Age estimation

SOME MEDICOLEGAL CONSIDERATIONS

Anil Aggrawal
Department of Forensic Medicine
Maulana Azad Medical College
New Delhi-110002
India

Age estimation in the living is one of the most important tasks of a forensic practitioner especially in developing countries where birth records are often not well-maintained. Despite the fact that there are a number of laws requiring registration of births (e.g Registration of Births and Deaths Act in India ) most births are not properly recorded. We get a number of cases every day for estimation of age in living individuals in various situations, both criminal and civil. Let us have a glimpse into a few such situations. Civil Cases

The minimum legal age for marriage in India is 21 years for boys and 18 years for girls. When a boy and girl want to marry in a court of law (this usually happens when they have eloped and want to marry against the wishes of their parents), the court official demands an age certificate from both of them. In case of non-production of this certificate, the court may refer the case to an age clinic (as is regularly run by the Forensic Medicine department of the Maulana Azad Medical College, New Delhi, India) for estimation of age. Criminal cases

The legal age of consent by a girl for sexual intercourse according to Indian law is 16 years. If a boy and a girl have eloped and have had intercourse willingly, the boy may still be prosecuted for rape, if the girl happens to be below 16 years of age. If the girl were above 16 years, it is not infrequent in such cases for the girl's parents to destroy her birth certificate (even if it were there), and claim their daughter's age to be below 16 years. This is done with a view to have revenge from the boy who instigated their daughter to run away from home. In such cases too, the police refers the case to the doctor for estimation of age. Ages of Medicolegal importance

Following ages are usually relevant in various medicolegal situations:

Medicolegal importance of 1 year of age

According to South Carolina ’s child passenger restraint law, Children from birth to 1 year old, or who weigh less than 20 pounds, must be secured in a rear-facing child safety seat. ( http://www.buckleupsc.com/cps/laws.htm). Washington state also has a similar law ( http://depts.washington.edu/booster/anton_skeen_bill.html). Similar laws exist in several other nations (http://www.ideamerge.com/leasing/childseat.html)
In some countries, such as Canada, Italy, the United Kingdom and Australia , murder of a child less than one year of age by its own mother is not considered homicide. Instead, the mother is charged with a lesser offence of infanticide for which the punishment is lesser. This is because such murders could be due to post-partum depression, or 'baby-blues' [supposed to be due to the effects of lactation and other aspects of post-natal care]. ( http://en.wikipedia.org/wiki/Murder)
Medicolegal importance of 2 years of age

According to the Code of Maryland, in certain cases of alimony, a determination of potential income may not be made for a parent who is caring for a child under the age of 2 years for whom the parents are jointly and severally responsible. (For details visit http://www.dhr.state.md.us/csea/help.htm)
Medicolegal importance of 3 years of age

According to the UK law, if a child under 3 years old is carried in the front seat of a car, an appropriate child restraint MUST be used (the adult seat belt is not sufficient). Children under 3 years old may not travel in the front unless they are in a child restraint. If carried in the rear seat, an appropriate child restraint MUST be used, IF AVAILABLE. If an appropriate restraint is fitted in the front of the car, but not the rear, children under 3 years old MUST sit in the front and use that restraint. Remember, you could move the restraint from the front to the rear if you wish. Rearward-facing seats are designed to be used in the rear as well as the front. You should always put a rearward-facing baby seat in the rear if is a front passenger airbag fitted. (http://www.childcarseats.org.uk/law/index.htm)
Medicolegal importance of 4 years of age

Under Pennsylvania law, children under 4 years of age are required to use a child restraint device. Nonuse is a primary offense. Children 4 to under 8 years of age are required to use a booster seat. It is a secondary offense. The fine is a sliding fine up to $100.00. ( http://www.psp.state.pa.us/psp/cwp/view.asp?A=310&Q=165399)
Medicolegal importance of 5 years of age

According to Section 6 (a) of The Hindu Minority and Guardianship Act 1956, a minor who has not completed the age of 5 years shall ordinarily be in the custody of the mother.
Medicolegal importance of 6 years of age

Under California law, automobile passengers under 6 years or lighter than 60 pounds must be securely fastened in a child safety seat. ( http://webtrafficschool.com/wts/content/California/s3_1ca.html).
Medicolegal importance of 7 years of age

