Causality-based conditions for a negative refractive index must be used with care P. Kinsler, M. W. McCall Blackett Laboratory Imperial College London, Prince Consort Road, London SW7 2AZ United Kingdom. Phys. Rev. Lett. 101, 167401 (2008). Using the principle of causality as expressed in the Kramers-Kronig relations, we derive a generalized criterion for a negative refractive index that admits imperfect transparency at an observation frequency $\omega$. It also allows us to relate the global properties of the loss (i.e. its frequency response) to its local behaviour at $\omega$. However, causality-based criteria rely the on the group velocity, not the Poynting vector. Since the two are not equivalent, we provide some simple examples to compare the two criteria.