中华人民共和国国境口岸卫生监督办法(附英文)

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中华人民共和国国境口岸卫生监督办法(附英文)

卫生部、交通部 等


中华人民共和国国境口岸卫生监督办法(附英文)

1982年2月4日,卫生部、交通部、中国民航管理局、铁道部

第一章 总 则
第一条 为了加强国境口岸和国际航行交通工具的卫生监督工作,改善国境口岸和交通工具的卫生面貌,控制和消灭传染源,切断传播途径,防止传染病由国外传入和由国内传出,保障人民身体健康,根据《中华人民共和国国境卫生检疫条例》第三条的规定,制定本办法.
第二条 本办法适用于对外开放的港口、机场、车站、关口(下称国境口岸)和停留在这些处所的国际航行的船舶、飞机和车辆(下称交通工具).

第二章 国境口岸的卫生要求
第三条 国境口岸应当建立卫生清扫制度,消灭蚊蝇孳生场所,设置污物箱,定期进行清理,保持环境整洁.
第四条 国境口岸的生活垃圾应当日产日清,设置的固定垃圾场,应当定期清除;生活污水不得任意排放,应当做到无害化处理,以防止污染环境和水源.
第五条 对国境口岸的建筑物,有关部门应当采取切实可行的措施,控制病媒昆虫、啮齿动物,使其数量降低到不足为害的程度.
第六条 候船室、候机室、候车室、候检室应当做到地面整洁、墙壁无尘土、窗明几净、通风良好,并备有必要的卫生设施.
第七条 国境口岸的餐厅、食堂、厨房、小卖部应当建立和健 全卫生制度,经常保持整洁,做到墙壁、天花板、桌椅清洁无尘土.应当有防蚊、防蝇、防鼠和冷藏设备,做到室内无蚊、无蝇、无鼠、无蟑螂.
第八条 国境口岸的厕所和浴室应当有专人管理,及时打扫, 保持整洁,做到无蝇、无臭味.
第九条 国境口岸的仓库、货场应当保持清洁、整齐;发现鼠类有反常死亡时,应当及时向卫生检疫机关或地方卫生防疫部门报告.
第十条 做好国境口岸水源保护,在水源周围直径三十米内, 不得修建厕所、渗井等污染水源设施.

第三章 交通工具的卫生要求
第十一条 交通工具上必须备有急救药物、急救设备及消毒、 杀虫、灭鼠药物.必要时,船舶上还需安排临时隔离室.
第十二条 交通工具上的病媒昆虫和啮齿动物的防除:
(一)船舶、飞机、列车上,应当备有足够数量有效的防鼠装置;保持无鼠或鼠类数量保持不足为害的程度.
(二)应当保持无蚊、无蝇、无其他有害昆虫,一旦发现应当采取杀灭措施.
第十三条 交通工具上的厕所、浴室必须保持整洁,无臭味.
第十四条 交通工具上的粪便、垃圾、污水处理的卫生要求:
(一)生活垃圾应当集中放在带盖的容器内,禁止向港区、机场、站区随意倾倒,应当由污物专用车(船)集中送往指定地点进行无害化处理.必要时,粪便、污水须经过卫生处理后方能排放;
(二)来自鼠疫疫区交通工具上的固体垃圾必须进行焚化处理,来自霍乱疫区交通工具上的粪便,压舱水、污水,必要时实施消毒.
第十五条 交通工具的货舱、行李车、邮政车和货车的卫生要求:
(一)货舱、行李车、邮政车、货车应当消灭蚊、蝇、鼠、蟑螂等病媒昆虫和有害动物及其孳生条件;在装货前或卸货后应当进行彻底清扫,做到无粪便、垃圾.
(二)凡装载有毒物品和食品的货车,应当分开按指定地点存放,防止污染,货物卸空后应当进行彻底洗刷;
(三)来自疫区的行李、货物,要严格检查,防止带有病媒昆虫和啮齿动物.
第十六条 交通工具上的客舱、宿舱、客车的卫生要求:
(一)客舱、宿舱和客车应当随时擦洗,保持无垃圾尘土,通风良好;
(二)卧具每次使用后必须更换.卧具上不得有虱子、跳蚤、臭虫等病媒昆虫.