According to Section 82 of the Indian Penal Code (I.P.C.), a child less than 7 years of age can not commit an offence.
[There is a common misconception among several students (unfortunately propagated by many text books) that under the Indian Railways Act 1890, a child even under 7 years of age is liable for punishment, if it does anything maliciously to wreck or attempt to wreck a train, to hurt or attempt to hurt persons traveling by railway or to endanger the safety of persons traveling by railway by willful act or by way of rash or negligent act or omission. This is not correct as the Indian Railways Act has now been completely modified. The new Act was passed in 1989, and it does not have any provision like this. Please click here for brief history of Indian railways, which gives the history of how Indian Railways Act, 1890 was passed. Please click here to see a mention of the new Indian Railways Act, 1989. ]
Medicolegal importance of 8 years of age

Under Pennsylvania law, Children under 4 years of age are required to use a child restraint device. Nonuse is a primary offense. Children 4 to under 8 years of age are required to use a booster seat. It is a secondary offense. The fine is a sliding fine up to $100.00. ( http://www.psp.state.pa.us/psp/cwp/view.asp?A=310&Q=165399)
Medicolegal importance of 9 years of age

According to the 1819 Factory Act of UK , no child under 9 could work in factories. Children from 9 to 16 were allowed to work a maximum of 72 hours per week with one and a half hours a day for meals. This age was however later reduced to 8 years by the 1844 Graham`s Factory Act. (http://www.historylearningsite.co.uk/law.htm)
Medicolegal importance of 10 years of age

According to Section 369 of I.P.C., to constitute a crime of kidnapping or abducting a child with the intention of taking dishonestly any moveable property from its person, the age of such child should be below 10 years.
Under the 1842 Mines and Colleries Act all women and children under 10 were banned from working underground. (http://www.historylearningsite.co.uk/law.htm)
Medicolegal importance of 12 years of age

According to Section 83 of I.P.C., the crime committed by a child between 7-12 years of age is not an offence, if he hasn't attained sufficient maturity of understanding. The judge often decides this issue. According to Section 90 of I.P.C, consent of a child below 12 years is not a consent, as is intended by any section of I.P.C.
According to Section 89 of I.P.C, a child below 12 years can not give valid consent to suffer any harm which may occur from an act done in good faith and for its benefit (as a general physical examination by a doctor)
Under the Indian Oaths Amendment Act 1939, the unsworn evidence of a child below 12 years of age is admissible if the court thinks he does not understand the nature of an oath.
Under the Bombay Shops and Establishments Act 1948, no child who has not completed 12 years shall be employed in these establishments.
According to Section 317 of I.P.C, exposure or abandonment of a child less than 12 years of age by parents or person having care of it, may lead to punishment for 7 years and/or fine.
According to Section 376 of I.P.C, if a man rapes his own wife and her age is less than 12 years, he will get punishment as if he raped any other girl (the sentence is not less than 7 years, and may extend to life). But if he raped his wife who was above 12 years of age, but below 15 years, he would get a lesser sentence of only 2 years. This clause may appear paradoxical as the minimum legal age for marriage in India is 18 years for girls. But despite this law, many marriages of young girls are going on in India , and section 376 caters to such cases.
Under the Children and Young Persons Act 1933 & 1952 of UK , it is an offence for a person over 16 years to have a child under 12 years in a room with an unguarded fire.
According to section 16 of Indian Arms Rules 1962, any person below the age of sixteen years but not below the age of twelve years may be allowed to use a fire-arm for the purpose of training in the use of such fire-arm in the immediate presence, or under the direct supervision and guidance of an adult instructor or the licensee:
Provided that no person below the age of sixteen years shall be allowed carry and firearm requiring a licence, in a public place, except in the immediate presence and supervision of the person who is lawfully entitled to carry such firearm. ( http://www.abhijeetsingh.com/arms/india/laws/rules/rule_15_24.html).
Medicolegal importance of 13 years of age

According to Section 375 of I.P.C, (local amendment by Manipur Government), sexual intercourse with one's own wife, even with her consent, is rape if she was below 13 years (This provision is for the state of Manipur only by a local amendment. For the rest of the country this age is 15 years)
In England and Wales , under section 5 of The Sexual Offences Act 1956, it is felony for a man to have unlawful sexual intercourse with a girl under the age of 13.
Medicolegal importance of 14 years of age

