警察強制護送就醫制度之研究－以精神衛生法第32條為中心

Abstract

精神病患常因缺乏病意識，加上社會大眾對於精神疾病之恐懼與汙名化，導致其孤立無援，進而延誤尋求適當之協助與就醫處理，如此則產生是否須將其強制護送就醫之爭議。而警察往往為處置精神病患案件之第一線人員，有「準精神醫療人員」之地位。現行我國關於警察強制護送就醫制度，主要規定於精神衛生法第32條、警察職權行使法第19條與行政執行法第37條等。然而現行之法規範，存有諸多不足之處，有待改善。據此，本文針對警察作為執行強制護送就醫之判斷主體是否適當、對於精神病患之程序保障充分與否，以及警察強制護送就醫之手段與比例原則之審查三大面向加以研究。 透過歐洲人權公約、歐洲人權法院判決、美國法院判決與文獻給予之省思與啟發，關於我國警察對於精神衛生領域欠缺專業性，本文建議可藉由加強警察人員專業訓練課程，或是積極促使醫療專業人員到場協助，予以改善。此外，未來修法應明確劃分權責，以確立警察在強制護送就醫制度之角色與定位。其次，針對現行精神病患程序保障（例如告知義務、當場異議權等）不足之情形，為避免因作成決定之機關不同，須適用不同法規，而產生不同之法律效果，或是在機關共同作成決定之情形，產生適用法規之爭議，故認為應直接於精神衛生法中明文規定。又在強制護送就醫之程序保障中，是否須採取「法官保留原則」之爭議上，本文贊成此一主張，因透過法院介入審查，對於當事人人身自由之保障更為周全。最後，關於警察處置精神病患之手段運用上，應審慎考量當事人患有精神疾病之事實，以作出合於比例原則之處置手段。另外，警察依個案情形宜盡量採取低致命性武力，避免行使強制力過當之狀況發生。準此，上述此等比較法之啟發，得作為我國未來修法之參酌典範。

Stigma, public fear, and general lack of awareness about mental illness often results in the isolation of people with mental illness and a delay in their treatment. This causes disputes about whether or not involuntary escort services to a psychiatric hospital should be allowed. The police are usually the first line of response for situations involving mentally ill patients in crisis, so are called on to act as “street-corner psychiatrists.” The system of police officers’ involuntary escort services for medical treatments is stipulated in article 32 of Mental Health Law, article 19 of Police Power Exercise Act, article 37 of The Administrative Execution Act, etc. However, there are many shortcomings in the current legal system that need to be improved. Therefore, this thesis focuses on the following issues: (1) Is it proper for police officers act as the subject for compulsory escort? (2) Are there adequate procedural safeguards for patients with mental illness? (3) The proportionality of police officers’ involuntary escort services. Drawing on the European Convention for the Protection of Human Rights and Fundamental Freedom, the cases of the European Court of Human Rights (ECHR) and the U.S. case law, this thesis suggests improving professional training for the police or impelling mental health professionals to arrive and assist the police on the scene. Also, in order to establish the role of police in involuntary escort services, the existing laws should specify the authority and responsibilities of police officers. The inadequate procedural safeguards should also be addressed (for example: the obligation of notification, the right of dissent on the spot). For the patients to achieve consistent legal representation, procedural safeguards should be stipulated under Mental Health Law directly. In addition, this thesis advocates the “Principle of Reservation by the Judges”. Through this principle, the law will more completely protect the right to liberty of persons. Finally, the police should carefully consider the fact that the person is suffering from mental illness when they respond in situations involving mentally ill people. This would ensure the measures the police use will not breach the principle of proportionality. Police officers should avoid using a higher level of force than necessary and instead properly use non-lethal weapons. Thus, the inspiration from comparative law can be considered for the upcoming legal reform.