Michael Potts, Paul A. Byrne, and David W. Evans are critical of donation after cardiac death (DCD). Contrary to the authors' assertion that the removal of vital organs is the proximate cause of death, the eventual fulfillment of the neurological criteria of death is solely dependant on the rate of brain cell death in the absence of circulation. Consistent with the "dead donor rule," DCD is not the cause of death.There are also procedural mechanisms to address the potential conflicts of interest that concern the authors. Rather than being prohibited, DCD may be an ethically justifiable exception to the rule that organ donors must be dead prior to organ recovery.