The Constitutional Review on Restriction of the Practice Location for Pharmacists

[[abstract]]科技日益發展與國民健康知識的提升，使臺灣醫療品質不斷受重視，醫藥分業推行後，醫療體系分工更臻明確，「看病找專科醫師；吃藥找厝邊藥師」，使藥師的專業角色之社會地位受到重視，藥師專任責任及藥師之中間專業義務等，具體實現於藥師法第11條規定係屬重要立法目的。人民之工作權為憲法第15條規定所保障，其內涵包括人民選擇職業之自由。人民之職業與公共福祉有密切關係，故對於從事一定職業應具備之資格或其他要件，於符合憲法第23條規定之限度內，得以法律或法律明確授權之命令加以限制。法律對職業自由之限制，因其內容之差異，在憲法上有寬嚴不同之容許標準。關於從事工作之方法、時間、地點等執行職業自由，立法者為追求公共利益，且採行之限制手段確屬必要者，始符合憲法第23條比例原則之要求。藥師法第11條規定：「藥師經登記領照執業者，其執業處所應以一處為限。」未於不違反該條立法目的之情形下，或有重大公益或緊急情況之需要時，設必要合理之例外規定，已對藥師執行職業自由形成不必要之限制，有違憲法第23條比例原則，與憲法第15條保障工作權之意旨相牴觸。實務上，2011年4月1日衛署醫字第1000007247號函限制兼具藥師及護理人員資格者，其執業場所應以同一處所為限，違反憲法第23條法律保留原則。國家有保障人民基本權之義務，為達保障國民健康為目的，國家得對工作權加以限制，但為求符合比例原則而加入合理之例外規定，必須建構良好的報備支援制度，以調和國民健康與藥師工作權之扞格。本研究以司法院釋字第711號解釋為中心，蒐集、整理相關文獻資料，逐步探討，研究現行法制下可能產生之問題及其相應之解決方法。[[abstract]]Thequalityofhealthcareserviceshasattractedmoreandmoreattentionbecauseofthedevelopmentoftechnologyandtheenhancementofpublichealthknowledge.Taiwanhasimplementedtheseparationsystemofdispensingfromprescriptionsince1997.Andthenthestatusoftheprofessionalroleofpharmacistsandthefunctionofthecommunitypharmacyarepromoted.Thebriefdefinitionofthe“SeparationofPrescribingandDispensing”issimplythat“thedoctorsfilluptheprescriptionsandthepharmacistsfollowthedispensations”."Pharmacistfull-timeresponsibility"isaconcreteimplementationofthe"pharmacist'sintermediateprofessionalobligations,"whichisanimportantlegislativepurposeofArticle11ofPharmacistsAct.Thepeople’srighttoworkisprotectedbyArticle15oftheConstitution.Itincludeswithinitsmeaningthepeople’sfreedomtochoosetheiroccupation.Asthepeople’soccupationiscloselyrelatedwiththepublicwelfare,thequalificationsorotherrequirementsforengagementinspecificoccupationsmaybedefinedbylaworbyordinancesissuedbyspecificauthorizationoflawtotheextentprescribedbyArticle23oftheConstitution.Article15oftheConstitutionprovidesthatpeople’srightofworkshouldbeprotected.Itscontentincludespeople’sfreedomofoccupation.Ifalawimposesobligationsonpeopleforcertainoccupations,itisarestrictiononsuchfreedom.Statutoryrestrictionsonfreedomofoccupationaresubjecttolooseorstrictconstitutionalstandardsdependingontheircontents.Withrespecttoexercisingthefreedomofoccupationintermsofmanner,timeandlocationofworking,legislatorshavestipulatedthatonlyinthecaseofpursuingpublicinterestsandwherearestrictivemeasureisstrictlynecessarysuchrestrictionmeetstherequirementsofthePrincipleofProportionalityunderArticle23oftheConstitution.Article11ofthePharmacistsActprovidesthat“apharmacistwhohasregisteredtopracticeshallpracticeatonlyonesinglelocation.”SuchprovisiondoesnotconstituteanecessaryreasonableexceptioninasituationwherethepharmacistdoesnotviolatethelegislativepurposeoftheArticle,orwherethereisaneedduetovitalpublicinterestsoremergency,imposesunnecessaryrestrictionsonpharmacistsexercisingthefreedomofoccupation,violatesthePrincipleofProportionalityofArticle23undertheConstitution,conflictswiththeintentofArticle15oftheConstitutionsafeguardingtherightofwork.TheLetterof1April2011No.1000007247issuedbytheExecutiveYuan,DepartmentofHealth,limitingthepracticelocationofapharmacistwhoisalsoqualifiedasaregisterednursetothesamelocation,violatesthePrincipleofStatutoryReservationunderArticle23oftheConstitutionandshallnolongerbeapplieduponthepublicationofthisInterpretation.Moreover,itistheobligationofaGovernmenttoensurethefundamentalrightsofthecitizens.Forthepurposeofsafeguardingnationalhealth,thecurrentpharmacistlawrestrictstherighttoworkofpharmacists.However,Theadditionoftheregulationsonreasonablemattersasexceptionstocomplywiththeprinciplesofproportionality.Atthesametime,theGovernmentshouldestablishasoundsystemforpriorpermission.AndtheGovernmentshouldreconciletheconflictbetweentheprinciplesofnationalhealthandtherighttoworkofpharmacists.ThisstudywillfocusontheJudicialYuanInterpretationNo.711,followingthestepsabovetocollectandmakeareviewofrelatedliteraturetofindoutlegalissuesoftherighttoworkanddiscussionofpharmacistpracticingoutsidethepractitionerspremises,andprovidesomepracticalsolutions