第四章 食品、饮用水及从业人员的卫生要求
第十七条 供应国境口岸和交通工具上的食品必须符合《中华人民共和国食品卫生管理条例》(注解:该条例已被一九八二年十一月十九日五届人大常委会通过的《中华人民共和国食品卫生法(试行)》明令废止,现按食品卫生法的有关规定执行.)的规定和食品卫生标准.
第十八条 凡供应国境口岸和交通工具上的饮用水必须符合我国规定的“生活饮用水卫生标准”.供应饮用水的运输工具、储存容器及输水管道等设备都应当经常冲洗干净,保持清洁.
第十九条 供应食品、饮用水的从业人员的卫生要求:
(一)患有肠道传染病的患者或带菌者,以及活动性结核病、化浓性渗出性皮肤病患者,不得从事食品和饮用水供应工作;
(二)从事食品、饮用水供应工作的人员,应当每年进行一次健康检查,新参加工作的人员,应当首先进行健康检查,经检查合格者,发给健康证;
(三)从事食品、饮用水供应工作的人员,要养成良好卫生习惯,工作时要着装整洁,严格遵守卫生操作制度.

第五章 国境口岸和交通工具的负责人的责任
第二十条 国境口岸和交通工具负责人在卫生工作方面的责任是:
(一)应当经常抓好卫生工作,接受卫生监督人员的监督和检查,并为其开展工作提供方便条件;
(二)应当模范地遵守本办法和其它卫生法令、条例和规定.
(三)应当按照卫生监督人员的建议,对国境口岸和交通工具的不卫生状况,及时采取措施,加以改进;
(四)在发现检疫传染病和监测传染病时,应当向国境卫生检疫机关或地方防疫部门报告,并立即采取防疫措施.

第六章 卫生监督机关的职责
第二十一条 国境口岸卫生检疫机关在当地人民政府的领导下,对国境口岸和交通工具进行卫生监督,其主要职责是:
(一)监督和指导国境口岸有关部门和交通工具的负责人对病媒昆虫、啮齿动物进行防除;
(二)对停留在国境口岸出入国境的交通工具上的食品、饮用水实施检验,并对运输、供应、贮存设施等系统进行卫生监督;
(三)对国境口岸和交通工具上的所有非因意外伤害致死的尸体,实施检查、监督和卫生处理;
(四)监督国境口岸有关部门和交通工具的负责人对粪便、垃圾、污水进行清除和无害化处理;
(五)对与检疫传染病,监测传染病有流行病学意义的环境因素实施卫生监督;
(六)监督国境口岸周围内采取防蚊措施的执行.
(七)开展卫生宣传教育,普及卫生知识,提高国境口岸和交通工具上的人员遵守和执行本办法的自觉性.
第二十二条 国境口岸卫生检疫机关设国境口岸卫生监督员一至五名,执行卫生监督任务,由思想品质好,工作认真负责的国境口岸卫生检疫机关领导干部、检疫医师以上的业务人员兼任.国境口岸卫生监督员,经卫生检疫机关推荐,省、自治区、直辖市卫生行政主管部门审核,由中华人民共和国卫生部委任,并发给《国境口岸卫生监督员证件》(式样附后).
第二十三条 国境口岸卫生监督员持其证件,有权对国境口岸和交通工具的负责人,进行卫生监督、检查和技术指导;配合有关部门,对卫生工作情况不良或引起传染病传播的单位或个人,提出改进意见,协同有关部门采取必要措施,进行处理.

第七章 奖励和惩罚
第二十四条 国境口岸卫生检疫机关,对贯彻执行本办法和国家有关卫生法令、条例、规定,做出显著成绩的单位和个人,应当给予表扬和奖励.
第二十五条 国境口岸卫生检疫机关,对违犯本办法和有关卫生法令、条例、规定的单位和个人,应当根据不同情况,给予警告、罚款,直至提请司法机关依法惩处.

第八章 附 则
第二十六条 本办法自发布之日起施行.