Under the law of England , a boy 14 year of age can not commit rape (In India no such age has explicitly been mentioned under the law pertaining to rape, but sections 82 and 83 of IPC serve as guidelines. According to these sections a boy below 7 years can not commit rape. If the age of the boy were between 7-12 years, then the judge would decide if his action amounts to an offence or not)
According to Article 24 of The Indian Constitution, a child below 14 years shall not be employed to work in any factory or mine or engaged in other hazardous employment (same provisions are reproduced in Section 67 of The Indian Factories Act 1948)
According to Section 23 of the United Provinces Excise Act, a licensed vendor is not allowed to employ children under the age of 14 years, in the premises in which foreign liquor or country spirit is consumed by the public.
Under section 375 of the I.P.C. (local amendment by Manipur Government), sexual intercourse with or without consent is rape if the age of the woman is less than 14 years (This provision is for the state of Manipur only by a local amendment. For the rest of the country this age is 16 years).
According to Section 15 of The Juvenile Justice (Care and Protection of Children), Act 2000, where a Board is satisfied on inquiry that a juvenile has committed an offence, then, notwithstanding anything to the contrary contained in any other law for the time being in force, the Board may, if it thinks so fit order the parent of the juvenile or the juvenile himself to pay a fine, if he is over fourteen years of age and earns money. (http://www.helplinelaw.com/bareact/index.php?dsp=juvenile-justice)
Medicolegal importance of 15 years of age

According to Indian Factories Act 1948, a child above 15 years and below 18 years is an adolescent. A Child is a person who hasn't completed 15 years. Young Person is either a child or adolescent.
According to Section 375 of I.P.C, sexual intercourse with one's own wife, even with her consent, is rape if she was below 15 years (By a local amendment this age has been reduced to 13 years for the state of Manipur)
According to International Labor Conference (1948 session), young persons between 15-17 years shall not be employed in factories, mines, railways and ports for a period of at least 12 consecutive hours.
According to Section 13 (2) (iv) of The Hindu Marriage Act 1955, a wife may divorce her husband if her marriage (whether consummated or not) was solemnized before she attained the age of 15 years, and she has repudiated the marriage after attaining that age but before attaining the age of 18 years.
According to Section 160 of The Criminal Procedure Code, a police officer has power to require attendance of witnesses, but he can't compel a male person below 15 years (or any woman) to attend at any place other than the place in which such male person (or woman) resides.
Medicolegal importance of 16 years of age

Under section 375 of the I.P.C, sexual intercourse with a woman even with her consent is rape, if she was below 16 years of age.
According to the Indian law, a child under 16 years of age, who is serving a sentence for some offence, can not be kept in a jail. He has to be confined in a Children's Home.
According to section 361 of I.P.C, whoever takes or entices any minor under 16 years of age if a male, (or under 18 years of age if a female, or any person of unsound mind) out of the keeping of the lawful guardian of such minor (or person of unsound mind), without the consent of such guardian, is said to kidnap such minor (or persons) from lawful guardianship.
According to Section 22 of United Provinces Excise Act, a licensed vendor is not permitted to sell any spirit or intoxicating drug to persons under 16 years of age.
According to The Bombay Children Act 1948, a child means a boy or girl under 16 years. If such a child commits an offence, he becomes a youthful offender, and shall not be sentenced to death.
Under the Bombay Prevention of Hindu Bigamous Marriage Act 1946, a minor means any person who is below 16 years of age (Under the Indian Majority Act 1875, a minor is a person below 18 years)
According to England 's Tattooing of Minors Act 1969, tattooing of persons under the age of 16 has been made illegal since 1969.
According to Section 363-A of I.P.C, kidnapping or maiming of a minor for the purpose of begging is an offence. If the person merely kidnaps, the sentence is 10 years and fine. If he maims, the sentence is life imprisonment and fine. For the purposes of this section a minor is a male below the age of 16 years, and a female below 18 years. This is an interesting section, as the ages for minors are different for males and females.
According to Section 2( aa ) of The Immoral Traffic (Prevention) Act, 1956 of India , a "child" means a person who has not completed the age of sixteen years. ( http://socialwelfare.delhigovt.nic.in/immoraltraffact1.htm)
According to Section 2(cb) of The Immoral Traffic (Prevention) Act, 1956 of India , a "minor" means a person who has completed the age of sixteen years but has not completed the age of eighteen years. ( http://socialwelfare.delhigovt.nic.in/immoraltraffact1.htm)
Under the Children and Young Persons Act 1933 & 1952 of UK , it is an offence for a person over 16 years to have a child under 12 years in a room with an unguarded fire.
According to section 16 of Indian Arms Rules 1962, any person below the age of sixteen years but not below the age of twelve years may be allowed to use a fire-arm for the purpose of training in the use of such fire-arm in the immediate presence, or under the direct supervision and guidance of an adult instructor or the licensee:
Provided that no person below the age of sixteen years shall be allowed carry and firearm requiring a licence, in a public place, except in the immediate presence and supervision of the person who is lawfully entitled to carry such firearm. ( http://www.abhijeetsingh.com/arms/india/laws/rules/rule_15_24.html).
According to section 9 of the Indian Arms Act 1959, a person below 16 years of age can not keep any any firearm or ammunition in his possession. ( http://www.abhijeetsingh.com/arms/india/laws/act/chapter_1_2.html).






