It could be justified, on the basis that these two patients were the only ones whose physicians requested access to ZMapp, and that their physicians had no obligations to put other patients before their own. Closely related to this would be the very limited supply of the drug—perhaps only enough for these two. This, of course, begs the question: what if there was only enough for one of them, how would you choose—i.e., the sickest, the youngest, the one most likely to benefit, the first patient? We have no generally agreed-upon ethical rules for this, but the fairest way is always to use a lottery method, assuming all in the pool of potential recipients have a reasonable chance to benefit from the drug