Profoundly immoral to openly extort very ill lady (4)
I believe the answer is:
evil
'profoundly immoral' is the definition.
(I've seen this before)
'openly extort very ill lady' is the wordplay.
I cannot quite understand how this works, but
'very' could be 'v' (common abbreviation) and 'v' is found in the answer.
The remaining letters 'eil' is a valid word which might be clued in a way I don't see.
This explanation may well be incorrect...
'to' acts as a link.
Can you help me to learn more?
(Other definitions for evil that I've seen before include "Malign" , "Very wicked or bad" , "Harmful; unlucky" , "Vile (anag) -- really bad" , "Live badly for badness" .)