彭钊¹　占梦军²　张奎²　戴鑫华²　宁刚³　范飞²　邓振华²

(1. 四川大学华西医院放射科，四川成都 610041; 2. 四川大学华西基础医学与法医学院，四川成都 610041; 3. 四川大学华西第二医院，四川成都 610041)

　　【摘 要】 法医学年龄评估在刑事案件、民事案件、保护权益和竞技体育等方面具有重要意义，放射学检查是年龄评估常用的方法之一。但放射学检查具有潜在危害的、侵入性的非诊疗目的检查，因此，此类检查的医学伦理和知情同意至关重要。国外此类鉴定检查常采用辐射剂量较小的鉴定方法，如手腕部平片和 / 或口腔曲面断层片。并有规定或条款强调非诊疗目的的放射学检查应遵守医学伦理四原则，尊重检查的自愿性、知情同意权，均衡潜在危害与可能收益，遵守剂量最低化原则。中国大陆涉及各类年龄评估多，但目前缺乏相关鉴定标准与指南，未重视放射学检查的伦理和受检者的知情同意权。因此，中国在规范标准化年龄评估程序中，应补充放射检查伦理相关条款，统一结果表述，规范知情同意书内容格式。

　　【关键词】 法医影像学;年龄评估;非诊疗目的放射检查;伦理;知情同意

　　【中图分类号】D915.13

　　【文献标识码】A

　　【文章编号】1674-1226(2019)03-0347-12

　　Ionizing radiation examination without medical indication in forensic age estimation. Peng Zhao1, Zhan Mengjun2, Zhang Kui2, Dai Xinhua2, Ning Gang3, Fan Fei2*, Deng Zhenhua2* (1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China;2 West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, China; 3The West China Second University Hospital of Sichuan University (WCSUH- SCU),Chengdu, Sichuan 610041, China).

　　【Abstract】 Forensic age estimation plays a significant role in criminal trials, civil trials, rights protection and athletic sports. The X-ray examination is one of the popular methods used for age estimation. However, ionizing radiation examination is an invasive method, which is potentially hazardous. So, the ethical framework and the testee’s right to grant informed consent is crucial to justify such radiation examination in forensic age estimation. In other countries, it is always required to use minimum amount of radiation necessary for age estimation. Such methods include X-rays of the hands and the panorama films of the jaws. In such countries, ordinance has also been made to require application of ionizing radiation examination be complied with four medical ethics principles, including respecting voluntariness, respecting the right to grant informed consent, balancing the potential benefits and damage, and As Low As Reasonably Achievable principle. Forensic age estimation has been performed widely in China. However, the relevant examination standards and guidelines are insufficient. The ethics of radiation examination and the testee’s right to be informed and consent have also been ignored. Therefore, in the process of standardizing forensic age estimation, the medical ethics should be considered, and the form of final age assessment report and the format of informed consent should be unified.

　　【Key Words】 Forensic imaging, Age estimation, Ionizing radiation examination without medical indication, Ethics, Informed consen