Medical Treatment or Medical Parole: What does Chen Shui-bian Want?

Medical Treatment or Medical Parole:
What does Chen Shui-bian Want?
United Daily News editorial (Taipei, Taiwan, ROC)
A Translation
April 3, 2013

Summary: Chou Yuan-hua, a Veterans General Hospital Special Medical Team member, told the Legislative Yuan that if Chen Shui-bian is returned to prison, the risk of suicide is high. Most members of the public feel that whoever requires medical parole should receive it. But they are afraid of being deceived, yet again, by Chen and his doctors.

Full text below:

Chou Yuan-hua, a Veterans General Hospital Special Medical Team member, told the Legislative Yuan that Chen Shui-bian should not be returned to Taipei Prison. He said Chen should be discharged from the hospital, and allowed to convalesce at home, or be transferred to a hospital closer to home, either a general hospital with a psychiatric department or a psychiatric hospital. When questioned by legislators, he said that if Chen Shui-bian is returned to prison, the risk of suicide is high.

This was the official report of the Special Medical Team to the Legislative Yuan. Naturally it carries a certain amount of weight. As a result, Chen Shui-bian's situation has once again attracted attention.

Chou Yuan-hua said Chen Shui-bian is suffering from severe depression and exhibits five other symptoms. Therefore, Chen Shui-bian should receive treatment. He said the public should not oppose this. The question however, is where Chen Shui-bian should be treated. Chou Yuan-hua contradicts himself. He said that, 1. Chen should not be returned to Taipei Prison. 2. Chen should be discharged. 3. Chen should perhaps be returned home to convalesce. 4. If Chen is returned to Taipei Prison, the risk of suicide is high. But Chen could also commit suicide at home. 6, Therefore, he added, perhaps Chen should be transferred to another hospital.

Basically Chou Yuan-hua talked in circles. What he said underscored a key concept. Just exactly what does Chen Shui-bian want? Medical treatment, or medical parole?

If what Chen wants is medical treatment, the Taipei Veterans General Hospital is recognized for its psychiatric expertise. This includes Chou Yuan-hua. The recommendation that Chen be transferred to a "hospital with a psychiatric department, or a psychiatric hospital closer to home" was medical boilerplate. Was it merely a compromise solution? What's more, this would amount to a "transfer," not the "discharge" or "home convalescence" that Chou Yuan-hua wanted. Therefore if "medical treatment" is the highest priority, the Taipei Veterans General Hospital boasts the highest standard of suicide watch medical care in the nation. If family members pay Chen regular visits, it is no different than "home convalescence."

Chou Yuan-hua recommends "home convalescence." But the law makes no such provisions. Since Chou thinks that if Chen returns home he could be a suicide risk, this leads to another concern. Therefore, we are back to whether to grant Chen "medical parole?"

Chou Yuan-hua said he does not oppose medical parole. But the family must bear responsibility. Medical parole has a pre-condition. Once one is cured, one must return to prison to serve out one's sentence. This really sounds like something a doctor would say.

In fact, according to existing laws, "bao wai jiu yi" is the same as "yi liao jia shi," i.e., "medical parole." It is release from prison so that one may visit one's doctor. One enjoys almost the same freedom as a parolee. But Chen Shui-bian is not paralyzed and lying in a bed. If he were to convene political meetings at home behind closed doors, no family member would assume responsibility. Also, medical parole also carries a suicide risk. Moreover, who will decide when Chen Shui-bian is "cured?" Who will decide when he must return to prison, to serve out his sentence? Suppose he is "cured," but refuses to return to prison? What then?

If Chen Shui-bian is paroled, there is no guarantee that he will not host political activities or participate in political meetings. Who can guaranteed that Chen Shui-bian will not commit suicide at home? From the perspective of legality, justice, or medical treatment, "medical parole" is highly problematic.

An even more critical issue is public mistrust. This mistrust has two dimensions. 1. The Chen family cannot be trusted. When Chen Shui-bian was running for county chief, he falsely claimed he had been poisoned. When Wu Shu-cheng was struck by a truck, she falsely claimed it was politically motivated. Chen Shui-bian is known for his dazzling variety of political tricks. As a result the Chen family simply cannot be trusted. Have we forgotten Wu Shu-chen's record of 17 court absences under the pretext of illness? Two. The credibility of the health care system has also been compromised. When Wu Shu-chen called in sick 17 times, National Taiwan University Hospital doctors backed her lies. No one really believes these physicians have any personal integrity or medical ethics. Since even physicians say Chen Shui-bian is a suicide risk, will family members really assume responsibility?

We are not opposed to medical parole. The law makes provisions for medical parole. If anyone qualifies for medical parole, the Ministry of Justice will assume responsibility. Inmates have the right to medical parole. Chen Shui-bian is no exception. He need merely meet the requirements for medical parole. This means he must not be a suicide risk in the event he is granted medical parole.

