Associate Professor James Tibballs has been a full-time intensive care physician at the Royal Children’s Hospital since 1979. He has been an active participant in the organ procurement programme after brain death in the late 1990s and helped initiate the programme of organ procurement after circulatory (cardiac death) around 2010. His interests include legal and ethical aspects of organ donation and procurement. He has had published several scientific articles which have been critical of the legality and reliability of the traditional medical diagnosis of brain death - which have led to the adoption of a reliable practice. He is critical of the policy of “presumed consent” for organ procurement after circulatory death and argues that the relatives should have the decisive role in cases when the potential donor had not expressed consent.