Over the past week, we have met with numerous civil society groups, non-governmental organizations, and government officials regarding the conditions of detention of former President Chen Shui-bian.
Within the highly polarised political environment surrounding this case, we have been committed to undertaking our assessment with independence, objectivity, and based on international standards of detention, the treatment of detainees, and principles of human rights. We are not lawyers and not in a position to comment on the legal status of the case. However, we have worked in and with prison departments and ministries of justice in dozens of countries in all parts of the world to promote adherence to these principles and standards.
During our time in Taiwan, we have met with many of his supporters, with representatives of the government, including the Ministry of Justice, the Speaker of Legislative Yuan, several current and former legislators, and President Chen himself. We would like to clarify at the outset that we have undertaken this mission without any political or partisan agenda. We are not affiliated with, nor do we support or oppose any political party or political interest. Instead we have tried to engage with all parties involved to address the increasingly grave and serious heath issues that have arisen in this case.
We would like to express our sincere appreciation to Ministry of Justice Tseng Yon-Fu for both providing us access to President Chen and, more importantly, making a number of important improvements in his conditions of detention, including increased time outside of his prison cell, access to a table and a chair, and time with his family and visitors.
However, one of the fundamental principles of imprisonment is that when a government makes the decision to imprison one of its citizens, it also takes full responsibility for ensuring the health and well-being of that person. It is this point that is of utmost concern at this point in time and creates an unprecedented urgency.
The minimal and often hasty medical examinations that have been carried out appear to raise concerns over respiratory and circulatory problems. There are reports that a recent MRI identified a 4mm by 4mm liaison in the frontal lobe that might have been the result of a stroke but has remained undetected for months. There have been further reports of as many as ten additional infarctions and blockages in the brain since that initial finding. Since comprehensive medical records and test results have not been made available to President Chen or his family a more complete understanding to these developments is difficult. Overall, there is evidence that the years of inadequate physical activity and movement have not only contributed to muscle atrophy and tendonitis but may have caused the serious down-turn overall health and cognitive capacity of the past week.
In response to concerns raised by our team and others early this week regarding President Chen’s slurred speech, disorientation, and unusual level of fatigue, the Taiwan Penitentiary Department has agreed to conduct a more extensive and thorough body of medical examinations. We have learnt that Department plans to transfer him to the Honorable Veteran Hospital (HVH) on Friday morning 21 September so that these examinations can be carried out in a fully equipped medical facility and expert staff.
While we welcome this move in principle and feel that it reflects the constructive spirit and good faith concern over the former President’s condition that was in evidence during our meetings on Tuesday and Wednesday of this week, we are seriously concerned by the selection of hospital.
The so-called “Oath of Athens” of the International Council of Prison Medical Services states that: “medical judgements be based on the needs of our patients and take priority over any non-medical matters.” Assignment to a government military hospital, itself, draws into question the degree of independence it can exercise.
During our meetings with the Government, the paramount importance of carrying out these examinations in an open, objective, and transparent environment; one that would build trust and confidence in the polarised political environment within which these concerns have been raised and the precipitous deterioration of President Chen’s health has taken place was stressed. We specifically requested that the medical team carrying out these examinations be comprised of the highest-level professionals agreeable to both the Ministry of Justice and the family and supporters of the former President.
Under the Standard Minimum Rules of the Treatment of Prisoners all prisoners have the right to an independent and objective evaluation of their medical condition. We believe that, in the absence of an agreement by the former President of the examination panel and the terms under which these examinations will take place, the planned examinations at Honorable Veteran Hospital cannot be considered to be independent.
While we agree that, given the urgency of the medical concerns in question, they must take place as quickly as possible, the Government’s previous practice of providing hasty and inadequate examinations should not be repeated.
In addition, the absence of an agreement from all parties involved regarding the conduct of these examinations is not only inconsistent with the assurances regarding objectivity and transparency received during our discussions this past week but it runs the risk of reinforcing the polarisation these efforts have sought to diminish. Finally it will, inevitably, bring into question confidence in the results of the examinations and the subsequent treatment plan.
In the course of our mission, we have encountered many people, both in the government and outside of it, who have approached this critical situation with good will and a deep and genuine interest in assuring the humane treatment of those in detention.
As we have noted earlier, it is often said that one can understand a great deal about values and principles of a country by the treatment of those within its prisons. Having visited with President Chen, learned of his treatment, and seen the profound deterioration of his health that has resulted, we look forward to hearing what measures the Government of Ma Ying-jeou seeks to undertake to ensure the well-being of President Chen. We do not view this as a special privilege bestowed on him but rather a reflection of the government’s commitment to carry out its obligations within the framework of international standards and the principles of human rights.
