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Medical age tests for refugees?

Nicolas Martin
April 25, 2018

In Germany, a refugee's age is generally established in an interview with youth welfare officers. A court decision could soon require authorities to determine it with a medical exam, but those methods are controversial.

A X-ray image showing the bones of a person's wrist
Image: picture-alliance/N. Lange

On Thursday, Germany's Federal Administrative Court will decide whether medical testing to determine the age of young refugees will become the rule rather than the exception. The case being heard involves an Afghan who filed suit after a visual inspection determined he was an adult.

Unaccompanied minor refugees arriving in Germany are currently cared for by local youth welfare offices, as required by federal law. Those offices are also tasked with confirming a refugee's age – or in some cases, verifying it – which is carried out by two specialists during a so-called visual inspection. If there is considerable doubt as to the age of a refugee, the office can order a medical test.

Read more: UNICEF: Number of unaccompanied refugee children reaches 'record high'

Now, the Federal Administrative Court must act as the final arbiter on whether a visual inspection is only applicable in cases in which a person is clearly a minor or adult.

"That could mean a medical test would only be avoided if social workers and the refugee are in agreement as to age," as Guido Kirchhoff of the Ostfalia University of Applied Sciences told DW. In all other cases, a federally approved medical exam would be carried out.

An emotional debate

Following the murders of a 19-year-old medical student in Freiburg and a 15-year-old girl in the village of Kandel, the issue of refugee age has become a hotly debated topic in Germany. In both of those cases, the perpetrators had been erroneously classified as minors — a status that brings a number of advantages. Underage refugees do not live in collective accommodations but rather in youth homes, they have easier access to education and receive psychological care. Family reunification is also made easier for minors, and youths are protected from deportation.

Underage refugees in Germany
Underage refugees in Germany generally have their age determined during an interviewImage: picture-alliance/dpa/U. Deck

Sean McGinley, managing director of the Refugee Council of Baden-Württemberg in southern Germany, does not deny that in light of such advantages, some refugees may declare themselves younger than they actually are when they arrive in the country. However, he believes that proponents of age-determining medical tests are primarily interested in showing they are tough when it comes to refugee policy.

"They give the impression that these tests are like counting growth rings on a tree — that simply isn't the case," McGinley told DW.

Read more: Top EU court strengthens family reunifications for young refugees

But Kay Ruge, head of the Asylum and Refugee Issues Department for Germany's Rural District Association, disagrees. He says the overall problem is that right now refugees are all claiming to be minors.

"The rule to date has been very lax as far as age is concerned," Ruge told DW. "We are of the opinion that one could be much stricter."

Political support for standardization

In early January, the right-wing populist Alternative for Germany (AfD) party put forward a motion in the Bundestag demanding jail sentences for refugees who lied about their age. The AfD also made the case for obligatory testing if official documents could not be provided to confirm a person's age.

Annegret Kramp-Karrenbauer, the former state premier of Saarland who now heads Chancellor Angela Merkel's conservative Christian Democratic Union (CDU), called for the establishment of a standardized nationwide system. Unlike in other states, all underage refugees in Saarland are examined in a so-called pre-clearing station. Exams carried out there have determined that roughly 35 percent of those claiming to be minors were in fact adults.

Unaccompanied minor entries to Germany, a graphic

Controversial age testing

In practice, tests to determine a refugee's age differ from state to state. When doubt about a person's age arises, his or her appearance is first assessed, followed by overall physical development and facial hair growth, but not the development of their sexual organs. Beyond that, age can also be determined by taking X-rays of teeth, bones, wrists and the pelvis. The margin of error for such tests is considerable: up to two years in either direction.

There are also ethical concerns. Earlier this year, Frank Ulrich Montgomery, president of the German Medical Association, told the daily Süddeutsche Zeitung that subjecting a person to an X-ray without having a medical need to do so was an invasion of one's physical integrity.

The Refugee Council of Baden-Württemberg's McGinley still considers visual inspection to be the best method.

"Medical procedures are always questionable from a legal standpoint," he said.

The controversy surrounding the practice has led to a search for alternatives, including hand scanners and gene tests developed in the United States. Still, consensus is lacking, as forensic medical specialist Andreas Schmeling of the University of Münster noted in an address to Lower Saxony's state parliament: "Neither method can definitively prove that a person is or is not 18 years of age."