附:
国境口岸卫生监督员证件式样
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中华人民共和国 | 此证根据中华人民共和
国境口岸卫生监督员证 | 国国务院文件
(国徽) | 国发(1981)号
中华人民共和国卫生部制发 | 批示监制
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85mm 正面(封面) 第二页
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| 相 | 姓名 性别 (注意事项另订) |
| | 年龄 籍贯 |
| 片 | 工作单位 |
|------| 职别 |
| 编号 字第 号 |
| 发证日期 年 月 日 |
----------------------------------------------------------
内第三页 内第四页
说 明
一、证件长为120mm,宽为85mm,用红色软皮塑料制成,正
面印有国徽图案,字体为金色印体字.
二、内页用卡片纸印成格式套在塑料皮内.
1、内第一页空白插入塑料皮内;
2、内第二页填写发证根据;
3、内第三页填写监督员自然情况;
4、内第四页填写监督员权力和职责;
5、内第五页空白填写[附记]二字;
6、内第六页空白插入塑料皮后面.

MEASURES CONCERNING SUPERVISION OF SANITATION AT BORDER PORTS OFTHE PEOPLE'S REPUBLIC OF CHINA

Important Notice: (注意事项)
英文本源自中华人民共和国务院法制局编译, 中国法制出版社出版的《中华人民共和国涉外法规汇编》(1991年7月版).
当发生歧意时, 应以法律法规颁布单位发布的中文原文为准.
This English document is coming from the "LAWS AND REGULATIONS OF THE
PEOPLE'S REPUBLIC OF CHINA GOVERNING FOREIGN-RELATED MATTERS" (1991.7)
which is compiled by the Brueau of Legislative Affairs of the State
Council of the People's Republic of China, and is published by the China
Legal System Publishing House.
In case of discrepancy, the original version in Chinese shall prevail.

Whole Document (法规全文)
MEASURES CONCERNING SUPERVISION OF SANITATION AT BORDER PORTS OF
THE PEOPLE'S REPUBLIC OF CHINA
(Approved by the State Council on December 30, 1981 and promul-
gated by the Ministry of Public Health, Ministry of Communications,
General Administration of Civil Aviation of China and the Ministry of
Railways on February 4, 1982)

Chapter I General Provisions
Article 1
These Measures are formulated, as required by Article 3 of the Frontier
Health and Quarantine Regulations of the People's Republic of China [*1],
to strengthen the supervision of sanitation at border ports and aboard
international means of transport, to improve their sanitary conditions and
to block up and extinguish sources of infection, cut off channels of
spreading, prevent infectious diseases from spreading into or out of the
country and protect the health of the people.
Article 2
These measures shall apply to sea ports, airports, railway stations and
passes open to the outside world (hereinafter generally referred to as
"border ports") and to international vessels, aircraft and vehicles
(hereinafter referred to as "means of transport") staying in these places.

Chapter II Sanitation Requirements at Border Ports
Article 3
A cleaning system shall be established in border ports to eliminate the
breeding grounds of flies and mosquitos, install litter bins and their
regular cleaning so as to keep the environment clean and tidy.
Article 4
Domestic refuse in border ports shall be removed every day and fixed
refuse dumps provided for that purpose shall be regularly cleared;
domestic sewage shall not be drained off indiscriminately and shall go
through disinfecting treatment so as to prevent the environment and water
sources from contamination.
Article 5
The departments concerned shall adopt feasible measures to reduce the
numbers of insect vectors and rodents to a harmless level in the buildings
of border ports.
Article 6
All floors of waiting rooms in piers, airports, stations and customs
houses shall be kept neat and clean, their walls dust-free and their
windows and tables bright and clean. They shall be well ventilated and
equipped with necessary sanitation facilities.
Article 7
A perfect sanitation system shall be established in restaurants, cafes,
canteens, dining rooms, kitchens, buffets and small shops in border ports
so as to regularly keep them clean and tidy and make their walls,
ceilings, tables and chairs clean and dustfree. The places shall be
provided with refrigeration equipment and equipment against mosquitos,
flies, mice and cockroaches and no such pests and rodents shall be found
inside these buildings.
Article 8
Attendants shall be put in charge of the toilets and bathrooms in border
ports, cleaning them regularly and keeping them clean and tidy so as to
rid them of flies and nasty odours.
Article 9
The warehouses, godowns and goods yards in border ports shall be kept
clean and tidy. When abnormal death of mice or rats is found, immediate
reports shall be given to health quarantine authorities or local public
health and epidemic prevention departments.
Article 10
The water sources for border ports shall be well protected and toilets,
seepage wells, etc. which will pollute the water sources shall not be
built within a distance of 30 meters in diameter from a water source.

