A call to reject the neurological standard in the determination of death and abandon the dead donor rule

Riley describes the organ donation system, in which the demand for organs far exceeds the supply, and provides a comprehensive overview of the neurological standard for determining death. She also details the pathophysiology of total brain failure and the clinical tests physicians use to diagnose the condition. She then outlines the main criticisms of the neurological standard, including the uncertainty involved in determining death by this criterion and the fact that patients with total brain failure continue to exhibit certain integrative functions. Furthermore, she explains the possible solutions to the problems associated with the neurological standard, including the use of legal fictions to retain both the neurological criterion and the dead donor rule. Finally, she argues that the ethical integrity of organ donation can be grounded in the constitutional right of personal liberty and the notion of informed consent.