Finding: Because of concerns about astronaut privacy, data and biological specimens that might ensure the health and safety of the astronaut corps for long-duration missions have not been analyzed. If these data and other data to be accumulated in the future are to be used to facilitate medical planning for the unique sets of pressures and extreme environments that astronauts will experience on long-duration space missions, the ethical concerns about astronaut privacy must be appropriately modified.

An unfortunate side effect of the overemphasis on individual astronaut privacy may be that future astronauts will be required to undergo observation and experimental investigations that would have been unnecessary if data from past space missions were available and had been analyzed. Repeating research or data collection, particularly if there is a risk to the participants in doing so, adds to the burdens placed on astronauts and is unjustified on grounds of individual privacy. Furthermore, whenever possible all of the data relevant to long-duration travel should be assembled and examined before the design of new protocols for such travel.

Earth-Based Analogs for Balancing Medical Confidentiality with Public Health

There is a long history of balancing individual rights against the health of the public in the monitoring and control of communicable diseases. Disclosure of limited aspects of individual medical data to public health authorities is required for some diseases such as measles and syphilis; in the case of drug-resistant tuberculosis, disclosure of individual medical data can lead to substantial limitations of privacy. These disclosures are based on the following rationale. If a physician is treating a patient for an illness that could affect in a substantive way either the general population or the local population to which the patient will return, the physician is justified in balancing the public health risks against the private needs of the patient. If the public health risk is particularly pressing, the boundaries of confidentiality may be loosened in a manner proportionate to the public health risk.

In another example, a physician may observe that several patients who are all working in a nearby factory each exhibit similar signs and symptoms. The physician may suspect that the work environment is causing or contributing to the health problems. If so, the physician has a duty to investigate the workplace for the source of the illness, even if doing so may require limited disclosure of information about the workers. Again, the severity of the risk



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