Chapter III Sanitation Requirements for Means of Transport
Article 11
Means of transport shall be equipped with first-aid medicines and
equipment as well as disinfectants, insecticides and rodenticides. If
necessary, provisional quarantine rooms shall be arranged aboard ships.
Article 12
Provisions concerning the prevention and elimination of insect vectors and
rodents from means of transport:
(1) ships, aircraft and trains shall be provided with adequate preventive
measures against rodents so as to eliminate them or to reduce their
numbers to a harmless level;
(2) these means of transport shall be kept free from mosquitos, flies or
other harmful insects, which shall be eliminated upon discovery.
Article 13
The toilets and bathrooms on means of transport shall be kept clean, tidy
and free from unpleasant odours.
Article 14
The sanitation requirements for the disposal of excrement, urine, refuse
and sewage on means of transport are as follows:
(1) daily refuse shall be put in containers with covers, prohibited from
being dumped indiscriminately into port areas, airports or station areas
and must be removed by means of special refuse vehicles (or vessels) to
designated places for treatment. If necessary, excrement, urine and sewage
shall go through sanitary treatment before being disposed of;
(2) the refuse in solid form on board means of transport from epidemic
areas of plague shall be disposed of by incineration, while the excrement,
urine, ballast water and sewage on board means of transport from the
epidemic areas of cholera shall be sterilized if necessary.
Article 15
The sanitation requirements for cargo holds, luggage cars, postal cars and
freight cars of means of transport as well as trucks are as follows:
(1) such insect vectors and harmful animals as mosquitos, flies,
cockroaches and mice and conditions favourable for their breeding shall be
eliminated from cargo holds, luggage cars, postal cars, freight cars and
trucks which shall be thoroughly cleaned before goods are being loaded or
unloaded so as to be free of excrement, urine and refuse;
(2) the freight cars or trucks carrying poisonous substances and food
shall be placed separately in different designated places so as to avoid
contamination and shall be thoroughly cleaned after goods are completely
unloaded;
(3) the luggage and goods from epidemic areas shall be carefully examined
so that no insect vectors and rodents shall subsist therein.
Article 16
The sanitation requirements for passenger cabins, lodging cabins and
passenger cars of means of transport as well as passenger vehicles are as
follows:
(1) passenger cabins, lodging cabins, passenger cars and other passenger
vehicles shall be cleaned whenever necessary, kept free of refuse and dust
and well ventilated;
(2) beddings shall be replaced and washed after use each time and be free
of lice, fleas, bedbugs or other insect vectors.

Chapter IV Sanitation Requirements for Food, Drinking Water and Personnel Engaged in These Trades
Article 17
The food supplied to border ports and on means of transport shall conform
to the provisions in the Regulations of People's Republic of China on Food
Hygienic Control [*2] and food hygienic standards.
Article 18
The drinking water supplied to border ports and on means of transport
shall conform to Hygienic Standards of Drinking Water stipulated by the
state. The vehicles used in transporting drinking water as well as storage
containers and water pipelines shall be cleaned regularly and kept clean.
Article 19
The health requirements for personnel engaged in supplying food and
drinking water as follows:
(1) the patients or carriers of infectious intestinal diseases or
sufferers from active tuberculosis or suppurative exudative dermatosis
shall not be engaged in supplying food and drinking water;
(2) all personnel engaged in the supply of food and drinking water shall
go through a medical check-up every year. Those newly engaged in this work
shall first have a medical check-up and those proved up to the standard
shall be granted health certificates;
(3) the personnel engaged in the supply of food and drinking water shall
cultivate good hygienic habits, dress neatly and cleanly at work and
strictly abide by the hygienic operation system.

