During 2009, 15 100 unaccompanied children sought asylum in Europe. Many of them came from 'failed states' like Somalia and Afghanistan where official documents with exact birth dates are rarely issued. This has led to requests to health care professionals in many countries to assist migration authorities in determining whether a young asylum seeker is a child or an adult. Many different methods are currently employed in Europe for this purpose by dentists, paediatricians, radiographers and social workers, but no currently available method has been demonstrated to have the accuracy needed to be of real use in this decision. Unclear guidelines and arbitrary practices may lead to alarming shortcomings in the protection of this high-risk group of children and adolescents in Europe. Medical participation, as well as non-participation, in these dubious decisions raises a number of ethical questions. Conclusion: To improve care for young asylum seekers with undetermined age, we suggest better legal procedures for the determination of age and a more flexible approach to chronological age. © 2011 The Author(s)/Acta Pædiatrica © 2011 Foundation Acta Pædiatrica.

Migration Age assessment Puberty Asylum seeker Refugee

Needs Assessment Clavicle bone age Europe molar tooth human Refugees medical ethics priority journal Minors wrist radiography child behavior puberty Age Determination by Skeleton interview clinical observation Humans Adolescent male atlas hand radiography Bioethical Issues female child asylum epiphysis bone examination Review cortical bone Age Determination by Teeth age determination Sexual Maturation United Kingdom Age Factors public policy psychosocial development mouth examination health care need child care Child