"Even if I were to consent, my family will never agree": exploring autopsy services for posthumous occupational lung disease compensation among mineworkers in South Africa.
BACKGROUND
In the South African mining sector, cardiorespiratory-specific autopsies are conducted under the Occupational Diseases in Mines and Works Act (ODMWA) on deceased mineworkers to determine eligibility for compensation. However, low levels of autopsy utilisation undermine the value of the service.


OBJECTIVE
To explore enablers and barriers to consent that impact on ODMWA autopsy utilisation for posthumous monetary compensation.


METHODS
In-depth interviews were conducted with mineworkers, widows and relatives of deceased mineworkers as well as traditional healers and mine occupational health practitioners.


RESULTS
A range of socio-cultural barriers to consent for an autopsy was identified. These barriers were largely related to gendered power relations, traditional and religious beliefs, and communication and trust. Understanding these barriers presents opportunities to intervene so as to increase autopsy utilisation.


CONCLUSIONS
Effective interventions could include engagement with healthy mine-workers and their families and re-evaluating the permanent removal of organs. The study adds to our understanding of utilisation of the autopsy services.
Chamber of Mines, Johannesburg, South Africa. abanyini@chamberofmines.org.za
Audrey V
AV
Banyini
David
D
Rees
Leah
L
Gilbert
D001344:Autopsy; D003142:Communication; D035881:Compensation and Redress; D003469:Culture; D004608:Eligibility Determination / Q000379:methods; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008171:Lung Diseases / Q000175:diagnosis* / Q000191:economics / Q000209:etiology / Q000401:mortality; D008297:Male; D008906:Mining; D009784:Occupational Diseases / Q000175:diagnosis* / Q000191:economics / Q000209:etiology / Q000401:mortality; D013019:South Africa; D018454:Spouses / Q000523:psychology; D035502:Trust
South Africa; consent for autopsy; mineworker autopsy; posthumous compensation