• Death/mortality
• ethics
• cardiac arrest

Bruce et al conducted an opinion survey using a convenience sample in the emergency department (ED) and concluded that patients and relatives are not averse to organ donation being ‘discussed shortly after ED death’ and that ‘organ preservation procedures [prior to donation consent] are acceptable to many’.1 We outline three main concerns regarding the validity of the conclusions drawn by Bruce et al from the survey.

First, the medical determination of death by the circulatory criterion (ie, mechanical asystole or cardiac arrest for 2–10 min) without simultaneously confirming that brain death has occurred is scientifically flawed.2–4 The use of a faulty ‘accepted medical standard’ potentially leads to high error rates of determining donor death, which would then inevitably be under-reported because of the terminality of surgical procurement. At …