Fig 1. Lateral view of the chest showing sternum and its pieces in a 16 year old male
N.B. Click this photo (as well as all the subsequent photos) to enlarge them

Medicolegal importance of 17 years of age

According to International Labor Conference (1948 session), young persons between 15-17 years shall not be employed in factories, mines, railways and ports for a period of at least 12 consecutive hours.
Indian Mines Act 1923: No person who hasn't completed his 17th year shall be allowed to be present in any part of a mine which is below ground unless a certificate of fitness is granted.
According to Section 44 of The Juvenile Justice (Care and Protection of Children), Act 2000, a juvenile or child over seventeen years of age but less than eighteen years of age would stay in the after-care organization till he attains the age of twenty years. (http://www.helplinelaw.com/bareact/index.php?dsp=juvenile-justice)
Medicolegal importance of 18 years of age

Under section 5 (iii) of Hindu Marriage Act 1955, the age for marriage for a girl is 18 years. If a girl marries before this age, the punishment is prescribed in section 18 (a) of the same act. It is simple imprisonment which may extend to 15 days, or fine which may extend to 1000 Rs, or with both. The marriage is not dissolved.
According to section 361 of I.P.C, whoever takes or entices any minor under 18 years of age if a female, (or under 16 years of age if a male, or any person of unsound mind) out of the keeping of the lawful guardian of such minor (or person of unsound mind), without the consent of such guardian, is said to kidnap such minor (or persons) from lawful guardianship.
According to Indian Majority Act 1875, a person attains majority when he/she attains the age of 18 years.
According to Section 4(a) of the TheHindu Minority and Guardianship Act 1956, a person who is below 18 years of age is a minor.
According to Section 87 of I.P.C, a person under the age of 18 years can not give valid consent whether express or implied to suffer any harm which may result from an act not intended or not known to cause death or grievous hurt (example: fencing, surgical operations by a doctor)
According to section 366-A of I.P.C, whoever procures any girl under the age of 18 years for the purposes of illicit intercourse with another person, shall be punishable with imprisonment which may extend to ten years and shall also be liable to fine.
According to section 372 of I.P.C, whoever sells, lets to hire, or otherwise disposes of any person under the age of 18 years for the purposes of prostitution or illicit intercourse with any person or for any unlawful or immoral purpose, shall be punished with imprisonment of either description for a term which may extend to ten years and shall also be liable to fine.
According to section 373 of I.P.C, whoever buys, hires, or otherwise obtains possession of any person under the age of 18 years for the purposes of prostitution or illicit intercourse with any person or for any unlawful or immoral purpose, shall be punished with imprisonment of either description for a term which may extend to ten years and shall also be liable to fine.
According to Indian Factories Act 1948, "Adult" is a person who has completed his 18th year. A person less than 18, but more than 15 years of age is adolescent.
According to section 305 of I.P.C, whoever abets the suicide of child below 18 years, would be punishable with death, or imprisonment for life, and shall also be liable to fine.
Section 300 I.P.C. exception 5: Culpable homicide is not murder when the person who died was above 18 years of age and he/she risked death with his own consent.
A child (Under Children's Act 1960) is sent to Children's home on commission of an offence, but is not retained there beyond the age of 18 years.
Children and Young Person's Act 1933 of England : A person below 18 years can't be sentenced to death.
According to Section 363-A of I.P.C, kidnapping or maiming of a minor for the purpose of begging is an offence. If the person merely kidnaps, the sentence is 10 years and fine. If he maims, the sentence is life imprisonment and fine. For the purposes of this section a minor is a female below 18 years (or a male below the age of 16 years). This is an interesting section, as the ages for minors are different for males and females.
This is the age for voting in India and several countries.
According to Section 2 (k) of The Juvenile Justice (Care and Protection of Children), Act 2000, a "juvenile" or "child" means a person who has not completed eighteenth year of age. ( http://www.helplinelaw.com/bareact/index.php?dsp=juvenile-justice)
According to section 3 (4) (a) of the Medical Termination of Pregnancy Act 1971, if the pregnant woman has not attained the age of 18 years, her pregnancy can not be terminated, except with the consent in writing of her guardian.
According to Section 13 (2) (iv) of The Hindu Marriage Act 1955, a wife may divorce her husband if her marriage (whether consummated or not) was solemnized before she attained the age of 15 years, and she has repudiated the marriage after attaining that age but before attaining the age of 18 years.
According to Section 2 (f) of The Transplantation of Human Organs Act, 1994, a "donor" means any person not less than 18 years of age, who voluntarily authorizes the removal of any of his human organs for therapeutic purposes.
According to Section 2(ca) of The Immoral Traffic (Prevention) Act, 1956 of India , a "major" means a person who has completed the age of eighteen years. According to Section 2(cb) of the same Act, a "minor" means a person who has completed the age of sixteen years but has not completed the age of eighteen years. ( http://socialwelfare.delhigovt.nic.in/immoraltraffact1.htm)