Should Chen Shui-bian be granted medical parole? There ought to be three pre-conditions. 1. One must first determine whether Chen Shui-bian is receiving medical treatment or being paroled. 2. His illness must be real. We must not permit a replay of the National Taiwan University Hospitial scandal, during which Wu Shu-chen called in sick 17 times, and the doctors backed her lies. 3. If the alleged illnesses are later found to be fabrications, or if Chen Shui-bian engages in outrageous behavior while on parole, someone must bear responsibility. The Chen family members cannot be trusted to bear responsibility. Nor can Chou Yuan-hua, from a legal standpoint.

Most members of the public feel that whoever requires medical parole should receive it. But they are afraid of being deceived, yet again, by Chen and his doctors.

就醫或保外：陳水扁要的是什麼？
【聯合報╱社論】
2013.04.03 04:21 am

榮總專案醫療小組周元華醫師在立法院報告指出，陳水扁不適合再回台北監獄，應該出院，可考慮居家療養，或轉介到離家較近設有精神科的綜合醫院或精神專科醫院安置；他在答覆立委詢問時且說，陳水扁若回到監獄，自殺風險肯定非常高。

這是專案醫療小組在立法院所作的正式報告，自然具有不同的分量，因而也使陳水扁的處遇問題再度成為視聽焦點。

周元華醫師說，陳水扁患有重度憂鬱症等五種病症。因此，陳水扁應當接受治療，對此應無社會異議。爭議的問題是在陳水扁應在何處接受治療，這卻連周元華的主張也自相矛盾。他說：一、扁不適合再回北監；二、應當出院；三、可考慮居家療養；四、他說，扁若回北監，自殺風險肯定非常高；五、但他也不排除若居家照護，亦有自殺死在家裡的可能性；六、於是，他又補充說，亦可轉介其他醫院安置。

周元華繞了一圈的論述，其實點出了一個關鍵性的概念，那就是：陳水扁要的究竟是「就醫」或「保外」？

如果重點在「就醫」，則北榮公認是精神科的權威，包括周元華醫師在內亦是此中菁英；則謂建議轉介到「離家較近設有精神科的綜合醫院或精神專科醫院」，就醫療水準言，是否倒有退而求其次之虞？何況，這只是「轉院」，而非周元華所主張的「出院」，或「居家療養」。因而，倘是以「就醫」為最高的目標，目前在北榮「戒護就醫」，可能即是國內醫療水準所能提供的最佳處遇；且若家屬勤於探病，實已無異於「居家療養」。

至於周元華建議的「居家療養」，則一方面是現行法律無此規制，另一方面扁既被認為有自殺風險而有死在家中的可能，因而亦多出一層顧慮。於是，又回到是否可以「保外就醫」？

周元華說，他不反對保外就醫，但責任須由家屬自負；且保外就醫的前提是，如果病好了，仍要回到監所服刑。這段話聽起來，真是醫生之見。

其實，依現行法制，「保外就醫」就是「醫療假釋」；也就是從獄中釋放去就醫，享有與假釋犯幾乎無異的自由。然而，陳水扁並非癱臥在床，即使在家關起門來召集政治會議恐亦找不到「家屬負責」，遑論保外就醫仍有自殺風險；更何況，要由誰來決定陳水扁何時「病好了」，又由誰來決定陳水扁「病好了，仍要回到監所服刑」？若「病好了」，卻不肯回監，將如何？

倘若「保外」不能保證陳水扁出來後不主持或參加政治性會議等活動，而又不能排除陳水扁在家中自殺；則就法律正義言，或醫療安排言，「保外就醫」似乎皆有顧慮。

更關鍵的問題是在社會信任的問題，可分兩個層次：一、陳家不可信任，陳水扁從選縣長詐稱被下毒、吳淑珍詐稱政治車禍，到陳水扁花樣百出的政治操作，皆使這一家人不可信任，何況吳淑珍還有十七次詐病不出庭的紀錄。二、醫療系統的公信力也已受傷，前述吳淑珍十七次詐病尚曾得到台大醫院的背書，實在令人無法相信這些醫師的人品與醫德。現在，如果連醫師都說陳水扁非常可能自殺，難道卻要家屬去負這個責任？

此文絕非反對「保外就醫」。既然法律定有「保外就醫」的體制，任何符合「保外就醫」條件者，法務部皆有准其「保外就醫」的責任，而相關受刑人亦有「保外就醫」的權利；當然亦絕不可視陳水扁為例外，只要他真正符合保外就醫的條件，包括不要在保外後自殺。

考慮陳水扁是否「保外就醫」，應有三個前提：一、必須確定陳水扁要的是「就醫」或「保外」？二、病情必須是真的，不可再出現類似台大醫院為吳淑珍十七次不出庭背書的醜事；三、如果後來證實其中作假，或阿扁保外後又鬧出不可思議的怪事，必須要有人「負責」，因為陳家的「家屬」照例不會「負責」，屆時周元華也是依法不必「負責」。

我們認為，多數的民意皆會認為，「有保外就醫必要者，應予保外就醫」。但是，國人畢竟被陳家及醫師們騙怕了。