NASA Procedural Requirements

NPR 8900.1B Effective Date: December 16, 2016 Expiration Date: September 08, 2025

Subject: NASA Health and Medical Requirements for Human Space Exploration

Responsible Office: Office of the Chief Health & Medical Officer

Appendix F. Ethical Principles and Responsibilities

F.1 Principles

a. Avoid harm—the principle includes the duty to prevent harm, exercise caution, and remove or mitigate harms that occur. All feasible measures should be taken to minimize the risks to astronauts from long-duration and exploration space flights, including addressing uncertainties through approaches to risk prevention and mitigation that incorporate safety margins and include mechanisms for continuous learning that allow for incremental approaches to risk acceptance.

b. Beneficence—the principle to provide benefit to others. The potential benefits of a specific mission including its scientific and technological importance, as well as its potential beneficiaries including, current and future astronauts and members of society at large should be considered in decision-making process regarding crew health standards.

c. Favorable balance of risk and benefit—the principle to seek both a favorable and acceptable balance between the risk of harm and potential for benefit. The risks and benefits of space exploration activities and the uncertainties attached to each should be systematically assessed, drawing on the totality of available scientific evidence, and ensuring that benefits sufficiently outweigh risks.

d. Respect for autonomy—the principle to ensure that individuals have both the right to self-determination and processes in place to exercise that right. Astronauts should be able to exercise that right. Astronauts should be able to exercise voluntariness to the extent possible in making personal decisions regarding participation in proposed missions, that they have all available information regarding the risks and benefits of the proposed mission, and that they continue to be apprised of any updates to risk and benefit information throughout the mission.

e. Fairness—the principle requires that equals be treated equally, that burdens and benefits be distributed fairly, and that fair processes be created and followed. Decision-making surrounding missions should explicitly address fairness, including the distribution of the risks and benefits of the mission, crew selection, and protections for astronauts after missions.

f. Fidelity—the principle recognizes that individual sacrifices made for the benefit of society may give rise to societal duties in return. Appropriate health care and medical oversight should be provided to astronauts participating in space missions.

F.2 Responsibilities

F.2.1 When appropriate, the following ethical responsibilities should be considered when developing, revising, and implementing health, human performance and medical standards, and when evaluating an exception to a health, human performance and medical standard as described in Appendix D:

a. Fully inform astronauts about the risks of long-duration and exploration space flights and make certain that the informed decision-making process is adequate and appropriate.

b. Adhere to a continuous learning strategy (including, health surveillance and data collection) to ensure that health, human performance and medical standards evolve and improve over time and are informed by data gained before, during, and after long-duration and exploration space flights, as well as from other relevant sources.

c. Solicit independent advice about any decision to allow any specific mission that fails to meet NASA health, human performance and medical standards or any decision to modify these standards.

d. Communicate with all relevant stakeholders the rationale for, and possible impacts related to any decision about health, human performance and medical standards in a procedurally transparent, fair and timely manner, providing adequate opportunity for public engagement.

e. Provide equality of opportunity for participation in long duration and exploration space flights to the fullest extent possible without jeopardizing mission operations.

f. Provide comprehensive health care and medical oversight for astronauts to protect their health, support ongoing evaluation of health, human performance and medical standards, improve mission safety, and reduce risks for current and future astronauts.

g. Develop and apply policies that appropriately and sufficiently protect the privacy and confidentiality of astronaut health data.

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