Table 6 Reasons and comments by the development partners (from the in-depth study) and survey respondents.

Survey Respondents:

Severity

Save life. Severity is most important, all factors being equal. Treat the severely ill to save life. It does not matter whether or not treatment is cost-effective. Treat severely ill if he will recover. Give benefit to the severely ill irrespective of other conditions

Cost-effectiveness

Treat the less severely ill because the severely ill might die anyway.

Equal distribution

It is unethical to treat one person and not the other. Treat both patients because it is unethical to withhold treatment however expensive.

In-depth interviews:

"Our goal is to get maximum benefit out of our money" "Cost-effectiveness is extremely important, we have money for value evaluation" "Cost-effectiveness is very important, we have the history from the United States" "It is important because we have to give an account to the government that support us" "Since we are not a donor organisation, this is important to us" "Cost-effectiveness is considered but does not over rule other criteria" "Cost-effectiveness is usually a work of economists who have never seen a suffering patient, they see just figures. You cannot tell someone who is sick that you are not in my package"

Other reasons

There are other considerations, e.g. age, social factors, if one of them is scheduled for execution due to a crime and is to be executed within 2 days, I would not treat him. Treat disease that affects many people although it may not be severe (or cost-effective). Treat one with less costly treatment Treat one who is likely to recover from treatment whatever the cost. The decision of who to treat involves more than just cost-effectiveness Difficult to decide.