研究生: |
陳郁潔 Chen, Yu-Jie |
---|---|
論文名稱: |
強制接種COVID-19疫苗之憲法分析 Constitutional Analysis of Mandatory COVID-19 Vaccination |
指導教授: |
陳仲嶙
Chen, Chung-Lin |
口試委員: |
洪淳琦
Hung, Chun-Chi 張兆恬 Chang, Chao-Tien |
學位類別: |
碩士 Master |
系所名稱: |
科技管理學院 - 科技法律研究所 Institute of Law for Science and Technology |
論文出版年: | 2024 |
畢業學年度: | 112 |
語文別: | 中文 |
論文頁數: | 70 |
中文關鍵詞: | 疫苗接種 、嚴重特殊傳染性肺炎 、公共衛生 、身體權 、健康權 、宗教自由 、傳染病防治法 |
外文關鍵詞: | vaccine mandate, compulsory vaccination, bodily integrity, physical integrity, freedom of religion |
相關次數: | 點閱:1 下載:0 |
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疫苗作為生物科技發展下的技術物,向來為人類社會對抗傳染病之利器,然對於國家能否強制個人接種疫苗之法律爭議自始便未曾消弭。特別是當人類社會遭遇傳染病嚴重肆虐,強制疫苗接種與否之正反意見間的衝突隨之加劇,使人們不得不直接面對其中長期存在的爭議。而此即為本文研究之主軸,藉由2020年因新型冠狀病毒所爆發的嚴重特殊傳染性肺炎疫情,探討國家強制人民接種COVID-19疫苗的合憲性,並以此反思我國法規範在疫苗接種議題上之潛在挑戰。
本文認為,討論強制疫苗接種之合憲性問題必須先區分各管制措施之性質。當規範本質內涵是為迫使人民接種疫苗,則不論其強制為直接或間接,構成干預之核心基本權即為身體權,而在我國釋憲實務下將另涉及對健康權之侵害。對此基本權干預,本文認為應以嚴格標準進行違憲審查。法規範在形式上必須由國會通過之法律作為依據,特別是針對COVID-19疫苗此種透過緊急使用授權審核上市、具有高度科學不確定性之疫苗,對於是否強制應交由立法者進行利益衡量。而在實質審查方面,雖不同案件所牽涉人員、限制方式皆須個案衡量,然本文認為在比例原則之審查須特別留意以下事項:(1)疫情嚴重程度是否已影響醫療體系之正常運作、(2)規範中必須包含醫療豁免,而若提供人民宗教及哲學豁免則違憲疑慮將大幅下降,及(3)針對COVID-19疫苗此類具有高度爭議與科學不確定性之疫苗,政府應持續監測其安全性並評估現狀是否合適強制接種。至於我國所涉強制接種COVID-19疫苗之爭議,本文認為相關法規範在形式上並無法通過上述審查標準,惟我國在司法院釋字第690號解釋中曾以涉及醫療衛生專業為由,降低形式上審查標準之前例,是以若不論規範在形式上之瑕疵而進行實質審查,則所涉爭議於實質上須注意醫療豁免之缺漏,並補足其他情況下可免於接種疫苗之規定,始可完備整體規範之合憲性。
Vaccines have played a crucial role in combating infectious diseases for centuries, yet the ongoing debate over whether the state can mandate vaccinations persists to the present day. During severe outbreaks, this debate intensifies, highlighting the longstanding controversy. This issue forms the central focus of this paper, which examines the constitutionality of mandatory COVID-19 vaccination during the 2020 pandemic and the challenges within our current legal framework.
To address the constitutionality of mandatory vaccination, it is essential to distinguish the nature of regulatory measures. If a measure compels citizens to be vaccinated, whether directly or indirectly, it constitutes an interference with the right to bodily integrity, necessitating strict scrutiny to determine the constitutionality of such laws. Thus, such laws must be grounded in legislation enacted by Congress, particularly for vaccines that received approval under emergency use authorization amid scientific uncertainties, such as the COVID-19 vaccine. Regarding the principle of proportionality, though each case is considered individually, key considerations for scrutiny should include the following: (1) The severity of the disease outbreak must significantly impact the healthcare system; (2) Medical exemptions must be included, while providing religious and philosophical exemptions can mitigate constitutional concerns; (3) For vaccines with significant scientific concerns, the government should continuously evaluate the necessity of mandatory vaccination.
