音樂治療法律管制之探討

Abstract

本研究目的在探討音樂治療的法律管制：1.衛福部《衛部醫字第1080008511號》對藝術治療團體（包含音樂治療）爭取工作權的見解；2.證照相關理論；3.從我國輔助治療相關的助人專業立法，來看音樂治療的法律管制；4.美國音樂治療協會核准的音樂治療大學課程標準與能力指標、實踐標準與專業分級；5.美國各州音樂治療立法情況與爭點。（建議一）音樂治療採「證照」管制為佳，「執照」排他性過強宜慎思：2011 年美國北達科他州訂州法要求音樂治療師須有州執照才能執業，雖維繫音樂治療專業受政府認可，卻造成外界質疑該立法壟斷音樂治療行業，恐違背美國《憲法》保障人民不受政府任意控制下的謀生權利、侵害人民職業自由。（建議二）推動音樂治療繼續教育與再認證，以激勵音樂治療師專業成長，並爭取其他專業人士與社會公眾對音樂治療的認同。（建議三）基於專業、市場與政府間的利益衝突與利益衡量，不宜過度強調音樂治療的執業排他性；過度強調執業排他性，將使具全面功能改善效益的音樂治療，因為與其他醫事或專業技術人員的執行業務有所重疊，而使音樂治療的使用受到限縮，反不利於民\n眾健康福祉。（建議四）凸顯專業、非專屬、服務重疊與專業協作，以研議專法：美國音樂治療協會闡明「服務重疊」即「音樂治療師認識到為使患者從整體、連續性的治療中受益，多種專業提供的服務會有一些重疊。我們承認，其他專業人員只要在自己的範圍內工作，就可以斟酌來使用音樂。」衛福部 2019 年接見表達性藝術治療團體時，建議參考《社會工作師法》立法精神，本文作者建議參考2020 年《公共衛生師法》專業、非專屬精神，研訂「音樂輔助治療師」專法之可行性。（建議五）發展教、考、訓、用合一以支援音樂治療法律管制：建議國內籌設非營利、超然獨立的專業組織，研議音樂治療大學系所之課程標準、能力指標與臨床實踐標準，並提出音樂治療從業人員認證、繼續教育與在認證的規劃。

The purposes of this thesis are including:1. The views of the Ministry of Health and Welfare on the right to work for art therapy groups(including music therapy) ; 2.Theories of Certificate; 3. Viewing the legal regulation of music therapy from the legislation of assisting therapy helping professions；4. Course standards and competency-based\nstandards of university music therapy degree approved by American Music Therapy Association(AMTA). Standards of clinical practice and levels of practice in music therapy advised by AMTA. 5.The legislations of music therapy and specific dispute in most states of US. Based on the above-mentioned regulations and practical insights, the following recommendations are proposed: (Recommendation 1) “ Certificate ”regulation is better for music therapy. The “license” is too exclusive and should be considered carefully: In 2011, North Dakota in the United States enacted a state law, music therapists are required to be licensed. Although this legislation maintains government recognition of the music therapy profession, it has caused outside doubts that the legislation monopolizes the music therapy industry and may go against the US Constitution to protect the people`s right to earn a living without arbitrary control by the government, and infringe on the people`s professional freedom. (Recommendation 2) Promote the music therapy continuing education and re-certification program to maintain the professional quality, it will inspire the professional growth of music therapists and win recognition from other professionals and the public.\n(Recommendation 3)Based on the conflicts of interest and balancing of interests among professions, markets, and government, it is not appropriate to overemphasize the\nexclusivity of music therapy. Music therapy can facilitate the comprehensive functions of people, it will be overlapped with other medical or professional personnel. If we overemphasize the exclusivity of music therapy, utilizing music in another helping professions will be restricted, and it is not favorable to the health and well-being of people. (Recommendation 4) Highlighting the professional but non-exclusive, overlap in services and professional collaboration, study and negotiate the feasibility of music therapist special law: “overlap in services”in the scope music therapy practice means “music therapists recognize that in order for clients to benefit from an integrated, holistic treatment approach, there will be some overlap in services provided by multiple professions. We acknowledge that other professionals may use music, as appropriate, as long as they are working within their scope”When the Ministry of Health and Welfare of Taiwan met with expressive art therapy groups in 2019, It was recommended to refer to the legislative spirit of the “Social Worker Act”to conduct research on the legislative act. It can be seen that the Taiwanese government tends to identify music therapy practitioners as non-medical personnel who provide auxiliary measures. The author of this thesis proposes to refer to the professional and nonexclusive spirit of the“Public Health Specialists Act”passed in 2020, and discuss the feasibility of formulating a “Music-Assisted therapist Act”.Recommendation 5)Integration of music therapy education, license, training and practices to support the legal regulation of music therapy: It is recommended that domestic non-profit and\nindependent professional organizations be established to discuss the standards for degrees and competency-based standards, standards of clinical practice and music\ntherapist certification.