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中醫醫療行為法律規制之研究-以中醫推拿助理為中心 / A Study on the Legal Regulation of Chinese Medical Practices-Focus on the Chinese Massage Assistants王國成, Wang, Kuo Cheng Unknown Date (has links)
中醫按摩源起於遠古時代,早於殷商甲骨文卽有按摩輔助人員之記載,春秋戰國名醫扁鵲併用弟子按摩搶救瀕死患者,戰國秦漢時期《黃帝內經》並以「按龜之法」作為按摩從業人員考覈取材標準,唐朝太醫署按摩科設立官方按摩博士及助理制度;說明中醫按摩法制早已完備。雖自明朝起「按摩」始有「推拿」之稱,清朝並分為十二流派,但按摩推拿法制仍能綿衍不絕。
然正當亞洲各國紛紛建立中醫推拿業務法制並重視第三醫學之際,我國行政主管機關卻仍在原地踏步、裹足不前。造成「真正從事中醫推拿助理業務者,無正規學歷與證照考覈管理制度;真正合法醫事人員,卻不從事中醫推拿助理業務且無相關法律配套」之窘境。
綜觀我國憲法、大法官解釋及相關法律規範,並未明文限制人民從事中醫推拿助理之業務。故在就業平等原則下,人民當具有自由選擇為職業之工作權、具有平等接受就業服務及不受歧視之就業與執業機會平等。且各種療法(包括民俗療法)皆存在著風險,甚至已關乎人命問題;是以不論各種療法之風險高低,均應有在職訓練及證照考覈制度管制、相關從業人員身份立法,不應有差別待遇或階級區分。依釋字第666號葉百修大法官協同意見書解釋之精神觀之,行政主管機關應有效提出配套措施、在職訓練及證照考覈制度,實不得以中醫推拿助理所執行之業務非正統醫療、有害社會或不具社會價值為理由,禁止其特定業務活動,使人民得從事該活動之自由『排除於職業自由的保障範圍之外』,藉此淘空憲法所保障中醫推拿助理之工作權。
據此,本論文蒐集歸納歷代與當代中醫按摩推拿歷史及法制文獻;比較當前亞洲國家推拿業務法制與英德日中職業證照制度;分析憲法及現行法秩序下,中醫推拿助理職業自由之保障與限制;並從歷年法院相關實務見解、衛生署行政函釋爭議、立法院質詢改革要點,彙整並比較當前司法、行政及立法機關之見解與措施,並對利弊得失作出評析。最後,提出個人自擬「中醫推拿技術士考覈與管理辦法草案」、「中醫推拿師法草案」及短中長期具體建議,作為未來中醫推拿法制與助理考覈管理改革之重要參考方針。
關鍵字:中醫推拿助理、工作權、職業自由、證照考覈制度 / The Chinese massage originated in ancient times. At the Shang dynasty, the oracle-
bone scriptures had already recorded a number of massage assistance personnel . At the
Eastern Zhou dynasty, a famous country Chinese herb doctor "pian-chiueh" who rescued
the dying with massage therapy by disciples . At the Warring States Period and Qin-Han
dynasties , " Laws of pressing the turtle " as the massage employee's standard examination
had already described by "Huangdi Neijing(Yellow Emperor's Canon of Medicine)". At the
Tang dynasty , imperial government established the official massage doctor and assistant systems . So that Chinese massage system had long been a complete system since then .
Althrough "massage" started "tueinar" of call since Ming dynasty, and which divided into
twelve divisions at Qing dynasty; the systems of Chinese massage could be still transmitted
for ever and ever.
However, many Asian countries have established legitimate Chinese massage systems
and paid much attention to the third medical science in succession ; but administrative
organizations in our country still have hesitated whether to move forward or not.Therefore,
those embarrassing situations caused a great deal of trouble to us that" those who engaged in
Chinese massage assistants with no formal qualifications and licence examination systems;
and those who engaged in legitimate medical personnel with no legal standards of Chinese
massage".
Taking a comprehensive view of our country Constitution , J .Y . interpretations and related laws,which don't explicitly limit any people engaged in traditional Chinese massage
assistants. Therefore , under the principle of equality in employment , people have freely choice of jobs for the right to work as a career;whom have equal acceptance of employment
service and free from discrimination of jobs. Various therapies(including folk remedies) all
exist risks which even have been already close to human life problems. Based on a variety
of treatments regardless of the level of risk,one should have job training, evaluation licence
examination systems,the relevant legislation as employees;but should not be discrimination
or class distinction. According to the coordination view of J .Y. interpretation NO. 666 by the Honorable Justice Pai- Hsiu Yeh , administrative organizations should put effective
integration of on-the-job training and licence examination for Chinese massage assistants ;
then those shouldn't forbid their particular business activity in which guaranteed by the Constitution by reason of non-medical, harmful or valueless to the society.
Accordingly, this thesis summarized collection of ancient and contemporary history of Chinese massage and legal documents; compared the massage systems in a few Asian
countries and occupational licence systems in England , Germany , Japan and China ; analyzed under the Constitution and existing legislation in order to comprehend guarantee
and restriction of occupational freedoms for Chinese massage assistants . In addition , it made assessment of the advantages and disadvantages about the related views of judicial ,
executive and legislature's organs till now. Finally, it proposed the personal draft plans "
ordinance draft for Chinese massage technician 's assessment and management " , " law draft for the Chinese massagist " and the short , medium , long term recommendations as important reform references for policy in the future.
Key words : Chinese massage assistant , Right to work, Freedom of occupation , Licence
examination system
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