Age estimation for forensic purposes in Italy: ethical issues

Abstract

Age assessment in children and young adults is a relevant medicolegal issue due to the gradual increase of persons devoid of proper identification documents in European countries. Because of the illegal immigration and growing crime rates among children and adolescents, age estimation for forensic purposes is often required. The scientific research and the extensive experience of forensic experts in the last decades focused on the use of radiographic methods addressed to evaluate the degree of skeletal or dental development as the most accurate parameters to estimate the chronological age of children and adolescents. This paper analyzes the ethical issues related to age estimation procedures based on radiographic methods, showing how the ethical principles of beneficence, nonmalevolence, justice, and autonomy may be guaranteed during the execution of the age assessment in forensic practice. The procedure might be conducted in accordance with international guidelines and protocols, though they need a higher homogenization and standardization. A strong collaboration between various scientific societies of professionals (forensic odontologists, forensic pathologists, forensic anthropologist, radiologists, pediatricians, and psychologists), who have been involved in age estimation for years, is needed to reach this goal.

Age estimation among Brazilians: Younger or older than 18?

“…International guidelines and protocols underlie the protection of the best interests of unaccompanied children and do not admit exposing individuals to ionizing radiation without therapeutic purposes as they consider that there is no safe level of radiation, and question the reliability of age estimation by radiological methods. 27 The consequences of the criminal procedures can significantly affect an individual's life. Due to this, it is important the establishment of different parameters to define whether an individual is younger or older than 18 years old.…”

Combining dental and skeletal evidence in age classification: Pilot study in a sample of Italian sub-adults

“…proceedings and the false positive rate of the applied methods should be accurately investigated and reported. Since age estimation is mainly based on radiological methods for the analysis of teeth and bone maturation, the X-rays exposition of growing subjects for forensic purposes, without clinical indications, stands as a relevant ethical issue [42][43][44]. The combined dental and skeletal age estimation in the same subject to improve accuracy and reduce misclassifications of the age implies double expositions for children, the involvement of two forensic experts, more expensive and time consuming procedures.…”

A new age estimation procedure based on the 3D CBCT study of the pulp cavity and hard tissues of the teeth for forensic purposes: A pilot study

“…A C C E P T E D ACCEPTED MANUSCRIPT 7 radiological techniques, in both a clinical environments and a forensic one so the average radiation dose from different kinds of X-rays exams must be prudently considered (22). The estimated effective X-ray dose for dento-alveolar CBCT using the Scanora 3D (small or medium Field of View -FOV) is 45 microsieverts (μSv) or 68 μSv in case of a maxillofacial CBCT (large FOV), which is slightly higher than an OPG (average dose from 3.85 to 38 μSv), but remarkably lower than a multislice CT whose dose varies from 429,7 to 1066 μSv depending on the machine used (23).…”