Intended for healthcare professionals


When childhood ends: estimating the age of young people

BMJ 2015; 351 doi: (Published 14 December 2015) Cite this as: BMJ 2015;351:h6699
  1. Daniel Messelken, researcher1,
  2. Johan Crouse, legal adviser2,
  3. David T Winkler, chair2
  1. 1Ethics Research Institute, Centre for Military Medical Ethics, University of Zürich, Zürich, Switzerland
  2. 2ICMM Centre of Reference for Education on International Human Law and Ethics, Centre for Military Medical Ethics, Zürich
  1. Correspondence to: D Messelken messelken{at}

Doctors should tread carefully through this ethical minefield

Minors are increasingly reaching countries far from their homes as migrants, and their ages are often unknown. In Europe, up to 1500 people per country annually have medical examinations and procedures to estimate their chronological age.1 These procedures can cause considerable harm to individuals, particularly if performed without appropriate safeguards. Inappropriate age estimation may deter minors from applying for asylum in specific countries, and doctors may find themselves exploited in the service of migration policy. During missions, military doctors face demands to estimate the age of child soldiers destined for potentially unlawful detention or interrogation. Doctors therefore need to be aware of the limitations of medically estimating age and the associated ethical problems.

Medical estimation of age is still inaccurate and the results are unreliable. Best medical practice recommends a multidisciplinary approach including radiological, dental, and general medical assessments.2 3 4 But all these methods have …

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