The UK government has wanted to leave to their dramatic fate children, teenagers, refugees and migrants who find themselves in Calais and elsewhere in Europe. This is true even of those minors with relatives in the UK, with a legal right to enter the country. The callousness and abdication of responsibility of this stance have been opposed by many, with limited practical success, even after Parliament clearly expressed the will of having the British borders open to at least some vulnerable children.
To much fanfare, fourteen children (legally meaning a person under 18) were finally allowed to cross the Channel on Monday 17 October to be reunited with members of their families. As the same paltry number of children arrived the next day, an uproar was started by the likes of David Davies MP and Nigel Farage, which some parts of the press were more than happy to relay. The suggestion was that some arrivals were actually adults, as they did not look like teenagers. There was a call for these young men to be subjected to dental X-ray.
For once the Home Office did do the right thing and said dental x-rays would be inappropriate and unethical. Indeed scientists have long warned that physical measurements and examinations cannot determine age. May it continue this way.
First thing first. Part of the reason why the age of these young people is unknown is linked to the fact that the birth of one in three children goes unregistered worldwide. Non registration is particularly prevalent in South Asia and Sub-Saharan Africa. Those who start their travels with official documents often lose them in the course of their long and perilous journey. Even if a document bearing a date of birth survives the journey, the authorities at arrival may question either its validity or the fact that it really belongs to its holder.
It therefore has to be accepted as a fact of life that many young people just cannot prove their age. It should also come as no surprise that minors who have travelled the world alone and experienced things that one would not wish on one’s children’s worst enemy, may look substantially older than they are.
People often think that, in an era where technological developments have defied the imagination of what would have been thought possible a generation or two ago, it should be possible to resort to scientific methods, such as x-rays, for determining age. This is a mistaken view: age cannot be specifically determined by physical examination. The reason for this is simple: people do not physically develop at the same rate within one population, let alone across ethnic groups. A multitude of factors, such as genetic inheritance, nutritional intake, environment, health and illnesses, influence individual development.
Neither skeletal X-rays of the hand and wrist, nor dental X-rays, nor bone development imaging, nor height or testicular volume for men, or measurement of any other part of the body, can specifically answer the question ‘how old is this person?’ Teenagers grow, acquire bone and tooth maturity, and develop sexually, at hugely different rates. What can be known is the range of ages compatible with a given measurement – but not the age of a person who presents certain measures.
Within a given population, 5% of normal boys aged 14 have heights above the average adult height. Some 15 year olds have wisdom teeth showing, even though these generally appear later. Once it is determined that an individual is physically mature because four (for boys) or five (for girls) indicators are all satisfied, this still need not mean the individual is over 18; they might be as young as 15.
In other words, physical examinations, however sophisticated and precise, are not a dependable age indicator. In the UK, medical professional bodies have ceaselessly highlighted the danger of wishing to ascribe adult age to individuals on the basis of developmental maturity. Their determination and clarity have successfully thwarted British government proposals, for example in 2009 and 2012, to introduce X-rays for age determination process.
Their opposition is based not only on medical and statistical grounds, but also on ethical considerations. Medical ethics give prominence to the principles of respect for autonomy and beneficence. In this case, not only is it difficult to think the young person would be in a position to give informed consent to the procedure, but X-rays would be used purely for government’s administrative convenience, without therapeutic benefit and indeed with potential harm such as an increased risk of brain tumour.
In the UK, official policy recognises that it would be wrong to assess age on the basis of physical appearance. This stance should continue. Although far from perfect the policy is that social workers perform a ‘holistic’ assessment to determine age if there are reasons to dispute the age the young person claims to be. This holistic assessment combines observations of physical appearance and social development with the taking of a family and educational history, and whatever else might be considered relevant (including possibly medical reports).
This method is far from perfect, but it is better than subjecting young people to dental x-rays or getting a young man to undress so as to match the size of his testicles to one ball in a chain of balls of increasing size. One should not have to point out that such a method, still practiced in Slovenia and possibly elsewhere, is demeaning and humiliating and fails to show respect for dignity and privacy. Of course, it is not even a reliable method to determine the biological age of the person subjected to it.
We are facing a humanitarian crisis in Calais that requires urgent action. This action must take the form of welcome. This is not the time to talk about introducing age assessment methods that do not work.