受刑人健康權－從歐洲人權法院判決開展之具體內涵

Abstract

受刑人就維護身心健康所得享有之監禁條件應具備何等要素？此疑問始於問題意識，終於結論，貫穿本文之各部而為本研究之核心。 歐洲人權公約第2條生命權保障與第3條酷刑禁止，為締約國受刑人之健康權設下了絕對的保障。而經由分析歐洲人權法院歷年來針對受刑人健康權之判決，可歸納出監獄或看守所在健康權保障上，負有之義務為提供充足飲食、維持適當監禁環境以及滿足受刑人之醫療需求。 回歸我國法檢視下，可確定者是健康權為憲法保障之基本權利。關於人權保障之規定已具備國內法效力之公民與政治權利國際公約以及經濟社會文化權利國際公約，更是對受刑人提供平等、無歧視之保障；兩公約之下，受刑人享有包含健康權在內之各項基本權利，實屬無庸置疑。本文認為，受刑人即使立於特別權力關係之下，仍應獲有與一般人相同之健康權保障，就此而言，國家必須確保受刑人不因監所環境或醫療之缺失而有健康惡化之虞，並應提供與社區相同水準之醫療照護。 具體而言，監所必須提供充足飲食、衛生用品與所需醫療，並維持監所環境之衛生清潔。相較於一般受刑人，老年人、女性以及精神病患具有較高之健康照護需求，惟即使面對此等較高之需求，監所仍不免其健康權保障義務。老年受刑人之顯著健康問題為身體機能障礙與慢性疾病，對此，監所應提供無障礙設施與長期慢性病照護。女性受刑人之醫療需求與男性受刑人截然不同，監所應針對女性受刑人之健康需求，而提供相應之醫療照護。最後，入監篩檢、精神疾病治療以及自殺預防是精神疾病受刑人健康照護之關鍵要素，為監所保障在監精神病患健康之核心義務。

What are the conditions of imprisonment entailed by the enjoyment of the right to health? This is the question to which this thesis aims to answer. Articles 2 (the right to life) and 3 (prohibition of torture and degrading or inhuman treatment) of the European Convention on Human Rights (the “Convention”) provide absolute protection for prisoners to their right to health in correctional facilities. The analysis of the cases of the European Court of Human Rights (the “Court”) in respect of the right to health of prisoners yields the finding that for a correctional facility to be considered acting in compliance with the Convention, prisoners within must have access to adequate food and water, proper and sanitary environment, and medical care. The right to health is protected under Constitution of Republic of China (“R.O.C.”). Similarly, the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights (the “Two Covenants”), of which the human rights protection provisions have domestic legal status in R.O.C., provide non-discriminative protection for prisoners. It is indisputable that prisoners shall enjoy fundamental rights under the Two Covenants, including the right to health. This thesis argues that prisoners are indifferently entitled to the right to health as free citizens, therefore, the state must ensure the adequacy of the environmental and medical resources in correctional facilities to the extent that the health of prisoners does not deteriorate owing to the lack thereof. This thesis also argues that the standard of correctional health care should be the same as in the community. More specifically, correctional facilities must provide adequate food and water, sanitary items and medical care, as well as keeping the environment clean and habitable. Old prisoners, female prisoners and prisoners with mental illness have higher medical needs than the general population, however, correctional facilities’ obligation to protect prisoners’ right to health, in times facing higher needs, remains unchanged. The prominent health issues among old prisoners are physical disability and chronic illness, and the needs arising accordingly require the correctional facility to provide barrier-free environments and long-term medical care. Female prisoners have distinct health needs as compared to male prisoners, correctional facilities should thus provide gender-specific health care to fulfill their distinct needs. Lastly, in-take screening, mental health treatment and suicide prevention are the core elements of health care of prisoners with mental illness, together they constitute correctional facilities’ obligation of health care towards mentally-ill prisoners.