The introduction of the Surrogacy (Regulation) Bill, 2016 into Parliament, in August 2016, was a much-awaited response to citizen voices and human rights groups calling for action in the unregulated area of commercial surrogacy arrangements. Both houses of Parliament have reviewed the Bill, and its fate was to be decided in the Winter Session of Parliament, 2017. It is still unclear whether the Bill will come up for decision in the Budget Session that will reconvene on March 5, 2018. The market for infertility treatments has attracted to India global clients seeking access to surrogates and procedures at lower costs. The Bill seeks to protect the rights of women and children at risk of exploitation and commodification as third parties in infertility treatments that use assisted reproductive technologies. Can commercial surrogacy be allowed in a country where injustice, inequalities, and poorly implemented laws place vulnerable women and children at risk? The proposed Bill could shut the door on commercial surrogacy arrangements in India and bring regulation into this sector of medical services.

Research using Controlled Human Infection Models is yet to be attempted in India. This study was conducted to understand the perceptions of the lay public and key opinion makers prior to the possible introduction of such studies in the country. 110 respondents from urban and rural Bangalore district were interviewed using qualitative research methods of Focus Group Discussions and In-depth Interviews. The data was analyzed using grounded theory. Safety was a key concern of the lay public, expressed in terms of fear of death. The notion of infecting a healthy volunteer, the possibility of continued effects beyond the study duration and the likelihood of vulnerable populations volunteering solely for monetary benefit, were ethical concerns. Public good outcomes such as effective treatments, targeted vaccines and prevention of diseases was necessary justification for such studies. However, the comprehension of this benefit was not clear among non-medical, non-technical respondents and suggestions to seek alternatives to CHIMs repeatedly arose. There was a great deal of deflection—with each constituency feeling that people other than themselves may be ideally suited as participants. Risk takers, those without dependents, the more health and research literate, financially sound and those with an altruistic bent of mind emerged as possible CHIM volunteers. While widespread awareness and advocacy about CHIM is essential, listening to plural voices is the first step in public engagement in ethically contentious areas. Continued engagement and inclusive deliberative processes are required to redeem the mistrust of the public in research and rebuild faith in regulatory systems.

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In moments of grief, human beings seek solace and attempt to discover the meaning of life and death by reaching out to wider and deeper dimensions of existence that stem from their religious, cultural and spiritual beliefs. Conventional patient care fails to consider this vital aspect of our lives. Many hold the view that life and its experiences do not end with death; the body is but a sheath which holds the soul that inhabits it. The use of a protocol-based practice to create a solemn atmosphere around the departed individual can bridge the gap between the materialistic and non-materialistic perceptions of the dimensions of care. The innovative practice, "Code Krishna", is aimed at institutionalising a practice which sensitises and empowers the treating team to address the grief of the relatives of deceased patients, and respect the departed in consonance with the family's cultural, religious and spiritual beliefs. The practice entails the creation of a solemn atmosphere amidst the action-packed environment of the critical care unit at the time of the patient's death, offering of collective prayer and floral tributes, and observation of silence both by the healthcare team and family members. Code Krishna attempts to blend current care practices with spirituality, ensuring that the treating team is the first to commiserate with the grieving family, with warmth and openness. In this piece, we briefly report our first-hand experiences of practising Code Krishna in our hospital [Shree Krishna Hospital, Karamsad, Central Gujarat].

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