提出了可供參酌與具體操作之判準？抑或是仍有未臻明確之處、甚至是未竟之功？本文嘗試以比較法之介紹與討論，聚焦在美國法對於商業性言論之認識，從和為商業性言論之定義與定位、司法審查標準之確立、對於特定立法方式之質疑，到針對特定專業人士，如醫師、律師，就其從事招徠廣告之行為，在商業性言論應受憲法保障的確論下，又應如何對之規範、如何就該規範進行審查，得出對其應有之掌握，以回應與檢討我國在本號裁判上容有再為省思與細緻化之處。

Freedom of speech is a fundamental right guaranteed by the Constitution, valued for its role in the pursuit of truth, the promotion of a pluralistic democracy, and the realization of personal autonomy and self-fulfillment. Among the various categories of speech, commercial speech is often regarded as low-value speech but is nonetheless afforded certain constitutional protections. While it may be subject to more regulations or stricter restriction, particularly when necessary for the public interest, its nature as constitutionally protected speech remains unchanged. The Medical Care Act only allows medical institutions to engage medical advertising, which effectively prohibits physicians from doing in commercial speech. Such a restriction, which fundamentally deprives professionals of a constitutionally protected right, raises the question: can it be justified under the pretext of maintaining the professional image of physicians, preventing the commercialization of medical practices, and safeguarding public health? Addressing these issues, the Constitutional Court rendered Judgment No. 17 in 2023, reviewing the constitutionality of Article 84 of the Medical Care Act, which prohibits physicians from engaging in medical advertising. While the majority opinion declared the provision unconstitutional, advocating for the protection of physicians' commercial speech rights, dissenting opinions offered alternative perspectives. More importantly, the judgment invites reflection on whether it provides clear and actionable standards or leaves certain ambiguities unresolved. This article seeks to explore these issues through a comparative legal analysis, focusing on the United States' approach to commercial speech. It examines the definition and values of commercial speech, the establishment of standards for judicial review, critiques of legal paternalism approaches, and the regulation of advertising by professionals such as physicians and lawyers. By analyzing how constitutional protections apply to commercial speech in such contexts, this article would identify lessons that may inform a more nuanced evaluation and refinement of the reasoning and standards established in the 2023 judgment.