When Practicality Overrides Humanity: Should a critically-ill old person be put to sleep

Rajkumari Sharma Tankha

The other day, I was watching an episode, Sister Mariam’s Dilemma, from the show Zindagi Ke Crossroads on Sony TV. Off and on, I do follow this serial, as it presents complex moral issues through small fictional stories and then explores what a person caught in a difficult life situation should ideally do. The show thoughtfully weighs the pros and cons of various decisions, often leaving viewers introspecting long after the episode ends.

In this particular episode, the story revolves around a nurse, Mariam, portrayed as an exceptionally caring and helpful woman—so much so that she is fondly nicknamed “Robin Hood” by everyone around her.

Mariam is the head nurse at Lifecare Hospital, a strict disciplinarian and a stickler for rules. She is conscientious about her duties, imposing fines of ₹100 on ward boys, junior nurses, and doctors for even minor lapses. However, the money collected is not for personal gain; she uses it to buy food and medicines for the poor and needy—an act that reinforces her image as a compassionate caregiver.

Soon, two patients enter her life, setting the stage for a moral conflict. One is an elderly man placed on a ventilator, and the other, introduced later, is a young accident victim in urgent need of organ transplants to survive.

The story takes a dark turn when the old man’s son approaches Mariam with a shocking request: to switch off the ventilator so that his father dies within three days—allowing him to claim an insurance amount of ₹25 lakh before the policy lapses. Desperate, he pleads that the money will help him marry off his sisters and rebuild his life. He even offers Mariam a share of the amount, suggesting she can use it to help others, as she always does. To strengthen his case, he produces an organ donation form signed by his mother.

This sets Mariam thinking. Each day, she wrestles with the question—should she pull the plug?

As she grapples with this dilemma, the young accident victim arrives, critically ill, with failing organs. His parents plead with the doctors to save their son’s life. Suddenly, the situation appears to present a “solution”: the old man’s death could save the young man, secure financial stability for the old man’s family, and provide Mariam with funds to help the underprivileged.

“Pulling the ventilator off the old man can save a life, support a family, and allow me to help many more,” Mariam reasons.

And that is where the story becomes deeply unsettling.

Unable to gather the courage to physically switch off the ventilator, Mariam resorts to something far more disturbing. She begins visiting the old man and, instead of offering care or comfort, she repeatedly curses him. “Why don’t you die? Why are you clinging to life? Your death will help so many people,” she tells him—again and again.

This is not just unethical—it is profoundly inhuman.

We know that even when a patient is on a ventilator, the mind may still be aware. Healthcare professionals often advise caregivers to speak gently and reassuringly to such patients. It reinforces their sense of being wanted and loved, thereby strengthening their will to recover. Yet here is a nurse doing the exact opposite. She is shown scolding a helpless patient, blaming him for obstructing his son’s financial gain. Indirectly, she is favouring the survival of another patient.

While Mariam’s intention to help the poor and save another life might appear noble, doing so at the cost of an existing life raises serious ethical concerns. It almost seems as though the creators are suggesting that elderly individuals in critical conditions are dispensable—a message that is both troubling and dangerous.

What is even more disheartening is the discussion that follows the episode. Several participants opine that pulling the plug is a “practical” decision. The host, Ram Kapoor, echoes this sentiment, stating that practicality should guide such choices. He even mentions that he teach his kids to think practically rather than emotionally in challenging situations.

But what are we if we remove emotions from our psyche?

What kind of times are we living in? Are we gradually turning into robots?

I do not deny that there are moments in life when practicality is necessary—perhaps even unavoidable. But can practicality justify playing with someone else’s life, regardless of age or illness?

Parents, after all, never differentiate between their children or consider abandoning them in times of critical illness. They fight, often against all odds, to save their child. Why then does it become so difficult for children to extend the same unconditional care and commitment to their parents?