in one ongoing extramural project, only 11 of 18 crew members agreed to participate in a project that involves noninvasive imaging (echo and magnetic resonance imaging) and ambulatory monitoring (Holter and blood pressure) of cardiovascular function; one participant dropped out 2 weeks before the flight. Similarly, in an ongoing intramural project that is evaluating a new evidence-based exercise prescription to minimize loss of muscle, bone, and cardiovascular function during ISS missions, only 3 of the first 6 crew members invited to participate were enrolled. Mission managers, who often have limited research background and are not incentivized to place a priority on research, control crew availability and make decisions concerning crew scheduling that can compromise research studies and outcomes, even when acceptable alternatives to these competing activities are available.
To address these systemic problems and restore the high priority of NASA’s life and physical sciences research program over the next decade, the following steps are important.
• Recognition of the need for a change of attitude and commitment to life and physical sciences research throughout the agency is essential. To reflect a vision that life and physical sciences research is central to NASA’s space exploration mission, research must be viewed as a priority. It is essential that every employee, from management through crew, subscribe to the view that a key objective of the organization is to support and conduct life and physical sciences research as an essential translational step in the execution of space exploration missions.
• Acknowledging life and physical sciences research as an integral component of spaceflight operations. For research to become a central component of exploration programs, it is necessary to develop a culture in which participation in research, both as a subject of investigation and as a surrogate investigator, is viewed as a fundamental element of the astronaut mission. Many crew members already display this attitude, and they frequently go to extraordinary lengths to participate in research studies in partnership with the extramural research community. However, the level of autonomy given to astronauts to choose whether or not to participate in research activities is surprising and inappropriate, given the scarce opportunities for human research in space. In addition, many types of experiments require specialized scientific or technical expertise to make knowledgeable observations, measurements, and judgments. It is important to optimize very limited opportunities to gain a better understanding of the effects of the space environment on human health, safety, and performance, and on systems that reduce risk and optimize performance, because such information will define the future limits of space exploration.
One possible solution is to include not only scientific and technical expertise but also willingness to participate in research that enables future space exploration as part of crew selection in the planning of specific mission assignments, and perhaps even as part of the astronaut selection process. Such an approach would define research participation as one of the responsibilities of an astronaut. The priority of research can also be reinforced during the training of ground support personnel (e.g., flight directors, mission controllers, training managers, and instructors).
Requiring astronauts to participate in research as part of a mission may generate questions about such issues as coercion and privacy rights. However, it is reasonable and ethical that, if research participation is defined as a component of being an astronaut, then the consequence of choosing not to participate would be understood to result in a different assignment. Astronauts would have to accept the risk of loss of confidentiality, with respect to data collected for research purposes, along with the many other risks associated with spaceflight. This approach would remain aligned with the Federal Policy for the Protection of Human Subjects.4 Because the NASA exploration mission is of national importance, research opportunities to advance this agenda become part of strategic decisions. This philosophy is consistent with that embodied in the National Aeronautics and Space Act of 1958,5 the Institute of Medicine (IOM) report Safe Passage,6 and the NRC report A Strategy for Research in Space Biology and Medicine in the New Century.7
• The collection and analysis of a broad array of physiological and psychological data from astronauts before, during, and after a mission is necessary to advance knowledge of the effects of the space environment on human health and to improve the safety of space exploration. As discussed below (see “Improved Access to Samples and Data From Astronauts”), ensuring the health, safety, and performance of astronauts during future space exploration will depend on the existence of comprehensive databases on astronaut health and performance. In addition to data collected from distinct research projects, such databases would ideally be populated with operational data collected during missions and with medical data obtained before, during, and after exposure to the space environment; extensive follow-up data will be necessary to understand the potential long-term effects