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I think this is an interesting concept as far as it goes, however, it's not one I would be comfortable supporting. That being said, I am an organ donor, registered and with family advised of my wishes. Personally, i think that this is going to end up backfiring badly and it's going to be EMS that suffers for it, not the Docs or anyone else. Simply put, we should continue to work a full arrest to the ED and allow them to make the determination and speak with the family. I have yet to see a death in the field that wasn't pulled for autopsy locally. Actually, i believe that any 'unattended' death in Onondaga County is automatically put in for a post mortem. This includes any death that is not... well... expected I guess is the best word. Hospice attended deaths are excluded. If we pronounce on site, it's generally going to be on someone who is not viable for any type of organ harvest. I jsut worry that something is going to happen with this and the family is going to end up having 'buyer's remorse' and blast it out at the EMS because the patient is taken to an ambulance, be it a harvest rig or what have you, and all they are going to see is that ambulance sitting there while it happens. We're the ones who will take the heat on that when it happens. *shrug* Again, this is my personal opinion, not meant to down anyone, I just don't see it working out at least here in the Central NY area. Jim