Dental X-rays, age and immigration

24 Apr 2012

Some of us are fortunate enough to look younger than our years and young adults are well used to producing evidence of their age at bars and clubs.  But what if you are from a country where birth records are poor or non-existent and you are claiming asylum in the UK?  

And what if your asylum Case Worker thinks you are an adult but you know you are still a minor? The UK Border Agency is reviving an old and discredited practice from the 1970s by trialling the use in Croydon of voluntary dental X-rays to establish an individual’s age.

Why Croydon?  It is the location of UK Border Agency’s Asylum Screening Unit where claims for asylum are processed.

Predictably this has stirred concerns about human rights and UKBA’s somewhat elastic understanding of that word "voluntary”.

The trial is more remarkable for the storm it is causing in the child welfare and scientific communities.  Vigorous opposition has come in the past from a former Children’s Commissioner and a former Chief Medical Officer.  The latter described the scientific basis of the trial as "weak and limited”; and that’s before one tackles the ethical issues surrounding individuals (often vulnerable and under strain) giving informed consent to the taking of X-rays. 

Arguably there should not be a debate at all because the deliberate exposure of individuals to ionising radiation (i.e. x-rays) is very strictly controlled by the Ionising Radiation (Medical Exposure) Regulations 2000.  These Regulations are vigorously applied throughout the health service and are rooted in the principle that no person shall be exposed to medical radiation, unless this is justified by a medical practitioner.  Justification means demonstrating a net medical benefit in terms of diagnostic and therapeutic functions, when weighed against the risks to the individual and the availability of alternative techniques.  Special care and consideration is always required in the case of minors and where exposure to radiation carries no direct health benefits for the individual.  

This is not another bizarre case of health and safety running amok; radiation can be extremely dangerous if misapplied, so the Regulations are one of the cornerstones of current radiological practice.

While the need to secure our borders is something that most of us welcome, we are not sure that this trial is a good idea.  In fact, we are sure that the sooner a better way of age verification is found, the better.