Abstract: The appraisal opinions in the Japanese medical treatment and supervision procedure have three main characteristics, namely, the prior consultation, the accompanying therapeutic and the suggestive nature of the content.Moreover, the appraisal opinions do not fully constrain the judge’s judgment, and the judge only needs to adopt a reasonable part. The appraisal opinions need to be subject to substantive and dynamic review in court, and the appraiser and other social forces will also participate. China’s compulsory medical procedures should establish a correct concept of procedural application, reduce confrontation, focus on determining the appropriate treatment for patients with mental disorders, and form a comprehensive decision-making model for judges based on “appraisal opinions plus trial opinions”. At the same time,several review elements are introduced to quantitatively determine the “personal danger” elements. By establishing a system of appraisal retention, activating the system of appraisers appearing in court, and attracting relevant experts to participate in the review, the substantive and dynamic review of appraisal opinions is achieved, ensuring the personal rights and interests of patients with mental disorders.

Key words: medical treatment and supervision, compulsory medical treatment, appraisal opinion, mental disorders

摘要： 日本医疗观察程序中的鉴定意见具有三大特点，形成的事前协商性、进行方式的伴随治疗性、内容的对处遇建议性，且其并不完全约束法官的裁判，法官仅需采纳合理部分。鉴定意见要在法庭上接受实质动态审查，鉴定人及其他社会力量也会参与。我国强制医疗程序应当树立程序适用的正确观念，减少对抗、聚焦于决定精神障碍患者的适当处遇，并形成法官依照“鉴定意见+庭审意见”综合决定处遇的模式。同时引入若干审查要素定量判断“人身危险性”要件，通过确立鉴定留置制度、完善鉴定人出庭制度、吸纳相关专家参与审查，进而实现对鉴定意见的实质动态审查，保障精神障碍患者的人身权利。

关键词: 医疗观察, 强制医疗, 鉴定意见, 精神障碍