In Taiwan, current provisions mandating COVID-19 vaccination may not meet the strict scrutiny standards mentioned earlier. However, based on the Interpretation No. 690 made by the Constitutional Court of R.O.C., formal defects could potentially be accepted. As for the substantive review, rectifying deficiencies in medical exemption and exemption under other circumstances is necessary to ensure constitutional compliance.
一、中文文獻
(一)、專書
行政院衛生署疾病管制局(2013),《感染與疫苗》,自刊。
行政院衛生署疾病管制局(2011),《認識流感疫苗:教學手冊》,自刊。
李惠宗(2019),《憲法要義》,8版,元照。
何建志(2018),《公費疫苗法制解析與重構—科學不確定性下自主與公衛之平衡》,元照。
法治斌、董保城(2014),《憲法新論》,6版,元照。
陳淳文、吳庚(2021),《憲法理論與政府體制》,增訂7版,三民。
莊國榮(2020),《行政法》,修訂6版,元照。
黃舒芃(2016),〈比例原則及其階層化操作—一個著眼於司法院釋憲實務發展趨勢的反思〉,氏著,《框架秩序下的國家權力(二)—公法學術論文集》,頁223-278,新學林。
黃舒芃(2013),〈法律明確性原則的制度功能:評司法院釋字第702號解釋對法律明確性原則之認定〉,氏著,《框架秩序下的國家權力—公法學術論文集》,頁145-158,新學林。
黃舒芃(2013),〈違憲審查中之立法形成空間〉,氏著,《框架秩序下的國家權力—公法學術論文集》,頁389-412,新學林。
顏厥安(1998),〈自由與倫理—由代理孕母的合法化問題談價值命題的論證〉,氏著,《法與實踐理性》,允晨文化。
(二)、翻譯書籍
宮坂昌之(著),藍嘉楹(譯)(2022),《疫苗與免疫的科學:到底要不要打疫苗?免疫療法有效嗎?免疫力愈強愈好嗎?》,晨星。
Richard H. Thaler, Cass R. Sunstein(著),張美惠(譯)(2022),《推力:每個人都可以影響別人、改善決策,做人生的選擇設計師(終極增訂版)》,時報文化。
Ronald Dworkin(著),梁永安(譯)(2015),《沒有神的宗教》,立緒文化。
(三)、期刊論文
王亞蕾(2018),〈疫苗研發的臨床參考要點〉,《當代醫藥法規月刊》,98期,頁1-10。
何建志(2022),〈政府與雇主強制接種疫苗及使用疫苗接種資訊法律問題〉,《醫藥、科技與法律》,27卷1期,頁1-41。
李震山(2021),〈憲法未列舉之「健康權」入憲論理—以司法院釋字第785號解釋為中心〉,《月旦實務選評》,1卷1期,頁119-135。
吳秦雯(2021),〈強制預防接種之健康權保障〉,《月旦法學教室》,222期,頁10-13。
林明鏘(2022),〈具有雙重功能之強制抽血-評憲法法庭111年憲判字第1號判決〉,《月旦裁判時報》,121期,頁20-30。
陳冠瑋(2022),〈初探COVID-19疫苗接種義務及疫苗護照之治理疑慮〉,《科技醫療與社會》,34期,頁141-180。
陳仲嶙(2020),〈從防疫出國禁令爭議再訪法律保留的疆界〉,《法律與生命科學》,9卷1期,頁1-37。
陳仲嶙(2018),〈我國憲法上未列舉權利之發展〉,《憲政時代》,44卷2期,頁51-101。
陳仲嶙(2009),〈身體權作為一種憲法權利〉,《法學新論》,14期,頁113-131。
陳婉青(2021),〈COVID-19疫苗系列專欄:接種疫苗後的保護力可以持續多久?〉,《疫情報導》,37卷23期,頁364-366。
郭亭亞、蔡甫昌(2022),〈獎勵與強制疫苗接種之倫理考量〉,《台灣醫學》,26卷5期,頁573-581。
張兆恬(2021),〈緊急的倫理:新型冠狀肺炎疫苗之臨床試驗及緊急授權的法制與倫理分析〉,《臺大法學論叢》,50卷特刊期,頁1073-1165。
許炳華(2021),〈強制學童接種疫苗之理論與實務:以合憲性探討為核心〉,《東海大學法學研究》,62期,頁121-186。
黃忠正(2013),〈人性尊嚴的概念與界限〉,《月旦法學雜誌》,221期,頁161-174。
邱玟惠(2011),〈由美、日經驗檢討我國預防接種救濟制度:從H1N1新型流感疫苗談起〉,《臺大法學論叢》,40卷2期,頁629-705。
趙俊祥、李郁強(2014),〈論兒童預防接種之法制建構〉,《法令月刊》,65卷5期,頁57-88。
劉邦揚(2018),〈強制接種疫苗的反思:以基本權干預與刑罰規制為討論中心〉,《月旦醫事法報告》,23期,頁174-180。
劉靜怡、邱文聰(2010),〈危機總動員背後的法律問題—從H1N1疫苗政策談起〉,《台灣法學雜誌》,147期,頁5-8。
蘇彥圖(2022),〈基礎權利的憲法與政治:當代美國實體正當程序的司法理論爭議及其啟示〉,《臺大法學論叢》,51卷4期,頁1385-1452。
(四)、判決
