研修医を指導管理する立場として、自分の管理下にある研修医が過労自殺したら本当にたいへんなことになると思います。勤務時間の長さだけが証拠として残り、また原因として認定されるのはこの部分だけですが、これではことの本質が明らかにされていないと思います。いずれの報道も超過労働のせいでうつ病にいたり、自殺したとありますが、多くの場合はパワハラやイジメが関与してるのがほとんどではないかと思われます。
実際に自分の関係者が過労自殺した経験はありませんが、パワハラで仕事継続ができなくなり職場を去っていったり進路変更したり人は少なからず知っています。また自分の担当していた外来患者さんが自殺したケースは数例あり、この場合の多くの原因が地域、生活の中に逃げ場がない、というのが原因です。おそらく多くの子供の自殺も同じ原因です。
職場を去る、という逃避行動で自分を守ることができない、逃げ場が確保できない場合に自殺という逃げ場に逃げ込むのではないかと思います。それを思いとどまらせる、もしくは逃げ場を上司なら同僚、職場が確保してあげられれば自殺は防げます。
パワハラで医局員が耐えられなくなって進路変更した人が何人かいましたが、進路変更せずにうまく救うことができ、仕事を継続できた人は、すぐに移動させて緩くリハビリさせることで復職し現在も活躍できたケースもあります。こうした救いが必要なのだと思います。
超過労働時間のみが取り上げられているようですが、医師としての情熱があれば時間も生活もすべて捧げて診療している医師をたくさん知っていますが、そうした医師が自殺するなんてとても想像できませんが。何らかのパワハラにあって逃げ場がない弱い立場の研修医は、自殺という逃げ場しか残されていない、という状況があるのではないでしょうか？
As a supervisor of residents, I think it would be really serious if a resident under my supervision committed suicide due to overwork. The length of work hours is the only evidence that remains, and this is the only part that can be identified as the cause, but I think this does not clarify the true nature of the situation. All of the reports indicate that overwork has caused depression or suicides, but in most cases, power harassment or bullying is probably involved.
Although I have not experienced any actual suicides due to overwork, I have known many people who left their workplaces or changed their career paths because they were unable to continue their work due to power harassment. There have also been several cases of suicides by outpatients in my charge, and in many of these cases, the cause was the lack of escape in the community or in their lives. Probably the same cause is responsible for many children's suicides.
If they cannot protect themselves by escaping from the workplace, or if they cannot secure a place to escape to, they may turn to suicide as a means of escape. Suicide can be prevented if the patient is discouraged from doing so, or if the boss, colleagues, or the workplace can secure a place for the patient to escape.
There have been several people who changed their career paths because they could no longer tolerate the power harassment in the medical office, but those who could be saved successfully without changing their career paths and who were able to continue their jobs were moved immediately and given loose rehabilitation, and in some cases, they were able to return to work and are still active today. I believe that this kind of rescue is necessary.
I know many doctors who are passionate about their work and dedicate all their time and life to their practice, but I can't imagine such doctors committing suicide. I think there is a situation where a resident doctor in a vulnerable position who has been harassed in some way and has nowhere to run is left with no other escape than to commit suicide.