Chapter V The Duties of Persons in Charge of Border Ports and Means of Transport
Article 20
The duties of the officers in charge of border ports and means of
transport pertaining to sanitation and hygiene are as follows:
(1) to do a good job in keeping up to the sanitation and hygiene
standards, and be always ready for the supervision and inspection by the
sanitary supervision personnel and provide them with facilities for their
work;
(2) to play an exemplary role in abiding by these Measures and other
sanitation decrees, regulations and provisions;
(3) to promptly adopt remedial measures to change the unsanitary
conditions of border ports and the means of transport in accordance with
the advice of the sanitation supervisors;
(4) to report to the border health quarantine authorities or local
epidemic prevention department and immediately adopt epidemic prevention
measures when a quarantine infectious disease or a monitored one is found.

Chapter VI The Responsibilities of Sanitation Supervision Authori- ties
Article 21
The health quarantine authorities in border ports shall exercise
sanitation supervision over border ports and means of transport under the
leadership of local people's governments. Their major responsibilities
are:
(1) to supervise and direct the officers in charge of the departments
concerned in border ports and on means of transport in the prevention and
elimination of insect vectors and rodents;
(2) to examine the food and drinking water on board means of transport
parked in border ports and ready to cross border in both directions and
exercise sanitation supervision over systems of transport, supply and
storage facilities;
(3) to carry out examination, supervision and hygienic treatment of
persons who have died from causes other than accidents in border ports and
on board means of transport;
(4) to supervise the officers in charge of the departments concerned in
border ports and means of transport in the removal and treatment of
excrement, urine, refuse and sewage;
(5) to exercise sanitation supervision over environmental factors which
are of epidemiological significance to quarantine and monitored infectious
diseases;
(6) to monitor the implementation of the measures to prevent mosquitoes
from breeding in the vicinity of border ports; and
(7) to conduct hygiene publicity and education, spread hygiene knowledge
among people and heighten the consciousness of the personnel in border
ports and on means of transport to abide by and implement these Measures.
Article 22
A border port health quarantine organ shall be provided with 1 to 5 border
port sanitation supervisors to carry out the tasks of sanitation
supervision and such ports shall be concurrently held by the leading
cadres and professional personnel above the rank of quarantine doctor of
the border port health quarantine organ, who are of commendable
personality and great conscientiousness in work. Border port sanitation
supervisors shall be recommended by health quarantine authorities,
screened by the public health administration authorities of the provinces,
municipalities directly under the Central Government and autonomous
regions, and appointed by the Ministry of Public Health of the People's
Republic of China and granted Certificates of Border Port Sanitation
Supervisors.
Article 23
On the strength of their certificates, border port sanitation supervisors
shall have the right to exercise sanitation supervision, inspection and
technical guidance over the officers in charge of border ports and means
of transport; they may in conjunction with departments concerned, put
forward proposals for improvement to the units or individuals concerned
whose sanitation work is dissatisfactory and has resulted in the spread of
infectious disease and take necessary measures to deal with them in
conjunction with the departments concerned.

Chapter VII Rewards and Punishments
Article 24
Border port quarantine authorities shall commend and reward units and
individuals that have made remarkable achievements in the implementation
of these Measures and the state decrees, regulations and provisions
relating to public health.
Article 25
Border port health quarantine authorities shall, on the merit of each
case, warn or fine the units and individuals that have contravened these
Measures and the decrees, regulations and provisions relating to public
health and may submit the cases to the judicial organs for punishment
according to law.

Chapter VIII Supplementary Provision
Article 26
These Measures shall go into effect as of the date of promulgation.
Notes:
[*1] The said Regulations were nullified by Frontier Health and Quarantine
Law of the People's Republic of China adopted by the Standing Committee of
the Sixth National People's Congress on December 2, 1986, the Measures
shall be effective. [*2] The said Regulations were nullified by Food
Hygiene Law of the People's Republic of China (For Trial Implementation)
adopted by the Standing Committee of the Fifth National People's Congress
on November 19, 1982 and the Law shall apply instead - The Editor.


