臺灣地區2008年至2022年65歲以上老人他殺案件之流行病學研究

Abstract

隨著全球人口急速老化，老人健康及社會安全議題逐漸受到各國政府及學者的重視，其中最嚴重威脅老人生存權及人身安全的莫過於他殺，然而老人他殺的全國性大型研究直至近年才開始於英美等國萌芽，亞洲國家則尚未有關於老人他殺的專門文獻。有鑑於此，本研究透過公文申請取得法務部法醫研究所授權，搜尋發生於臺灣、案發時間介於2008年至2022年、案發時被害人年滿65歲之老人他殺案件，由法醫研究所提供解剖報告書暨鑑定報告書，並輔以司法院裁判書查詢系統之公開內容，以完善被害人特徵、加害人特徵，及案件特徵等重要資訊。 本研究總計收案243名被害人，含144名男性及99名女性；並統計出參與犯案之250名加害人，包括205名男性及45名女性。研究結果顯示近年臺灣老人他殺占全體他殺比例快速攀升，其速度甚至超越人口老化速度，且女性被害人的比例高於全體他殺，被害人婚姻狀態及社經地位亦可能與老人他殺具有相關性。關於臺灣老人他殺的案件特徵包括：複合手法及徒手攻擊作為他殺方法的比例較高；家中物品為僅次於刀械第二常見的凶器；約一半的案件案發前無跡象或徵兆；細故占犯案動機超過四成；精神疾病患者無故殺人為第二常見的動機，以上各項皆增加老人他殺預防的難度，另外照顧者犯案及慈悲殺人的比例也都高於國外文獻。男性與女性被害人的共同特徵包括：案發地點以被害人住處最多，尤其女性超過八成於住處遇害；具親屬關係的加害人以子女最多；與加害人共同居住的比例高。此外透過性別分析發現女性被害人獨有之特徵如：行動能力受限；親屬犯案占四分之三強；曾遭加害人家暴（老人虐待）；動機與照顧因素有關；扼死及勒死與悶死的比例較高，總結以上各點可歸納出老年女性健康衰退導致家庭內照顧壓力上升且易於引發老人他殺，是女性被害人比例高於全體他殺的重要原因。此外，物質濫用與精神疾病對老人他殺加害人的影響甚巨，其中男性受酒精及非法毒品影響較大，女性受精神疾病影響較多。 本研究完成了臺灣老人他殺初步但全面的分析，已發掘許多老人他殺的特徵及一些可預防的風險因子，期望藉此引起政府相關單位的重視從而採取積極的介入措施，以達促進臺灣老人健康福祉的最終目的。

As the global population continues to age rapidly, the health and social security of the elderly have drawn growing attention from governments and researchers worldwide. Homicide is among the most serious threats to the rights and safety of older adults. While large-scale nationwide studies on elder homicide have recently emerged in countries like the UK and the US, such research remains absent in Asian nations. To address this gap, this study was authorized by the Institute of Forensic Medicine, Ministry of Justice of Taiwan, to analyze elder homicide cases involving victims aged 65 and older between 2008 and 2022. It leverages autopsy and cause-of-death reports from the Institute of Forensic Medicine, supplemented by publicly accessible court verdicts from the Judicial Yuan's database, to provide comprehensive insights into victim, perpetrator, and incident characteristics. This study examined 243 elder homicide victims, comprising 144 males and 99 females, and identified 250 perpetrators, including 205 males and 45 females. The proportion of elder homicides in Taiwan has risen rapidly, surpassing the rate of population aging. Female victims were disproportionately represented compared to overall homicide cases, and factors such as marital status and socioeconomic status may be linked to elder homicide. Key incident characteristics include a higher prevalence of combined methods and bodily force as the method of homicide, with household items being the second most common weapons after knives. Approximately half of the cases showed no prior warning signs, while trivial disputes accounted for over 40% of motives. Unprovoked killings by individuals with mental illness were the second most common motive. All of above complexities make prevention challenging. Besides, caregiver-related and mercy killings were notably more common than in previous studies. Both male and female victims shared similar patterns, such as most incidents occurring at the victim’s residence (over 80% for females) and a high proportion of perpetrators being relatives, particularly children, often cohabiting with the victim. However, sex-specific analysis revealed unique traits among female victims, including limited mobility, over three-quarters of perpetrators being relatives, prior exposure to domestic violence (elder abuse), and motives tied to caregiving stress. Females were also more frequently killed through strangulation or smothering. These findings suggest that declining health among elderly females amplifies caregiving pressures within families, increasing their vulnerability to elder homicide and contributing to their higher representation among victims. Additionally, substance abuse and mental illness significantly impacted perpetrators, with male offenders more influenced by alcohol and illicit drugs, while female offenders were more affected by mental health conditions. This study conducted a preliminary yet comprehensive analysis of elder homicide in Taiwan, uncovering numerous characteristics and identifiable risk factors. It is hoped that these findings will draw the attention of relevant government agencies and prompt proactive interventions, ultimately promoting the health and well-being of the elderly population in Taiwan.