The family of a 26-year-old doctor in Japan who died by suicide last year after working more than 200 hours of overtime in a single month have pleaded for change in a nation long plagued by overwork culture.
Takashima Shingo had been working as a resident doctor at a hospital in Kobe City when he took his own life last May, according to public broadcaster NHK.
According to the family's lawyers, Takashima had worked more than 207 hours overtime in the month before his death, and had not taken a day off for three months, NHK reported.
The hospital, Konan Medical Center, has denied those accusations in a press conference last week. But in June, the government's labor inspection body ruled his death a work-related incident due to his long hours, according to NHK -- highlighting the immense pressures placed on health care workers.
Japan has long battled a persistent overwork culture, with employees across various sectors reporting punishing hours, high pressure from supervisors and deference to the company, according to the Ministry of Health, Labor and Welfare.
The ensuing stress and mental health toll has even caused a phenomenon called "karoshi," or "death by overwork" -- leading to legislation meant to prevent death and injury from excessive work hours.
In a news conference last Friday, Takashima's family described what they said was a young man driven to desperation and expressed their grief over his death.
Prior to his suicide, his mother Junko Takashima said, the doctor would say "it was too hard" and that "no one would help him," according to video published by local media of the news conference.
"No one is looking out for me, he kept telling me. I think the environment put him over the edge," she said.
"My son will not become a kind doctor, nor will he be able to save patients and contribute to society," she added. "However, I sincerely hope that the working environment for doctors will be improved so that the same thing will not happen again in the future."
Takashima's brother, who was not named, also spoke in the news conference, saying: "No matter how we look at my brother's work hours, 200 hours (of overtime) is an unbelievable number, and I don't think the hospital is taking a solid approach to labor management in the first place."
In a press conference last week, the Konan Medical Center pushed back. "There are many times when (doctors) spend time studying on their own and sleeping according to their physiological needs," a spokesperson said. "Due to the very high degree of freedom, it is not possible to accurately determine working hours."
When contacted by CNN on Monday, a hospital spokesperson said: "We do not recognize this case as overtime work and will stop commenting on this in the future."
A number of overwork cases have made national and global headlines over the years -- for instance, Japanese officials concluded in 2017 that a 31-year-old political reporter, who died in 2013, had experienced heart failure from spending long hours on the job. She had worked 159 hours of overtime in the month before her death, according to NHK.
The problem remains especially high in the health care sector. One 2016 study found that more than a quarter of full-time hospital physicians work up to 60 hours a week, while 5% work up to 90 hours, and 2.3% work up to 100 hours.
Another report, published this year by the Association of Japan Medical Colleges, found that more than 34% of physicians are eligible for a "special level of overtime hours exceeding the upper limit of 960 hours per year."
Reforms to labor law and overtime regulations in 2018 have seen some small progress, with the government reporting last year that the average amount of annual hours worked per employee has been "gradually decreasing." However, though the number of actual working hours has been declining, overtime working hours have fluctuated over the years, it added.