我國自家庭暴力防治法實施後，已在今年六月二十四日屆滿六週年。本法的制定，不但使我國成為大陸法系國家中首度以特別法處理家庭暴力者，更課予醫療體系、社工、教育人員、以及警察機關對於家庭暴力案件的強制通報義務，充分體現了家暴法「積極保護家庭中弱勢」的精神。然而，本法第四十一條第一項針對醫護人員所訂的強制通報責任，卻存有多重爭議。本條立法乃源自舊兒童福利法第十八條與第三十六條，由於責任通報制對於發現兒童虐待案件有極大助益，因此對於婚姻暴力中的虐待，也課予醫護人員強制通報之責任。惟受虐婦女畢竟非兒童，是否適宜不顧其意願，即強制醫療人員向縣市家暴防治中心通報？而強制通報所導致醫病關係出現不信任、以及對於成年受暴婦女自主權的侵害，又如何與「家暴防治」之公共利益加以平衡？ 本文擬以提升受暴婦女自主性為主軸，從正、反兩個面向來觀察並檢驗「醫療人員強制通報制度」的優缺點，並嘗試提出一個「以受暴者為關懷核心」的介入模式，以取代單一面向的現行強制通報模式。本文主張，國家在鼓勵受暴婦女脫離受虐情境的同時，必須藉由肯認受虐婦女為保護自身與子女所做的努力，尊重其改善自身處境的步調時程，並積極提供其所欠缺的資源與資訊，始能建構受暴婦女與國家之間的良性互動關係，使脫離施虐者的危險性減到最低。而非將受暴婦女與受虐兒童等同看待，進而不顧其主觀意願、對於通報主管機關的時程進行全面控管，其結果不但將增加婦女脫離施虐者的危險性、妨礙婦女就醫、也將使社會資源無法集中服務具有急迫危險的個案。

Domestic Violence Prevention Act (the Act) in Taiwan has just celebrated its sixth anniversary on June 24[90bb] , 2005. The promulgation of this Act has turned Taiwan into the first country of civil law tradition with a specialized domestic violence law. In addition, aiming to provide sufficient protection to the less advantaged in a family unit, the Act shifts the burden of mandatory reporting upon medical personnel, social workers, educational workers and police officers. Among them, mandatory reporting for medical personnel, which is devised in Article 41 of the Act, is surrounded in controversy. Originating from Art. 18 and 36 of Child Welfare Act, mandatory reporting has proved to be efficient in identifying child abuse. A fully grown-up battered woman is no child, however-therefore, is it the best practice to mandate reporting, regardless of her disagreement? Besides, judging from the disadvantages of breaching the physician-patient privilege, and the potential infringement of battered women's autonomy-how shall these consequences be balanced against the public interests of combating domestic violence? The arguments of this article are mainly based upon the autonomy of battered women. Both the advantages and deficiencies of mandatory reporting policies concerning medical personnel are presented. In an effort to replace the current mono-dimensional mandatory policy, the author proposes a "Survivor-Centered Intervention Model". According to the Model, the state should encourage batted women to improve their situation by showing respect to their individualized plans of leaving the abusive relationships. Besides, in establishing a positive dynamics between the battered women and the state, the much-needed resource and information must be provided to battered women in order to reduce the potential danger they may encounter when leaving the relationships. Mandatory reporting that ignores the subjective wishes of battered women not only increases the danger of leaving the batterers, discourages battered women from receiving medical treatment, but also diverts the limited resource from focusing on cases of utmost emergence. Thus, a standardized procedure, including mandatory recording, for hospitals in treating victims of domestic violence is proposed in the hope of enhancing both the safety for battered women and their autonomy.