Figure 2. Diagram showing the fusion of various parts of sternum (click to enlarge)

Medicolegal importance of 19 years of age

Under the Maine law, a court order requiring the payment of child support (in cases where payments are made by one parent to the other following disputes between them) remains in force as to each child until the order is altered by the court or until that child attains 19 years of age. (The actual law is somewhat more complex than this. Please see http://janus.state.me.us/LEGIS/STATUTES/19-A/title19-Asec1653.html for details.)
Medicolegal importance of 20 years of age

Section 293 I.P.C. if a person sells, lets to hire, distributes, exhibits or circulates obscene objects to any person under 20 years of age, then on first conviction, he would be sentenced to an imprisonment of 3 years and a fine of 2000 Rs. On second conviction, the punishment would be 7 years and a fine of 5000 Rs.
According to Section 44 of The Juvenile Justice (Care and Protection of Children), Act 2000, a juvenile or child over seventeen years of age but less than eighteen years of age would stay in the after-care organization till he attains the age of twenty years. (http://www.helplinelaw.com/bareact/index.php?dsp=juvenile-justice)
Medicolegal importance of 21 years of age

Under section 5 (iii) of Hindu Marriage Act 1955, the age for marriage for a boy is 21 years. If a boy marries before this age, the punishment is prescribed in section 18 (a) of the same act. It is simple imprisonment which may extend to 15 days, or fine which may extend to 1000 Rs, or with both. The marriage is not dissolved.
Under section 366-B of I.P.C., whoever imports into India from any country outside India or from the State of Jammu and Kashmir any girl under the age of 21 years with intent that she may be, or knowing it to be likely that she will be, forced or seduced to illicit intercourse with another person, shall be punishable with imprisonment which may extend to 10 years and shall also be liable to fine.
When a minor is under the guardianship of the Court of Wards, or is under a guardian appointed by the Court, he is not deemed to attain majority until he is 21 years of age.
Under section 16 of Indian Arms Rules 1962, an adult means a person who has completed the age of twenty one years (http://www.abhijeetsingh.com/arms/india/laws/rules/rule_15_24.html).


Figure 3. X-ray Pelvis and femur in a two and a half year old male (Click to enlarge).

