保外就医保证人制度的困境及出路

【中图分类号】D926.8 【文献标识码】A 【文章编号】2095-7009（2026）02-0082-08

Abstract：Medical parole，as a critical component of the temporaryservice of sentenceoutside prison，embodies respect for inmates’rights tolife and health.However，the supporting guarantor system hasexposed multiple operationaldilemmas that severely undermine its efficacy，especially those who objectively qualify as guarantors but refuse to act as such，the flawsin theestablishmentof guarantorconditionsandobligations，andtheinefectiveness inthefulfilmentof theseobligations.This stems from practicalfactors such as exorbitant medical costsand estranged familial relationships，alongside systemic issues including excessive institutional bias toward“reducing burdens and expanding coverage，”misguided functional positioning of guarantors，and inadequateoversightandaccountabilitymechanisms.To address theseissues holistically，front-end measures should establish a diversified medical cost-sharing system and promote family reconciliation to reduce refusal incentives；mid-stagereforms must refine guarantor qualifications，reasonably narow and clarifyobligation boundaries，strengthen primary responsibilitiesofcommunitycorrections agencies and procuratorates，and establish effectiveguarantor interaction mechanisms；back-end safeguards require introducing tiered accountability clauses for guarantors to ensure operational efectiveness，thereby balancing inmates’legitimate rights withthe solemnityof penalty enforcement.

Keywords：medical parole；guarantor;modification of penalty enforcement；temporary serviceof sentence outside prisor

一、问题的提出

近年来我国不断提高对刑罚执行的重视程度，随着《关于规范判处监禁刑罚罪犯交付执行工作若干问题的意见》《关于进一步规范暂予监外执行工作的意见》《关于加强减刑、假释案件实质化审理的意见》等一系列规范性文件的出台以及《中华人民共和国监狱法》的修订，刑罚执行工作愈发规范化，重刑事审判轻刑事执行的局面也在一定程度上得以扭转。（剩余12259字）