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Ahmed A. Mahmoud, PharmD, BCCCP; Ryan Hakimi, DO, MS; Jessica L. Elefritz, PharmD, BCCCP Prescribers often are faced with ethical dilemmas regarding allocation of scarce medications among the most critically ill patients. This challenge is further compounded when alternatives do not exist, the medication is being used as salvage therapy with low probability of clinical success, or there is a paucity of evidence supporting clinical benefit. This article aims to summarize the principles of bioethics and strategies for applying an ethical framework to the allocation of drugs on shortage.