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鹰潭市市对乡镇奖励政策实施办法(暂行)

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《鹰潭市市对乡镇奖励政策实施办法(暂行)》已经市政府第十九次常务会研究通过,现印发给你们,请认真贯彻执行。
二00四年十二月二十八日



鹰潭市市对乡镇奖励政策实施办法(暂行)



第一章 总则

第一条 为了进一步调动全市乡镇生财、聚财、用财的积极性,鼓励乡镇加快发展,不断壮大财政实力,参照《江西省省对市县奖励政策实施办法》,结合我市实际,特制定本办法。

第二条 本办法的适用对象为全市各乡镇。

第三条 对上年经济发展快、税收收入增幅高、实现了“三个确保”和收支平衡的乡镇,市财政给予奖励。

“三个确保”具体为:确保行政事业单位国家标准工资按月足额及时发放;确保机构正常运转;确保维护社会稳定支出需要。

第四条 2004年市财政安排30万元资金,用于对有关乡镇进行奖励。以后每年市财政根据财力的增长逐步增加奖金规模。

第二章 奖励资金的计算

第五条 凡当年实现了“三个确保”及财政收支平衡、地方税收增幅超过市财政核定该乡镇前3年地方税收平均增幅的乡镇,取得参加奖励评选的入围资格。

第六条 在入围的乡镇中,按照当年地方税收调整增幅的高低取前8名,评出一等奖1名,奖金6万元;二等奖3名,奖金各4万元;三等奖4名,奖金各3万元。

第七条 考虑各乡镇地方税收收入基数的差异,对各乡镇的地方税收增幅进行适当调整,按调整后的税收增幅进行比较排名。地方税收调整增幅=地方税收实际增幅*调整系数; 调整系数=各乡镇当年地方税收收入数/全市乡镇地方税收收入平均数。

第八条 如果当年没有符合入围资格的乡镇,或者奖励资金当年用不完的,其奖励资金留在下一年度。

第九条 乡镇前3年地方税收平均增幅核定后3年不变。

地方税收(即地方所得部分)包括:增值税、营业税、企业所得税、个人所得税、城市维护建设税、车船使用和牌照税、资源税、房产税、印花税、城镇土地使用税、土地增值税和契税。

第三章 奖励资金的审核拨付

第十条 每年度结束,在做好账务核对工作的基础上,各县 (市、区)财政局向市财政报送本地区的财政收入国库决算报表和分乡镇财政收入明细表;同时向市财政报送本地区(含所属乡镇)当年“三个确保”落实情况和财政收支平衡情况的书面材料。

第十一条 市财政按照本办法有关规定,对符合奖励条件的乡镇进行审核,提出奖励方案,报市政府审批。

第十二条 市政府批准奖励方案后,市财政在批复县(市、区)财政决算时,将奖励资金下达给获奖乡镇。

第三章 奖励资金的监督管理

第十三条 奖励资金由当地乡镇政府统筹安排使用,并可适当拿出部分奖励个人,但不得超过50%。

第十四条 各地要加强资金管理,不得安排用于违反廉政规定和财经纪律的开支项目。

第十五条 各地要本着实事求是的原则,加强税收征管,严格依法治税,严禁”寅吃卯粮”、收“过头税”。对采取“买税”“空转”等弄虚作假行为,虚报数字冒领奖金的,市财政将扣回全部奖金,停止其评奖资格3年。