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「人權行動中心」聲明
陳水扁總統健康問題的顧慮
2012年9月21日
漢斯華爾，巴黎
哈瑞丁勤時，華盛頓DC
過去這一星期，我們拜會了許多社團、非政府組織、以及政府官員，關切陳水扁前總統受到監禁的狀況。
由於此案發生在政治極端對立的環境，我們堅持基於監獄及囚犯待遇之人權國際標準及原則，獨立客觀地來進行此次評估的任務。我們不是律師，並不是適合對本案的法律問題做評論。不過，我們過去在世界各地數十個國家的獄政單位及法務部門內工作或提供諮詢，提倡這些權責機關必須遵守這些原則與標準。
在台灣這段期間，我們會見了許多他的支持者、政府代表，包括法務部長、立法院院長、數位前任與現任立法委員、以及陳總統本人。我們首先要澄清，我們此次的任務不具任何政治或政黨的目的。我們與任何政黨或政治利益團體毫無關連，也不表態支持或反對這些團體。相反地，我們試圖接觸所有相關單位，強調陳水扁前總統日益惡化與嚴重的健康議題。
我們要向法務部長曾勇夫表示誠摯的感謝，他同意讓我們見到陳總統，更重要的，對陳總統的監禁環境做了一些重要的改善，包括放封的時間、有桌椅可以使用、與家屬及友人面會的時間。
不過，監禁的基本原則之一，就是當政府決定監禁一位公民的時候，它也必須連帶負有確保這個公民的健康與權益的完全責任。這原則就是在此時刻最需要關注的焦點，具有前所未有的迫切性。
目前已經進行之最少且急躁的醫療檢查已經查出他呼吸與循環器官的問題。有報告指出，最近的ＭＲＩ已經確認他腦前葉有一個4mm Ｘ 4mm的陰影。它可能是中風所留下來的結果。不過，這個症狀幾個月以來未曾被檢查出來。進一步的報告指出，在那次初步檢查之後，又發現在腦部有多達十處的血塊與阻塞。因為詳細的醫療紀錄與檢查結果並未提供給陳總統及其家屬，要更完整地了解這些發展是有困難的。整體而言，事實證實，長期不足的身體活動與運動不但造成陳總統肌肉萎縮及肌腱退化，也可能是他這個星期來整體健康與認知能力嚴重惡化的主要原因。
在這個星期稍早，我們團隊與其他人都對陳總統的口齒不清、精神混亂、及不尋常的疲倦等症狀提出關切，台灣獄政司已經同意對他進行更詳細而完整的身體健康檢查。我們已經得知獄政司預定在9月21日星期五早上將陳總統轉往榮民醫院，以便在一個設備完善的醫療設施及專業團隊之下進行一些檢查。
雖然原則上我們認同這樣的決策，也覺得這是我們在這個星期二與星期三的拜會訪談中，政府對陳前總統情況所反映之積極正面與善意的回應，但是我們對醫院的選擇有高度的疑慮。
國際監獄醫療服務委員會有此「雅典誓言」，它陳述：「醫療上的決定必須將病患的需要視為第一優先，超越其他非醫療事務的考慮」。指定轉院到政府與軍事色彩濃厚的醫院，這件事本身就會讓人質疑這種醫院有多少獨立自主的運作空間。
在我們與政府部門的會談中，我們一再強調在一個開放、客觀與透明的環境裡完成這些健康檢查的高度重要性，因為這樣可以在兩極化的政治環境中建立互信。在兩極化的政治環境下，互信已遭疑慮，陳總統的健康更已因而受害急遽惡化。我們特別具體提出要求，進行這些檢查的醫療團隊必須由得到法務部與陳前總統家屬與其支持者雙方同意之高水準專業人士來組成。
在受刑人待遇的最低標準規範中，所有受刑人都有權利要求他們的健康狀況受到獨立與客觀的評估。我們相信，缺乏陳前總統對健康檢查團隊及進行檢查之協議內容的同意，轉院到榮民醫院的檢查不能被認定為具有獨立自主性。
由於陳前總統健康問題顧慮的迫切性，雖然我們認同這些檢查必須儘快進行，但是我們認為政府部門過去提供急躁與不充足之檢查的作為不應該再度發生。
除此之外，缺乏相關當事人的同意，即進行這些檢查，不但與我們過去這個星期以來在會談中所感受到客觀性與透明性的承諾不符，更會加深兩極化，讓想要彌平的努力前功盡棄。這樣做，無可避免將令人對這些檢查的結果及其後續醫療計畫的可信度產生質疑。
在我們這次任務的過程中，我們會見了許多包括政府內部與外部的人士，面對這個關鍵的情況，他們都以善意與高度的誠心與熱忱表示願意確保受刑人的人道待遇。
如同我們先前所指出，從一個國家之監獄受刑人所受到的待遇就可以了解這個國家的許多價值與原則。從面會陳總統、瞭解他受到的待遇，及目睹已經造成對他健康的深度惡化，我們期待可以聽到馬英九政府要尋求採取甚麼樣的方式來確保陳總統的權益。我們不認為這樣做是對陳總統的一項禮遇，反而這是反映在人權國際標準與原則之架構下、這個政府要履行這個責任做出多少承諾。
