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In 1996, a meningitis epidemic swept across Nigeria. Thousands of children were struck and, lacking appropriate medicine, were liable to die from the disease. Doctors at Pfizer had an antibiotic that could probably save most of these children's lives. The drug was new, however, and had not yet undergone clinical trials with children. The company must decide whether to use the Nigerian outbreak as the site for a new and potentially risky trial.

In 2002, a handful of entrepreneurs began to ship drugs from Canada into the United States, taking advantage of regulatory and price differentials across the neighboring countries. Using the Internet and a low-cost network of Canadian pharmacies, firms like Rx Depot allowed U.S. customers to order their prescription medications in the United States, purchase them at a substantial discount from prevailing U.S. prices, and deliver the medications directly to their homes. It was a powerful business model that made Rx Depot a prominent player. In November 2003, however, a U.S. court decreed that Rx Depot violated federal law. The company was forced to close, but its founder, Carl Moore, announced that he was ready to fight. Did Rx Depot simply breech U.S. laws of intellectual property? Or did its actions suggest that the laws were ready for change?