Soon after completing my basic medical degree, MBBS, in 1983, I worked as a house-officer under a physician in a mission hospital in Kerala. One day a patient was admitted with chronic failure of both kidneys. The physician called me and told me that the patient had been admitted for nursing care, and would soon die, and that no attempt should be made to resuscitate him. He told me that the patient had no chance of a transplant and had exhausted all his resources on dialysis. His family had spent as much as they could, and they were heading towards pauperisation. The physician had counselled the patient to accept death to prevent the disintegration of the family.