Medicolegal importance of 25 years of age

According to Article 84 (b) of The Constitution of India, minimum age for contesting for the membership of Parliament is 25 years.
According to Article 173 (b) of The Constitution of India, minimum age for contesting for the membership of any State Legislative Assembly is 25 years.
This is the maximum age for entry into some government services.
According to Punjab Excise Act 1914, a person below this age can not buy and consume liquor.
Medicolegal importance of 30 years of age

According to Article 84 (b) of The Constitution of India, this is the minimum age for election to the Council of States (Rajya Sabha).
According to Article 173 (b) of The Constitution of India, this is the minimum age for election to the State Legislative Council.
Medicolegal importance of 35 years of age

According to Article 58 (1) (b) of The Constitution of India, this is the minimum age for appointment as the President of India.
According to Article 66 (3) (b) of The Constitution of India, this is the minimum age for appointment as the Vice-President of India.
According to Article 157 of The Constitution of India, this is the minimum age for appointment as the Governor of any State.
According to Section 4 (3) (i) of The Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994, no pre-natal diagnostic technique shall be used or conducted unless the age of the woman is above 35 years.
Medicolegal importance of 60 years of age

This is age of retirement from Government service (and Delhi University )


Figure 4. X-ray pelvis and femur in a fourteen and a half year old male (Click to enlarge).

Medicolegal importance of 65 years of age

According to Section 10 (2) of the Consumer Protection Act 1986, every member of the District Forum shall hold office for a term of five years or upto the age of 65 years, whichever is earlier, and shall not be eligible for reappointment. District Forum is a kind of civil court which delivers judgments in cases of consumer grievances. Similarly the State Commission and the National Commission (mentioned below) are also akin to civil courts which are higher in rank to District Forum.
Medicolegal importance of 67 years of age

According to Section 16 (3) of the Consumer Protection Act 1986, every member of the State Commission shall be below 67 years of age.
Medicolegal importance of 70 years of age

According to Section 20 (3) of the Consumer Protection Act 1986, every member of the National Commission shall be below 70 years of age.
This is the age prescribed by some State Governments which qualifies a person to get pension from "Old Age Pension Scheme".
Estimation of age from X-rays

Age can usually be estimated in the living from the following four criteria (1)Teeth (2) Ossification of bones (3)Secondary sex characters (4)General development (in case of children). In this paper we shall concentrate on the estimation of age from X-rays only.

Age from Sternum

This is usually a neglected bone even by forensic practitioners engaged in the determination of age. But it can give strikingly accurate ages. Figure 1 is an example. This case was brought to the author for age estimation. A lateral X-ray of chest was advised. All the four pieces of sternum can be seen clearly.

The third and fourth piece have almost united, which allowed the author to opine on the age as around 15 years. This was later found to be true from other evidences. Figure 2 shows the usual ages of fusion of other parts of this bone.

Age from femur and hip bone

The case shown in figure 3 was a male, who was brought to the author for alleged sodomy on him. The police wanted to know his age, as a tender age could lead to stricter punishment to the accused. If we look at the X-ray carefully, we see that the head of femur has appeared. This meant that the age was above 1 year. But the greater trochanter has not yet appeared which allowed us to say that he was below 4 years. The actual age of the boy was found to be 2 and a half years from other evidences.

The case shown in figure 4 is also a male. He was brought as he had stolen some jewelry from a female, and he had applied for confinement in a Children's home. In this case, the tri-radiate cartilage can easily be seen which allowed us to say that the person was above 13 years and below 15 years of age. However a very faint shadow of lesser trochanter could also be seen. Lesser trochanter appears at around the age of 14 years. Opinion given was that the child was between 14-15 years.




Figure 5. Lateral X-ray foot in a eight and a half year old male (Click to enlarge).

Age from foot bones

The case shown in figure 5 is very interesting, and I include this case just to show that even the neglected foot bones can sometimes be very useful in estimation of age. This is the X-ray of an eight and a half year old child. The Secondary center in the calcaneum has appeared (>6 years), but has not united (<14 years). By examination of just this bone, we can limit our gap to 8 years. Of course examination of other bones was also required to pin-point the age, but this served as an important initial step. References The reader is well advised to visit the following sites for further information on estimation of age in the living David Lucy: Human age estimation from Skeletal and dental evidence (Abstract of Ph.D. Dissertation) Age reconstruction Age determination from x-ray