Article 61

A performance study on minors may be conducted only where, in addition to the conditions set out in Article 58(5), all of the following conditions are met:

1. (a)

   the informed consent of their legally designated representative has been obtained;

2. (b)

   the minors have received the information referred to in Article 59(2) in a way adapted to their age and mental maturity and from investigators or members of the investigating team who are trained or experienced in working with children;

3. (c)

   the explicit wish of a minor who is capable of forming an opinion and assessing the information referred to in Article 59(2) to refuse participation in, or to withdraw from, the performance study at any time, is respected by the investigator;

4. (d)

   no incentives or financial inducements are given to subjects or their legally designated representatives, except for compensation for expenses and loss of earnings directly related to the participation in the performance study;

5. (e)

   the performance study is intended to investigate treatments for a medical condition that only occurs in minors or the performance study is essential with respect to minors to validate data obtained in performance studies on persons able to give informed consent or by other research methods;

6. (f)

   the performance study either relates directly to a medical condition from which the minor concerned suffers or is of such a nature that it can only be carried out on minors;

7. (g)

   there are scientific grounds for expecting that participation in the performance study will produce:

   1. (i)

      a direct benefit to the minor subject outweighing the risks and burdens involved; or

   2. (ii)

      some benefit for the population represented by the minor concerned when the performance study will pose only minimal risk to, and will impose minimal burden on, the minor concerned in comparison with the standard treatment of the minor's condition;

8. (h)

   the minor shall take part in the informed consent procedure in a way adapted to his or her age and mental maturity;

9. (i)

   if during a performance study the minor reaches the age of legal competence to give informed consent as defined in the national law, his or her express informed consent shall be obtained before that subject can continue to participate in the performance study.

Point (g)(ii) of paragraph 1 shall be without prejudice to more stringent national rules prohibiting the conduct of those performance studies on minors, where there are no scientific grounds to expect that participation in the performance study will produce a direct benefit to the subject outweighing the risks and burdens involved.