我国成年精神障碍患者意定监护制度的价值与完善建议  

The Value and Improvement Suggestions of the Voluntary Guardianship System for Adult Patients with Mental Disorders in China

作　　者：杨菲 朱飞 YANG Fei(College of Medical Humanities,Guizhou Medical University,Guiyang,Guizhou,550025,China)

机构地区：[1]贵州医科大学医学人文学院,贵州贵阳550025 [2]贵州众芳律师事务所,贵州贵阳550000

出　　处：《医学与社会》2024年第9期130-136,共7页Medicine and Society

基　　金：四川医事卫生法治研究中心项目,编号为YF21-Y11;贵州省高等学校教学内容和课程体系改革项目,编号为2023135。

摘　　要：意定监护制度主要适用于老年人和精神障碍患者,但国内关于精神障碍患者意定监护的理论研究和实际运用极少。肯定精神障碍患者具备成为意定监护被监护人的主体资格,在社会、经济、法律、医疗层面都具有重要价值。然而,成年精神障碍患者意定监护制度在实践中仍存在不少局限性,包括现有立法对监护人资格和对被监护人行为能力的过高标准要求,以及缺乏有效的制度保障。对此,在精神障碍意定监护的主体资格方面,应以意思能力替代行为能力作为审核被监护人资格的条件,更契合精神障碍疾病特性;应严格制定监护人选任条件,确保监护人的公正性和适格性,并明确意定监护人的监护权优先于法定监护人;在订立意定监护协议时,鼓励公证机关介入,发挥在规范订立形式、内容及监督等领域的积极作用;建立意定监护启动的多元化判断标准。在权利义务方面,制度设计应尊重并保障精神障碍患者的合法权益,帮助其回归正常社会生活。关于退出机制,考虑到多数精神障碍患者有提出撤销监护申请的能力,应赋予其在意定监护启动后的撤销权。The voluntary guardianship system primarily serves the elderly and individuals with mental disorders.However,theoretical research and practical applications of voluntary guardianship for mental disorder patients are scarce in China.Recognizing the eligibility of mental disorder patients to become subjects of voluntary guardianship holds significant value in social,economic,legal,and medical contexts.Nevertheless,there are several limitations in the current practice of voluntary guardianship for adult mental disorder patients,including stringent legislative requirements for guardian qualifications,high behavioral capacity standards for ward,and a lack of effective institutional safeguards.To address these issues,mental capacity should replace behavioral capacity as the criterion for assessing the qualifications of ward,which aligns better with the characteristics of mental disorders.The selection criteria for guardians should be stringent to ensure impartiality and suitability,with the voluntary guardian's rights prioritized over those of the statutory guardian.Notarial bodies should be encouraged to intervene in the establishment of voluntary guardianship agreements to standardize their form,content,and supervision.Diverse criteria for initiating voluntary guardianship should be established to better reflect the patterns of mental illness.In terms of rights and obligations,the system design should respect and protect the legal rights of individuals with mental disorders,aiding their reintegration into normal social life.Regarding the termination mechanism,considering that most mental disorder patients have the capacity to request the revocation of guardianship,they should be granted the right to revoke voluntary guardianship after its activation.

关 键 词：卫生法 精神障碍 意定监护 

分 类 号：R-05[医药卫生] R19-019