 The practice of DCD, which has expanded to several medical centers, has provoked considerable controversy. Critics have charged that in DCD vital organs are removed before patients are really dead, implying that organ procurement kills the patients. Some proponents of the whole-brain approach argue that the patients are not yet dead because only total brain failure (or perhaps that of the brainstem) constitutes human death. But current American law in its disjunctive form suggests otherwise—at least for legal purposes. Other critics of DCD charge that a patient cannot be dead two minutes after cardiac arrest because the loss of cardiopulmonary functioning is not irreversible: Victims of heart attack are sometimes revived more than two minutes after the arrest. One might reply that the loss of functioning is irreversible because, the patient having requested removal of life supports, no one may violate the patient's rights by resuscitating him or her (Tomlinson 1993). It seems fair to reply, however, that a decision not to resuscitate does not mean that resuscitation is impossible as suggested by the concept of irreversibility. Has the latter concept been conflated in DCD with the concept of permanence? Permanent loss of function does not imply that resuscitation is impossible, just that it will not  occur.[3]  These concerns about abandoning the standard of irreversible loss of cardiopulmonary function apply even to more modest proposals, such as that advanced by the Institute of Medicine (2000), in which a declaration of death and DCD proceed after a waiting period of five minutes: Resuscitation is sometimes possible more than five minutes after a heart attack. Proponents of DCD might reply that permanence, rather than irreversibility, is the appropriate standard in this context (see, e.g., Bernat 2006, 41) or that DCD represents an instance where it is permissible to remove vital organs from someone who is dying but not yet dead. Certainly, any proponent of DCD will see the current law's (disjunctive) acceptance of cardiopulmonary criteria for death as offering a major practical advantage over any policy that accepted only whole-brain criteria.