憲法法庭111年憲判字第1號。
最高行政法院111年度抗字第177號裁定。
最高行政法院110年度上字第590號判決。
臺北高等行政法院110年度訴字第623號判決。
二、英文文獻
(一)、專書
Jenner, E. (1798). An Inquiry into the Causes and Effects of the Variolae Vaccinae (1st ed.). Sampson Low.
Gostin, L. O., & Wiley, L. F. (2016). Public Health Law: Power, Duty, Restraint (3rd ed.). University of California Press.
(二)、期刊論文
Anderson, R. M., & May, R. M. (1985). Vaccination and Herd Immunity to Infectious Diseases. Nature, 318(6044), 323–329.
Arde-Acquah, P. (2015). Salus Populi Suprema Lex Esto: Balancing Civil Liberties and Public Health Interventions in Modern Vaccination Policy. Washington University Jurisprudence Review, 7, 337–366.
Burki, T. (2022). COVID-19 Vaccine Mandates in Europe. The Lancet Infectious Diseases, 22(1), 27–28.
Fekete, J. (2021). Required Protections for the Right of Medical Exemption from Vaccine Mandates: A Modern Analysis of a Deeply Rooted Fundamental Right. Charleston Law Review, 15, 821–889.
Fine P. E. (1993). Herd Immunity: History, Theory, Practice. Epidemiologic Reviews, 15(2), 265–302.
Fox, J. P., Elveback, L., Scott, W., Gatewood, L., & Ackerman, E. (1971). Herd Immunity: Basic Concept and Relevance to Public Health Immunization Practices. American Journal of Epidemiology, 94(3), 179–189.
Gates, A. A. (2022). Legal and Ethical Implications of Mandatory COVID-19 Vaccination Programs. Quinnipiac Health Law Journal, 25, 125–153.
Gostin, L. O., Reiss, Dorit, & Mello, M. M. (2023). Vaccination Mandates—An Old Public Health Tool Faces New Challenges. JAMA, 330, 589–590.
Gostin, L. O. (2005). Jacobson v Massachusetts at 100 Years: Police Power and Civil Liberties in Tension. American Journal of Public Health, 95, 576–581.
Grabenstein, J. D. (2013). What the World’s Religions Teach, Applied to Vaccines and Immune Globulins. Vaccine, 31, 2011–2023.
Hodge, J. G., White, E. N, Freed, R., & Wells, N. (2022). Supreme Court Impacts in Public Health Law: 2021-2022. Journal of Law, Medicine & Ethics, 50(2), 608–612.
Hodge, J. G., & Gostin, L. O. (2004). School Vaccination Requirements: Historical, Social, and Legal Perspectives. Kentucky Law Journal, 90, 831–890.
Holland, M. (2012). Compulsory Vaccination, the Constitution, and the Hepatitis B Mandate for Infants and Young Children. Yale Journal of Health Policy, Law, and Ethics, 12, 39–86.
