Saskatchewan: present day. A young family is out for the day, only this is no ordinary family. Doug Ramsay, 42, stands atop a firetower, next to Keith Martel, 27. An employee at the hardware store Doug owns, Keith has always been more of a surrogate son. That Keith has Down's syndrome is of little concern to Doug; his own daughter, Tina, 12, has severe cerebral palsy. On this fine autumn day, Tina sits in her wheelchair by the foot of the tower, her mother Sandra, beside her. Both watch as Doug and Keith release a kite-like bird in the air, then race down to see who can reach the ground first. Despite their child-like glee and the festive atmosphere, Tina doesn't respond. The Ramsays head home, haing tried to engage Tina as best as they could.

Keith heads off on his bike, passing a caravan of trucks heading into town to set up a carnival. Doug and Sandra do their best to stimulate, to no avail. The moving windshield wipers she once loved to watch have no visible effect on her. But Doug is determined to do what he can to alleviate the pain his daughter is enduring. He wantts to take Tina fishing, but stops by the post office to pick up an herbal remedy that might help. Doug Ramsay is clearly not the type to try herbs, but it's clear he's willing to give anything a shot. As he fishes with Tina he makes a vow he will never break: she will not undergo any further operations. The previous ones, including steel rods in her back, have taken their toll, and as far as Doug is concerned, there is nothing the medical community can now offer his daughter.

Keith has another agenda all together: he'd love nothing more than to go to the carnival with Tina, as they've done in the past. But Sandra quickly dismisses the idea, in light of Tina's deteriorating state. Tina's condition is what spurs Doug to come up with a proposition Sandra has a hard time refusing: more time at home with TIna, less time at his hardware store. He's confident Keith can help out at the store in his absence, provided he's overseen by Darrell, a young man who's made it a past time to tease Keith behind Doug's back (not to mention steal hardware supplies).

Doug's plans to spend more time with Tina at home are quickly doused at Tina's check up. Doug and Sandra are told in no uncertain terms that Tina must undergo another operation to help her cope with her pain, a "salvage procedure" in which part of her thigh bone is removed.

And thus begins Doug's slow, internal journey, where he moves toward the decision to take Tina's life rather than subject her to further medical intervention and months of rehab. Yet everything seems to conspire to box Doug in as he retreats toward a small piece of emotional landscape where he feels he, and he alone, must bear what he believes is a terrible responsibility. Keith's entreaties to go to the carnival suddenly take on a new meaning, as Doug begins to realize Tina deserves whatever joy the carnival might bring, given what is to follow. When Sandra reminds him that they have to visit the rehab center where Tina will reside after the operation Doug plays along, unwilling to burden his wife with his decision, yet confident she would understand; she has spoken of her own desires that perhaps she'll die in her sleep.

Doug's private journey takes an unexpected turn when he's told that Tina's operation will be happening in a matter of days. Whatever plans he had to end Tina's life are suddenly put front-and-centre. Thus his insistence that they take Tina to the carnival, despite Sandra's concerns.

The carnival. Bright lights, bad food, and a ferris wheel that dominates the Prairie sky. Keith is in heaven, but Tina is oblivious to it all. As Doug sits in a ferris wheel seat high above the fair grounds, with Keith at one end and Tina between them Doug hums to his beloved daughter, desperate to find a sign he is getting through. By the time he is standing at her bedroom door that evening, it is clear Doug has decided to act in what he believes is his daughter's best interest.

The next morning, as Sandra goes to church, Doug prepares for his final hours with Tina. If he believes it's a fated act, then fate has a way of making sure it will not be an easy task. Vera, one of Sandra's closest friends, shows up carrying Team Tina hockey sweatshirts for Doug, Sandra and Tina herself. Team Tina, Vera tells Doug, is made up of a group of women who have agreed to lend a helping hand once Tina is in rehab.

Determined to stay the course, Doug leaves Tina in Vera's care as he heads off to the hardware store to get some tools he needs. Just as he cuts some rubber hose Keith walks into the store, looking for some paint to complete the bird house he's building for Tina, to house the mourning dove he's carving. Doug manages to get rid of Keith. He returns to the house, thanks Vera for her help, then drives his daughter into a back shed, where he rigs the rubber hose from the exhaust pipe of his pickup to the cab in front. He tells Tina he loves her, then steps out of the truck.

Sandra returns from church...and discovers Tina lying in her bedroom. At first she is in shock. By the next morning — shortly after Keith has hammered in Tina's new bird house — Sandra has taken an axe to the shed doors where Doug had killed their daughter. She is in a fury, caught in a torrent of emotions she can barely put words to. At first, Doug doesn't intervene, but then he finally steps in, stepping over an emotional fracture that will soon drive him and Sandra apart. Keith is in no better shape. His grief curdles into bewilderment when he overhears the truth behind Tina's death: that she did not die peacefully in her sleep, as he had been lead to believe, but was 'gassed' by her own father. The police, of course, have been hearing the same rumours. An autopsy is ordered, and it falls upon Craig Pierce, a police officer and good friend of the Ramsays, to arrest Doug Ramsay.

Doug's arrest promptly makes national headlines. A posse of national reporters descend on his home town. Sacks of mail — largely supportive — flood the post office. But the only reaction that seems to have any bearing on Doug's life are those belonging to those he holds dearest: Sandra and Keith. Ultimately, Sandra decides she can no longer live with the man she still loves. With their daughter gone, Sandra feels Tina's absence will become a permanent void in any life they shared.

Keith's response is more instinctive. Shortly after hearing how Tina was killed, and having witnessed Doug cut the rubber hose, Keith takes matters in his own hands and metes out his own defintion of justice by torching Doug's hardware store. He then flees to the very firetower seen off the top of the film, only to be confronted by Doug himself, who is out on bail and believes the arsonist to be Darrell. When Doug learns otherwise from Keith, he's blindsided emotionally, but determined to explain to Keith why he did what he did. The meeting on top of the firetower takes an unexpected turn when Doug attempts to return Keith's carving knife. Keith misinterprets the gesture and is convinced Doug is trying to kill him, too. The two men struggle, then collapse into each other's arms. As Keith struggles to understand why Doug did what he did to the daughter he claims to love, Doug reverses an earlier decision and decides to take the stand at his own trial.

By then, of course, it's too late, insofar as Doug has already received a verdict that's all together different from the one the judge delivers shortly afterwards — ten years in prison without parole. Doug's real sentence, from his perspective, is a life without his wife by his side and his surrogate son nearby.