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J Med Ethics 36:71-74 doi:10.1136/jme.2009.031948
  • Clinical ethics

Skeletal age determination in adolescents involved in judicial procedures: from evidence-based principles to medical practice

  1. Marie-Odile Pruvost1,
  2. Cyril Boraud1,
  3. Patrick Chariot1,2,3
  1. 1Unit of Forensic Medicine, Hôpital Jean-Verdier (AP-HP), avenue du 14 juillet – 93143 Bondy, France
  2. 2Institut de recherches interdisciplinaires sur les enjeux sociaux (INSERM, CNRS, EHESS, Université Paris 13, UMR 8156-723) – 74, rue Marcel-Cachin – 93017 Bobigny cedex, France
  3. 3UFR SMBH, Université Paris 13 – 74, rue Marcel-Cachin – 93017 Bobigny cedex, France
  1. Correspondence to Professor Patrick Chariot, Hopital Jean-Verdier (AP-HP), Avenue du 14 juillet, Bondy, 93143, France; patrick.chariot{at}jvr.aphp.fr
  • Received 30 June 2009
  • Accepted 8 September 2009

Abstract

Background The ideal basis of age estimation is considered to be a combination of clinical, skeletal and dental examinations. It is not easy to determine how forensic physicians take account of evidence-based data obtained from medical journals in their medical decision-making. The question of what is an ethically acceptable probability that adolescents are incorrectly considered to be over 18 has not been answered.

Methods In a retrospective study over 1 year (2007), 498 files (for 141 female subjects and 357 male subjects) regarding age assessment requested by the public prosecutor's office for purposes of criminal or asylum proceedings were reviewed. Chronological age was estimated from a combination of physical examination, radiographic examination of the left hand and determination of dental status.

Results Estimates of chronological age in 498 subjects claiming to be 9–14 years old were incompatible with the alleged age in 356 (71%) when made by the forensic physician but in only 17 (3%) when based on data from published studies on age estimation in adolescents.

Conclusions The present study suggests that in most cases the forensic physician ignores the adolescent's word. Medical mission and ethics imply a need to listen to the claims of persons in custody, whatever the risk of false claims. This situation should prompt forensic physicians to keep up with published data on estimating the age of adolescents.

Footnotes

  • Funding Assistance Publique Hôpitaux de Paris, 3 avenue victoria, 75001 Paris, France. Also supported by a grant to Dr Chariot from the Programme hospitalier de recherche clinique, Ministry of Health (Pratiques de prise en charge médicale des personnes en garde à vue en France, AOM 02133).

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.