We find evidence in 71 of these reports, spread nationwide, that brain death could not have properly been declared. In these cases, the removal of the heart during organ procurement must have been the proximate cause of the donor's death.
Yeah, the "must have been" quotation is interesting, isn't it?
The PRC papers we have identified do not describe how the donor was incapacitated before procurement, and the data is consistent with multiple plausible scenarios. These range from a bullet to the prisoner's head at an execution site before they are rushed to the hospital, like Tsai's description, or a general anesthetic delivered in the operating room directly before procurement. Paul et al. have previously proposed a hybrid of these scenarios to explain PRC transplant activity: a lethal injection, with execution completed by organ procurement. They write: “in cases in which thiopental's effect is insufficient and organ explantation begins immediately after cardiac arrest, the inmates may suffer from excruciating pain induced by organ explantation surgery, the surgical opening of the abdomen and/or chest.”11 It is also possible that a specialized device was used to inflict brain death in close quarters and thus insulate medical professionals from the process. A patent for a “Primary brainstem injury percussion machine” was held by a former PRC police chief involved in organ transplants.53 The patent description says it was to be used for medium-sized animals. There is no public evidence that it was ever used on humans. Previous anecdotal, eyewitness, and textual evidence is consistent with these accounts—including procurement from donors prior to death,12 and targeted execution procedures intended to forestall cardiac arrest and thus minimize warm ischemic time.
There's a lot of speculation in the paper, and the only thing that I can see is that they can't document brain-death prior to organ harvest in those cases.
Again, I completely believe that execution by organ procurement is a real possibility (China is an asshole), but I don't see this in the meta-analysis here.
You?