Forensic Age Estimation Methods, Certainty, and the Law

Background: Forensic age estimation is requested by courts and other government authorities so that immigrants whose real age is unknown should not suffer unfair disadvantages because of their supposed age, and so that all legal procedures to which an individual's age is relevant can be properly followed. 157 age estimations were requested in Berlin in 2014, more than twice as many as in 2004. Methods: This review is based on pertinent articles retrieved by a selective search in the PubMed and MEDPILOT databases, supplemented by relevant recommendations and by the findings of the authors' own research. Results: The essential components of age estimation are the history, physical examination, X-rays of the hands, panorama films of the jaws, and, if indicated, a thin-slice CT of the medial clavicular epiphyses, provided that there is a legal basis for X-ray examinations without a medical indication. Multiple methods are always used in combination, for optimal accuracy. Depending on the legal issues at hand, the examiner may be asked to estimate the individual's minimum age and/or his or her most probable age. The minimum-age concept can be used in determinations whether an individual has reached the age of legal majority. It is designed to ensure that practically all persons classified as adults have, in fact, attained legal majority, even though some other persons will be incorrectly classified as minors. Conclusion: Forensic age estimation lets courts and other government authorities determine the official age of persons whose actual age is unknown-in most cases, unaccompanied refugees who may be minors. The goal is to carry out age-dependent legal procedures appropriately in accordance with the rule of law. The minimum-age concept is designed to prevent the erroneous classification of minors as legal adults.