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Medical, Ethical, and Legal Risks in Forensic Age Assessment Procedures in Current Swedish Asylum Processes Involving Unaccompanied Minors

Conference contribution
Authors Josephine T. V. Greenbrook
Henry Ascher
Published in Program and proceedings of the Oxford Global Health & Bioethics International Conference in Oxford, United Kingdom, July 1-2, 2019 (oral presentations)
Publication year 2019
Published at Institute of Medicine, School of Public Health and Community Medicine
Department of Sociology and Work Science
Institute of Medicine
Institute of Clinical Sciences, Department of Pediatrics
Institute of Health and Care Sciences
Language en
Keywords unaccompanied minors, migration, forensic age assessment, forensic medicine, human rights, convention on the rights of the child, medical ethics, asylum seekers, risk assessment
Subject categories International Migration and Ethnic Relations, Ethics, Sociology, Law, Medical Ethics, Public Health, Global Health, Social Medicine and Epidemiology, Forensic Science

Abstract

There is a broad consensus surrounding the acutely vulnerable plight of asylum-seeking unaccompanied children, transcending international policy, academic literature, and expert opinion in both medicine and jurisprudence. Children migrating alone are at extreme risk of exposure to violence, exploitation, and poor health, and thus require extensive social, medical, and legal support, both during migration, and post migration whilst waiting for their asylum claims to be processed. The Swedish government has voiced intent to protect the human right to asylum in Europe, accenting that processes must be solidarity-based, legally certain, sustainable, efficient, and humane in facilitating reliable assessments protecting the rights of asylum-seekers. The present study explores current debate surrounding the deficient scientific reliability of recently introduced two step forensic age assessment procedures in Swedish asylum processes involving unaccompanied minors, and discusses the stakes involved from a medical, ethical, and legal perspective. The analysis included current policy documents, health professions unions' statements and reports, expert and media debate, and United Nations committee reports. Although the vast majority of forensic age assessment conducted thus far in Sweden have assessed biological age as 18 or above, expert consensus has decried methods applied as being unable to withstand the test of scientific scrutiny. Concerns surrounding the procedures’ medically unjustifiable and highly unethical nature, as well as the misuse of the medical profession' authority, expertise, and skill in forwarding political agendas have been noted. Furthermore, in disregarding the precautionary principle by default, current reductionist and pseudoscientific forensic methods risk facilitating the bypassing of laws intended to protect the human rights of children at their most vulnerable. These highly consequential forensic age assessments must yield results greater than chance, as the aftermath of failures are neither humane, sustainable, or legally certain. Flawed results can impede children from accessing foundational human rights, such as the right to health, to thrive, and to meet their full potential, raising resounding medical, ethical, and legal concerns. The social sciences must contribute with expertise and actively engage in this debate, and work toward developing and establishing a thorough and holistic age assessment process, including biomedical aspects such as growth curves, x-rays, and adding psychosocial components such as recollection of childhood memories, psychosocial maturity, along with reports from adults in the children’s social networks (such as teachers, social workers, and others) on how the assessed child handled everyday life.

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