Shiraishi H
Saitama Comprehensive Mental Health Center, Japan.
Jpn J Psychiatry Neurol. 1994;48 Suppl:117-24. doi: 10.1111/j.1440-1819.1994.tb03047.x.
In this paper, the author examines the current working and drawbacks of the "hogosha" system as set out in the Mental Health Law of 1988, and goes on to suggest a plan for reform. Critics point to two main problems with the current system. One is that the hogosha's powers infringe on the patient's human rights. The other is that the system places too heavy a burden on hogoshas in its efforts to protect the community from the patient. The author argues that the hogosha should retain the power to consent for admission for medical care and custody, but other responsibilities should be reduced. The author stresses that local mayors must be prepared to take their responsibilities seriously when they assume the role of the hogosha.
在本文中，作者审视了1988年《精神卫生法》规定的“保佐人”制度的现行运作情况及弊端，并进而提出了一项改革计划。批评者指出当前制度存在两个主要问题。一是保佐人的权力侵犯了患者的人权。另一个是该制度在努力保护社区免受患者侵害的过程中给保佐人带来了过重的负担。作者认为保佐人应保留对医疗护理和监护入院的同意权，但其他职责应予以减少。作者强调，地方市长在承担保佐人角色时必须准备好认真履行其职责。
