Joe Brierley

Joe Brierley

Birmingham Law School
Doctoral researcher

Contact details

Title of thesis: Organ donation from children: An ethical and legal exploration

Supervisors: Dr Sheelagh McGuinness and Dr Angus Dawson


  • MBChB
  • MA


  • Children’s ICU consultant. Trained Leeds, London, Australia. MA ethics.
  • Co-chair Great Ormond St Hospital CEC,
  • Chair LREC and RCPCH ethics and law advisory committee.
  • Lead on end of life care and ethics for the ICUs at GOSH
  • 4 children, never sleep

Doctoral research

PhD title Organ donation from children: An ethical and legal exploration
Course Law PhD / PhD by Distance Learning / MPhil / MJur


The development of medical therapies and technologies means that children who would once have died when they suffer organ system failure now often survive. However, a proportion do not return to normal health, but have persisting chronic organ dysfunction. Other children remain in severe organ failure, but the technologies maintaining them have developed to a state where children with irreversible vital organ failure can be kept alive. Both groups can benefit from organ transplantation - which can, therefore, be described as either life-saving or life-transforming.

Paradoxically, improvements in medical care detailed above - in combination with measures such as seatbelts and motor-vehicle speed restrictions– has lead to a decrease in deaths from severe traumatic brain injury - the commonest situation in which child-size organs are procured for transplantation.

UK organ donation initiatives have ignored children to date (OK so generic improvements might help somewhat) Donation rates remain low – many ICUs do not facilitate child-donation, parents often refuse and in small infants UK guidelines uniquely prevent donation unlike elsewhere.

This dissertation aims to explore ethical and legal issues in child organ donation and to develop a set of practical recommendations, akin to the Organ Donor Task Force.

Other activities

  • President-elect European Society of Paediatric and Neonatal intensive Care Medicine,
  • Grant GOSHCC £100,000 – ethical exploration of long-term ICU patients
  • Expert witness in non-accidental head/other injury cases
  • Clinical Lead Organ Donation GOSH
  • Organ Donation Lead RCPCH/PICS
  • Member UK Donation Ethics Committee
  • Member Nuffield council bioethics working group on research and children


  • Deep A, Goonasekera CD, Wang Y, Brierley J. Evolution of haemodynamics and outcome of fluid-refractory septic shock in children. Intensive Care Med. 2013 Sep;39(9):1602-9.
  • Brierley J. Preventing arrests in the intensive care unit. J Med Ethics. 2013 Jul 30
  • Brierley J. Current status of potential organ donation in cases of lethal fetal anomaly. The Obstetrician & Gynaecologist. 2013; 15 (3):184–188
  • Friedman S, Brierley J, Which inotrope?,Paediatrics & Child Health. 2013; 23(5): 220-225
  • Brierley J, McShane P, Adelson P. Tragedy's legacy. N Engl J Med. 2013 9;368(19):1846-7.
  • Bishay M, Giacomello L, Retrosi G, Thyoka M, Garriboli M, Brierley J, et al. Hypercapnia and Acidosis During Open and Thoracoscopic Repair of Congenital Diaphragmatic Hernia and Esophageal Atresia: Results of a Pilot Randomized Controlled Trial. Ann Surg. 2013
  • Funnell D, Fertleman C, Carrey L, Brierley J. Quantitative valuation placed by children & teenagers on participation in two hypothetical research scenarios. J Med Ethics. 2012 Nov;38(11):686-91.
  • Brierley J, Linthicum J, Petros A. J Med Ethics. 2012 Aug 25. Should religious beliefs be allowed to stonewall a secular approach to withdrawing and withholding treatment in children?
  • Brierley J, Pierce C. Introducing a pastoral care consultant to a PICU. BMJ careers.
  • Peters MJ, Brierley J. No representation without taxation: Declaration of (load) independence in septic cardiomyopathy. Pediatr Crit Care Med. 2012 13(3):349-50.
  • Brierley J, Hasan A. Aspects of deceased organ donation in paediatrics. Br J Anaesth. 2012 Jan;108 Suppl 1:i92-5.
  • Brierley J, Peters MJ. Errors of Fact and Reasoning in Consideration of Shaken Baby Syndrome. Am J Forensic Med Pathol. 2011 Oct 10.
  • Brierley J, Highe L, Hines S, Dixon G. Reducing VAP by instituting a care bundle using improvement methodology in a UK Paediatric Intensive Care Unit. Eur J Pediatr. 2011 Aug 11.
  • Brierley J, Larcher V. Organ donation from children: time for legal, ethical and cultural change. Acta Paediatr. 2011 Jun 10. doi: 10.1111/j.1651-2227.2011.02380.x.
  • Brierley J, Larcher V. Emergency research in children: options for ethical recruitment. J Med Ethics. 2011 Jul;37(7):429-32. Epub 2011 Feb 23.
  • Pierro A, Eaton S, Rees CM, De Coppi P, Kiely EM, Peters MJ, Brierley J. Is there a benefit of peritoneal drainage for necrotizing enterocolitis in newborn infants? J Pediatr Surg. 2010 Nov;45(11):2117-8.
  • Rowlands HE, Goldman AP, Harrington K, Karimova A, Brierley J, Cross N, Skellett S, Peters MJ. Impact of rapid leukodepletion on the outcome of severe clinical pertussis in young infants. Pediatrics. 2010 Oct;126(4):e816-27.
  • Brierley J, Larcher V. Lest we forget... research ethics in children: perhaps onerous, yet absolutely necessary. Arch Dis Child. 2010 Nov;95(11):863-6. Epub 2010 Aug 10.
  • Brierley J, Marks SD. Treating the causes of paediatric hypertension using non-invasive parameters. Med Hypotheses. 2010 May 3.
  • Brierley J, Larcher V.Compassionate & innovative treatments in children: proposal for ethical framework. ADC. 2009 Sep;94(9):651-4.
  • Agrawal S, Hulme SL, Hayward R and Brierley J. A Portable CT Scanner in Pediatric Intensive Care Unit Decreases Transfer-Associated Adverse Events and Staff Disruption. European Journal of Trauma and Emergency Surgery. November 03, 09.
  • Brierley J et al. Crit Care Med. Clinical practice parameters -hemodynamic support pediatric septic shock: 2007 update from American College of Critical Care Medicine. 2009 Feb;37(2):666-88.
  • Brierley J, Peters MJ. Distinct hemodynamic patterns of septic shock at presentation to pediatric intensive care. Pediatrics. 2008 Oct;122(4):752-9.7
  • Brierley J. Danger of flumazenil use in pediatric status epilepticus. Pediatr Emerg Care. 2006 Mar;22(3):168-9.
  • Brierley J. Decisions for critically ill patients. Chest. 2005 Nov;128(5):3774
  • Brierley J. "Right to die": changing "right" to "duty" may focus debate. BMJ. 2005 Jun 11;330(7504):1388
  • Brierley J Congenital cardiac emergencies. Hosp Med. 2005 Jan;66(1):46-50.