強制住院司法審查新制之變革、衝擊與因應【月旦時論】 試閱
Reforms, Impacts, and Responses of the New Judicial Review System for Involuntary Hospitalization
中華民國《精神衛生法》之強制住院審查機制，經歷了由醫師行政決定（1990年）、行政審查會（2007年），發展至法院專家參審合議庭（2022年修法、2026年施行）之三次歷史性變革。新制以憲法層次之法官保留原則為核心，導入了程序監理人與律師代理機制，並建立得依職權或聲請將強制住院轉軌至強制社區治療之機制。在人權保障方面，新制將強制住院期間嚴格限縮為最長120日（含一次延長），並全面確立執行強制社區治療時之知情同意原則，刪除舊制不告知之例外規定。然而，新制之運作亦面臨諸多重大隱患與實務挑戰，包含必須於7日緊急安置期限內完成三方庭審協調之即時性壓力、程序保障與臨床緊急醫療時效間之結構性張力、醫院端面臨訴訟文書法律化之指數級增長，以及過渡期間舊制留院個案集中補聲請對法院造成之龐大負荷衝擊。本文系統性地分析制度沿革、聲請前置作業、審理程序、聲請結果與可能產生之衝擊，並提出前端分流、文書智慧化、審前協商標準化等因應建議，以期在人權保障與臨床治療時效間尋求實質均衡。
The compulsory hospitalization review mechanism under Taiwan’s Mental Health Act has undergone three historic transformations: from unilateral medical decisions in 1990, to administrative review committees in 2007, and ultimately to judicial review by collegiate panels with expert participants, enacted in 2022 and effective in 2026. Centered on the constitutional principle of judicial reservation, the new system introduces procedural supervisors and mandatory legal representation, and establishes a transitional mechanism allowing courts to convert compulsory hospitalization into compulsory community treatment. In terms of human rights protection, the new legal regime strictly limits the maximum duration of compulsory hospitalization to 120 days (including one extension) and comprehensively incorporates the principle of informed consent for compulsory community treatment, eliminating the previous exceptions to non-disclosure. Nevertheless, the operation of the new system faces significant potential risks and practical challenges, including the pressure to coordinate three-party hearings within a seven-day emergency placement period, the structural tension between procedural safeguards and the urgency of clinical intervention, the exponential increase in litigation-related documentation for hospitals, and the massive judicial workload caused by transitional applications for patients hospitalized under the previous system. This article systematically analyzes the legislative evolution, pre-application procedures, judicial proceedings, adjudication outcomes, and potential impacts, while proposing responses such as front-end triage, smart documentation systems, and standardized pre-trial negotiations, aiming to achieve a substantive balance between human rights protection and clinical treatment efficiency.
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