第十六条 各县(市、区)可在市财政奖励的基础上,筹集一定资金对乡镇进行奖励,具体办法自行制定,并报市财政局备案。

第十七条 本办法由市财政局负责解释。

第十八条 本办法自2004年1月1日起试行。


浅谈病理性半醒状态
韩强

病理性半醒状态属于睡眠障碍,可见于正常人,更多见于神经症、人格障碍患者中。是一种短暂的、一过性的、很少重复发作的精神障碍,因此,在精神病学临床中少见,多见于司法鉴定中。下面结合案例进行分析。
一、 案例
被鉴定人女性,有偶,农民,小学文化,因杀人罪被逮捕,因行为异常而委托鉴定。
案情摘要:被鉴定人家居农村,平素性情温和,与邻里关系融洽,婚后感情不睦,长为家务事争吵,曾因家务事争吵生气而发作不省人事,经医生扎针后清醒。其丈夫曾因盗窃罪被判刑一年,嫌丈夫不务正业,丈夫的父亲也有调戏她的行为,她曾数次出走。案发当晚,夫妻发生激烈争吵,其丈夫拿了一把铡刀放在她脖子上吓唬她,其跪地求饶才放下了刀,各自上床睡觉。她想起一桩桩往事,出走在外的困难,,伤心的久久不能入睡。后来她丈夫睡着了,她也睡着了。到凌晨2时许,她不知是做梦,还是真的听见喊“砍”的声音,便突然起来,衣服也没穿,拿了铡刀就砍,连砍13刀,像砍木头一样,越砍越有劲,砍完突然发现砍的是一个人。其夫头、颈严重砍伤致死。
精神检查:意识清楚,接触良好,检查合作,未发现思维障碍,自知力存在。自述曾有发作性头痛,身上发抖,手脚发凉,全身发麻,喉咙里似有啥东西往上攻,便不会说话,啥都想不起来了。要6-7天才好。检查过程中出现了哭泣、两眼紧闭、身上发抖、问话不答的情况,历时2-3分钟,经电刺激治疗后终止。脑电图检查正常,韦氏成人智力测定智商78,艾森克人格测验示外倾性格,回答问题无明显掩饰倾向。
鉴定结论:作案时处于情绪激动后的病理性半醒状态。
二、 讨论
引起病理性半醒状态的前提条件是最近一段时间的睡眠不足,大量饮酒或服用了催眠药物,便换环境以及精神刺激之后,在很深的睡眠状态下被不寻常的外界条件(酷暑、噪音、不适体位)的刺激,突然被不完全弄醒,起床活动。下半夜出现较多,错觉、幻觉、惊恐和敌对情绪与攻击行为较多。国外已有数十例凶杀、伤害行为的案例报道。
发生机制是睡眠与觉醒之间存在移行状态。从睡眠状态转入觉醒状态的时间可长可短。较长的移行状态下,如果意识先行恢复而运动系统仍处于抑制状态,个体便感觉自己的肢体不听使唤,似有鬼压住而十分惊恐,此种肢体麻痹状态(睡眠麻痹)无论持续多久,都不会出现违法行为。与此相反,如果运动系统首先恢复,而意识未清醒,个体即起床活动,一切行为沿以往习惯称自动状态,此时可出现错误感知、片段幻想与妄想、惊恐与敌对情绪,以及攻击行为。由此产生的严重违法行为,往往是对同时亲友的无情伤害、凶杀,亦有纵火与自伤致死者。
Schmidt(1943)就病理性半醒状态发表了长篇论文,首次提出了本状态与梦游症的概念和差异,认为病理性半醒状态的犯罪行为发生在睡眠到觉醒的过程,而不是发生在从觉醒进入睡眠的阶段。究其原因,他认为入眠时期与熟悉的环境保持着联系,尽管处于浅眠阶段,但和环境还存在松懈程度的联系;而出眠期则不同,已丧失了与外界的接触能力,觉醒恢复愈是缓慢。例如,从深度睡眠中突然觉醒过来的场合,与外界的适应更显困难,而且容易出现攻击行为,如自伤或暴力行为。
诊断病理性半醒状态主要根据临床特征。Macko witi 提出了下列前提条件:异常深度睡眠(如过度劳累或长期睡眠不足等),大量饮酒、过食、睡眠环境变化等,与平时睡眠不同的时间被突然唤醒等。Schmidt叙及应该仔细了解行为是意识障碍存在的证明,及其行为特征与平时为人之差异,及其行为性质与行为者的原来人格缺乏联系。Roth提出了以下事实有助于诊断,是否发生与睡眠不足之后,是否被人为引起觉醒,是否存在过度劳累,最近是否有不愉快体验,是否在不习惯的环境中睡觉,以及有无恐怖梦的体验等。并认为有必要进行重复的脑电图检查。
1979年-1968年各国汇集的病理性半醒状态共47例,除一例为侮辱罪外其它均为伤害和故意杀人罪,因此认为伤害和凶杀是病理性半醒状态的典型案例。近年来国内报告的案例及本案例也均是如此。可以认为“伤害和凶杀行为”是病理性半醒状态的典型表现和共同特征。这种对外界攻击行为的心理机制可能是意识模糊下残留梦的影响,或对外界歪曲感知片段的幻觉妄想而至,表现对“入侵者”作出原始性防御反应,其作案动机显然不能理解,而且与行为者的一贯人格特征迥然不同。由于病理性半醒状态的作案是在意识障碍状态下发生的违法行为,丧失了辨认能力,应属无责任能力。