One-sided Overview of the Problem

It is alarming that a psychological assessment of the refugee minors was not mentioned anywhere in the article (1). The psychological developmental status is crucial to assessing a young person’s maturity. Significantly, the authors excluded political and ethical aspects of age assessment of unaccompanied young refugees of disputed ages—from a medical ethical perspective this is a limited approach. The argument proffered in favor of using X-ray examinations without medical indication is, “This does not necessarily require a benefit for the health of the individual, but can also be considered as the expected benefit of the relevant laws to the public.” This reasoning is dangerous, because in our legal system, an individual’s autonomy ranks very highly. The German Medical Assembly has repeatedly argued against using X-ray examinations to assess a person’s age. The article says that “resolutions made by the German Medical Assembly express professional statements and are not legally binding.” Decisions passed by the German Medical Assembly can obviously result in professional legal consequences, and obviously the delegates at the 113th German Medical Assembly had considered this by saying in decision V93: “Because of several additional age assessments in underage refugees that were undertaken by using hand X-ray examinations, we wish to remind colleagues of the German Medical Assembly’s decisions of 1995 and 2007—namely, that the involvement of doctors in forensic age estimations is to be adamantly opposed,” and “questions pertaining to aliens law absolutely cannot legitimize medical indications of procedures that pose a risk to the body, such as X-ray examinations.” No one can simply ignore these decisions. This review article provides a limited and one-sided overview of the problem.