title: [Ethical shortcomings of skeletal age determination to establish minority for single young asylum seekers].
abstract: Each year tens of thousands of asylum seekers from all over the world come to the Netherlands. Amongst them are minors who come alone. They are eligible for a separate, less severe, admittance procedure than for adults and their under-age children. Because of abuse of this procedure by adults an X-ray age examination of the claviculae and hand-wrist has been introduced to determine minority. A person who claims to be a minor but appears to be an adult is invited to submit to the examination on a 'voluntary' basis. The selection procedure, the informed consent, the voluntariness and the technical aspects of the age measurement suffer from ethical shortcomings. An ethical committee should ensure that the procedures conform to the generally accepted Dutch ethical principles laid down in the Dutch Medical Treatment Act. In addition, the selection of asylum seekers for age determination should be carried out by specialized officials (an alternative would be to subject all single minor asylum seekers to age measurement). The waiting time for age measurement should be reduced to prevent the medial clavicular epiphyseal disc from closing during the waiting time. Age should not be judged on the basis of a partially closed epiphyseal disc, as this is controversial. It is recommended that the age for the single minor asylum seeker regulation be reduced from 18 to 16 years.
authors.affiliation: Universitair Medisch Centrum, locatie Wilhelmina Kinderziekenhuis, Centre for Migration and Child Health, Utrecht.
authors.forename: C J
authors.initials: CJ
authors.lastname: van Ree
authors.forename: T W
authors.initials: TW
authors.lastname: Schulpen
mesh_terms: D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton / Q000379:methods*; D002968:Clavicle / Q000000981:diagnostic imaging; D004641:Emigration and Immigration / Q000331:legislation & jurisprudence; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D009426:Netherlands; D012036:Refugees / Q000331:legislation & jurisprudence*; D014953:Wrist / Q000000981:diagnostic imaging
vernacular_title: Ethische tekortkomingen van het leeftijdsonderzoek ter beoordeling van minderjarigheid van alleenstaande asielzoekers.