Industrial Manslaughter in Medicine: It Only Ends with Us

Under new industrial manslaughter laws, a doctor’s suicide linked to workplace mental injury may no longer be just a tragedy – it can be a crime. All medical workplaces, colleges, medical defence organisations (MDOs) and the AMA must unite to address systemic WHS breaches and to strengthen, coordinate and fund evidence-based suicide prevention initiatives in medicine. Failure to do so may expose individuals and organisations to catastrophic penalties including imprisonment – but, more importantly, cost more doctors’ lives.

“… these doctors were essentially suffering in silence. Their colleagues who were working next door to them were often just entirely unaware, and that’s what hurts. For too many of our colleagues, the pain is hidden.” – Past RACGP Vice President Associate Professor Michael Clements reflecting on five doctor suicides in two years in one regional city (here).

Under recently expanded industrial manslaughter laws (here, here, here), a person conducting a business or undertaking (PCBU) (such as a medical organisation, hospital or practice) with a WHS duty may be criminally liable if they:

1. breach a duty of care under WHS law;
2. and that breach causes the death;
3. in circumstances where they knew (or reasonably should have known) that their conduct posed a risk of death or serious harm or acted in reckless disregard of that risk.

While employee and contractor mental health risks are increasingly regarded as part of WHS duties to manage psychosocial hazards (here), industrial manslaughter laws have so far only been tested in the context of physical safety failures in Australia (environmental hazards contributing to accidents, assaults, repetitive physical injuries etc).

The new possibility that industrial manslaughter could apply to work-related suicide in the future must now be taken seriously. The potential penalties – including multi-million-dollar fines and potential imprisonment of individuals (here) – are severe, and should drive all medical workplaces and organisations to demonstrate how they are meeting their WHS duties and reducing work-related mental injury in doctors (here).

For example, if a doctor suicides and the employer’s grossly negligent (or reckless) failure to manage known, severe workplace psychosocial hazards (eg, persistent bullying, harassment, extreme unreasonable work demands, known suicidality among staff) can be shown to have caused or substantially contributed to the death, then the industrial manslaughter offence might be possible.

The true scale of work–related mental injury and suicidality is underestimated in medicine

Aside from industrial manslaughter, medical organisations and workplaces already know they must be more proactive in reducing psychosocial hazards, especially following the widely publicised legal action against the Victorian Coroner’s Court (here) and several hospitals under the OHS Act (here). As coroners increasingly attribute suicides to toxic workplace culture and psychosocial hazards (here), and as model WHS laws require notification of work-related suicides, it becomes more plausible that in the future, industrial manslaughter prosecutions will test these provisions in the context of work-related suicide.

“It’s awful, it’s heartbreaking, this wonderful young man was no longer with us. He felt ready to resume work … He returned … but the system put more and more pressure on his brain and something broke.” – a father calling for a senate inquiry in October 2025 after the suicide of his son (here).

Recent Australian and international research (here) paints a confronting picture of the level of mental distress in our profession. In 2013, the beyond blue survey of about 14000 doctors and medical students reported that 27 % experienced clinically significant depression or anxiety. A 2024 scoping review of Australian medical students and doctors–in–training found persistently high levels of psychological distress, burnout and suicidal ideation directly linked to training and workplace conditions (here), while a study found that working more than 50 hours per week doubled the risk of common mental disorders among junior doctors (here).

Data gaps on suicide remain, meaning the true scale of the magnitude and work–related nature of mental injury and suicidality in medicine may be underestimated (here, here).

“Six months ago, I never would have thought I’d have a daughter that would have committed suicide. I had a daughter who loved her life, sisters, boyfriend, and to think that she’s given that up because of the position medicine has put her in is just heartbreaking.” – The mother of Dr Chloe Abbott (here).

The medical profession’s failure to exercise due diligence in WHS

In the context of these long standing issues, recently expanded WHS laws should prompt the medical profession to examine its lack of progress and potential failure to exercise due diligence in relation to suicidality and suicide in doctors over the last decade or more:

