伴侶告知法制之研究：以HIV感染類型為中心

Abstract

伴侶告知為典型的性傳染疾病防治手段之一，目的在於促使疾病感染者之性伴侶等接觸者，意識自己有因接觸感染者而感染疾病之潛在風險，並及早採取相關措施以降低疾病擴大感染之可能性，維護個人健康與公共衛生。縱然如此，伴侶告知可能造成感染者擔憂其身份揭露之不安與個人隱私侵害之疑慮，使感染者配合或參與伴侶告知之意願下降，反有礙伴侶告知之推展。鑑於我國伴侶告知相關法制並不完備，本文乃以愛滋病毒感染之傳染病類型為研究主軸，旨在提出一套較完整的伴侶告知制度。 本文嘗試從伴侶告知所涉及公共衛生目的與個人隱私疑慮，此二方面切入觀察並整理學說與司法實務之見解，認為個人隱私非受絕對保障，應在合理且必要限制範圍內調和隱私權與其他利益之衡平。由於伴侶告知可能揭露個人敏感醫療資訊，且資訊揭露對象為親密關係之第三人，基於愛滋例外主義與醫療人權保障，應嚴格檢視伴侶告知的程序與要件規範。本文亦借鏡比較法上伴侶告知的立法實踐，以國際組織、美國與加拿大的法規範為研究對象，分別整理伴侶告知的程序與實體要件之規範內容，作為重構我國伴侶告知法制之主要參考。 最後在伴侶告知規範模式的選擇上，本文傾向尊重感染者之自主性及保障其個人隱私，於伴侶告知程序，賦予感染者事前同意權與程序參與決策權，並強化伴侶告知的事前諮詢程序，以不揭露感染者身份的方式進行之。另一方面，訂定嚴謹的強制伴侶告知規範，在有防止伴侶遭受感染之危險性與急迫性的必要情形，允許衛生機關進行強制伴侶告知。

As a typical control strategy for sexually transmitted diseases (STDs), partner notification aims to ensure all contacts of the infected person are aware that they are in danger of the infection, and adopt appropriate measures to prevent the further infection. Nevertheless, partner notification might bring about the concern of disclosing the status of infection for the infected person, which causes the infected person hesitant about whether to participate in the procedure of partner notification. In order to strengthen the control for STDs and resolve the invasion of individual privacy, this thesis focuses on the perspective of HIV infection, attempting to propose a model for the legislation of partner notification in Taiwan. The protection of an individual’s right to privacy is not absolute, while ought to be examine against other competing interests through ad hoc balancing to adopt the proper approach to privacy protection. Nevertheless, partner notification might disclose the personal sensitive medical information to patient’s intimate contacts (spouse, sexual partner, needle-sharing partner). On the basis of AIDS exceptionalism and the concept of right to health care, it leads to promote patients’ human rights and eliminate the discrimination and stigmatization against the infected person. The legislation for partner notification, therefore, shall be subject to the application of strict scrutiny. Also, this thesis refers to the legislation related to partner notification of the international organization, the United States and Canada. This thesis suggests that patient’s autonomy and privacy in partner notification procedure be fully respected, consisting of patient’s informed consent and procedure participation towards partner notification. Pre-consultation for partner notification and non-disclosure of patient’s identifiable information are also emphasized. On the other hand, to enhance the effectiveness of partner notification, public health officers are allowed to proceed mandatory partner notification, in the situation that the infected person poses the imminent danger of HIV transmission to their partners.