Scholars have argued that it is impermissible to prevent deontological and optimific wrongs. That is, it is wrong to stop someone from pushing the massive man in front of a trolley that will otherwise kill five people and it is wrong to wake or move the massive man on the trolley tracks if his body will otherwise stop the trolley from killing five people. This chapter maintains this approach is misguided. A more nuanced understanding of the means principle yields that because the five people are not entitled to the sleeping man’s serving as a shield for them, not only is he allowed to get up but also third parties are entitled to wake or move him. Agents must recognize the normative relationships between patients and how these relationships bear on what agents may do.