Kohrs, B. (2002). Bioterrorism Defense: Are State Mandated Compulsory Vaccination Programs an Infringement upon a Citizen’s Constitutional Rights? Journal of Law and Health, 17, 241–270.
Krammer F. (2020). SARS-CoV-2 Vaccines in Development. Nature, 586(7830), 516–527.
Macdonald, N. E. (2015). Vaccine Hesitancy: Definition, Scope and Determinants. Vaccine, 33, 4161–4164.
Morens, D. M., Folkers, G. K., & Fauci, A. S. (2022). The Concept of Classical Herd Immunity May Not Apply to COVID-19. The Journal of Infectious Diseases, 226(2), 195–198.
Pardi, N., Hogan, M. J., Porter, F. W., & Weissman, D. (2018). mRNA Vaccines - a New Era in Vaccinology. Nature Reviews Drug Discovery, 17(4), 261–279.
Phalen, E. (2019). Mandatory Vaccinations in the United States and the European Union. Arizona Journal of International and Comparative Law, 36, 537–562.
Razai, M. S., Chaudhry, U. A. R., Doerholt, K., Bauld, L., & Majeed, A. (2021). Covid-19 Vaccination Hesitancy. BMJ, 373, 1–4. https://doi.org/https://doi.org/10.1136/bmj.n1138
Riedel S. (2005). Edward Jenner and the History of Smallpox and Vaccination. Proceedings (Baylor University. Medical Center), 18(1), 21–25.
Savulescu, J. (2023). Good Reasons to Vaccinate: Mandatory or Payment for Risk? Journal of Medical Ethics, 47, 78–85.
Sacks, D. P. (2022). Judicial Protection of Medical Liberty. Florida State University Law Review, 49, 515–576.
Tolsma, E. C. (2015). Protecting Our Herd: How a National Mandatory Vaccination Policy Protects Public Health by Ensuring Herd Immunity. Journal of Gender, Race & Justice, 18, 313–339.
Topley, W. W., & Wilson, G. S. (1923). The Spread of Bacterial Infection. The Problem of Herd-Immunity. The Journal of Hygiene, 21(3), 243–249.
Toward a Twenty-First-Century Jacobson v. Massachusetts. (2008). Harvard Law Review, 121(7), 1820–1841.
Trangerud, H. A. (2023). “What Is the Problem with Vaccines?” A Typology of Religious Vaccine Skepticism. Vaccine: X, 14, 1–7. https://doi.org/10.1016/j.jvacx.2023.100349
Wilder-Smith, A. (2022). What Is the Vaccine Effect on Reducing Transmission in the Context of the SARS-CoV-2 Delta Variant? The Lancet Infectious Diseases, 22, 152–153.
(三)、判決
1.Supreme Court of the United States
National Federation of Independent Business v. Department of Labor, Occupational Safety and Health Administration (2022).
Biden v. Missouri (2022).
Zucht v. King (1922).
Jacobson v. Commonwealth of Massachusetts (1905).
2.United States Courts of Appeals
Commonwealth v. Biden (6th Cir. 2023).
Feds for Medical Freedom v. Biden (5th Cir. 2023).
Louisiana v. Biden (5th Cir. 2022).
Kheriaty v. Regents of the University of California (9th Cir. 2022).
Klaassen v. Trustees of Indiana University (7th Cir. 2021).
3.United States District Court
Feds for Medical Freedom v. Biden (S.D. Tex. 2022).
4.European Court of Human Rights
Vavřička and Others v. the Czech Republic (2021).
三、德文文獻
(一)、專書
Kersten, J./Rixen, S. (2022). Der Verfassungsstaat in der Corona-Krise (3. Aufl.). C.H.Beck.
四、其他資源
European Parliament (2022, Mar.). Legal Issues Surrounding Compulsory Covid-19 Vaccination. https://www.europarl.europa.eu/RegData/etudes/BRIE/2022/729309/EPRS_BRI(2022)729309_EN.pdf.
Covid-19 Litigation. https://www.covid19litigation.org/.
Verfassungsgerichtshof, G 37/2022-22, V 173/2022-11. https://www.vfgh.gv.at/downloads/VfGH_23.06.2022_G_37_2022_EN.pdf.
Bundesverfassungsgericht, Beschluss vom 27. April 2022. https://www.bverfg.de/e/rs20220427_1bvr264921en.html.