• Failure to act on known risks: No repeat of the Beyond Blue National Mental Health Survey of Doctors and Medical Students (2013) which reported widespread psychological distress, suicidality (1 in 10 doctors), poor access to mental health treatment, and high levels of self–medication, particularly in doctors in training (here). Twelve years on, the evidence has only grown stronger – and more alarming (here, here, here).
• Persisting supervisor abuse: Six years of Medical Training Survey data confirming that senior doctors remain major perpetrators of workplace abuse of doctors in training.
• Enduring WHS breaches: Unsafe hours, heavy patient loads, unpaid overtime and wage theft, and denied leave entitlements and other systemic WHS breaches, are predisposing doctors to mental injury (here).
• Lack of safe reporting mechanisms of WHS incidents and complaints: In a climate of fear among doctors in training, the scale of unrecognised work–related mental injury remains unknown, which is itself a serious WHS breach. Despite this known risk, many medical workplaces still lack anonymous systems to report discrimination, racism, sexual harassment, bullying and violence (DRSBV).
• Low WHS literacy: Many medical employers and doctors have failed to strengthen WHS systems in line with contemporary WHS law and the Model Code of Practice on psychosocial hazards.
• Myths surrounding mandatory reporting deterring help seeking: Only a minority of mandatory reports lead to regulatory action, suggesting that some employers and others are misinterpreting criteria and reporting inappropriately (here).
• Inadequate access to evidence-based treatment: Doctors suffering work-related mental injury, including burnout, major depression, PTSD and CPTSD face barriers to accessing evidence-based treatment, due to the stigma attached to mental illness and fear of career damage. When doctors express suicidal thoughts, intervention is often delayed or inconsistent.

“As soon as Jono died, I knew that I wasn’t going to hide the fact that it was suicide. If he had been seeing his GP regularly and had someone to keep in touch with, to see how he’s going, things might have been different. I know that Jono’s attitude was very much, ‘I’m not going to focus on myself, I’m going to focus on others and look after others.” – the wife of Dr Jonathan Morling (here).

A collective duty to fund an evidence based national suicide prevention strategy

All medical workplaces, the AMA, colleges, the Council of Presidents of Medical Colleges (CPMC), and medical defence organisations (MDOs) are now aware of their collective duty  to lead WHS reform and advocate for better funding of WHS with a coordinated evidence based strategic approach to the prevention of suicide and suicidality in doctors (here, here, here, here, here). Here are some of the current initiatives:

1. Prevention: Colleges, Black Dog Institute The Essential Network (TEN), Hand n Hand Peer Support, Hush Foundation, Crazy Socks for Docs, A Better Culture (recently defunded), the AMA wellbeing hub, and other groundswells of great work by dedicated doctors to create psychologically safe workplaces (here).
2. Early intervention: Initiatives to improve mental health and WHS literacy across the profession to support doctors before harm escalates, including education and training of non-psychiatrists and senior doctors/supervisors of doctors in training (here, here, here).
3. Optimal management and postvention: Evidence-based treatment of work-related mental injury (here), private GPs, psychologists, psychiatrists, Doctors Health Alliance, Drs4Drs or Employee Assistance Programs (here).

There are also currently many dedicated doctors committed to improving the mental health of doctors through research (UNSW, University of Sydney; University of Tasmania, University of Melbourne, University of Western Australia and Monash University).

What is required now is for the medical profession, through its organisations, to resource a national funding pool to support, coordinate and scale up these efforts across states and territories, and to ensure ongoing research, evaluation and evidence based mental health and suicide prevention programs that can drive progress in reducing medical workplace abuse and suicidality.

“The family is not apportioning blame, but we feel there are questions that remain unanswered … My younger brother William was young and in the prime of his life. His death has tragically cut that short.” – the brother of Dr William Huynh (here).

There are solutions – our failure to fund and implement them is unacceptable

As medical practitioners, we have a responsibility to understand transformational new WHS laws for our patients, our colleagues, other health workers – and our own protection. We must protect doctors’ lives and the devastating human toll on their families, colleagues, and communities.

Based on the complex issues and the many potential solutions raised in this opinion piece, ignoring known psychosocial hazards is no longer merely an ethical failure. It is emerging criminal exposure for senior doctors, medical leaders and directors and officers of hospitals and practices who fail to seek legal advice about their new duties.

“They were going to save many lives and do great things, and that potential is lost.” – Senior doctor (here).

Industrial manslaughter in medicine is not a distant threat. The laws are in place, the evidence is clear, the deaths are real, and the tragic loss of our precious colleagues will only end with urgent collective action from all of us.

Clinical Professor Leanne Rowe AM is an experienced GP with specialised clinical expertise in the comprehensive assessment and management of physical and mental injury. In the past, she chaired public and private hospital boards and gained medico–legal expertise in work health and safety. Among her many non–executive director roles, she has served as Chair of the RACGP, and Deputy Chancellor of Monash University.

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