 In order for an agent to count as using another, it is not enough that she do something to the other in order to realize some end of hers, some have suggested. She must also intend the presence or participation of some aspect of the other to contribute to the end’s realization (Scanlon 2008: 106–107; Guerrero 2016: 779). The usher does not intend the spectator’s presence or participation to play any role in her preventing the child from falling. She thinks of her simply as “in the way”. On one account, an agent uses another (or, equivalently, uses or treats another as a means) if and only if she intentionally does something to or with the other in order to realize her end, and she intends the presence or participation of the other to contribute to the end’s realization (Kerstein 2013: 58). On this account, an agent can count as using another when she is striving to benefit him. For example, a physician giving a patient a treatment to save his life is using the patient. Some find this implication of the account implausible (Parfit 2011:  222).[6]  Others do not, pointing to cases such as that of a physician using a patient in a study of a new drug in order to ameliorate the patient’s condition.