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Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
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A

Meeting Agendas

COMMITTEE ON ETHICS PRINCIPLES AND GUIDELINES FOR HEALTH STANDARDS FOR LONG DURATION AND EXPLORATION SPACEFLIGHTS

National Academy of Sciences Building, Room 125
2101 Constitution Avenue, NW
Washington, DC 20001

OPEN SESSION – May 30, 2013

10:45 – 11:15 a.m. Welcome and Introductions

Carol Scott-Conner, Chair, IOM Standing Committee on Aerospace Medicine and the Medicine of Extreme Environments

Jeffrey Kahn, Chair, IOM Committee on Ethics Principles and Guidelines for Health Standards for Long Duration and Exploration Spaceflights

 
11:15 a.m. – 12:00 p.m. Charge to the New Committee

Richard Williams, Chief Health and Medical Officer, NASA

Jeffrey Davis, Director, Human Health and Performance Directorate, Johnson Space Center, NASA

 
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
12:00 – 1:00 p.m. Committee Discussion with NASA Staff
 
Lunch
 
1:00 – 1:30 p.m. NASA and the Importance of Risk Charles Bolden, Administrator, NASA
 
1:30 – 3:15 p.m. Risk Acceptance and Health Standards
 

1:30 – 1:50 p.m.

NASA Risk Acceptance – George Gafka, Chief, Safety Officer, International Space Station Program, NASA

 

1:50 – 2:10 p.m.

NASA Health Standards – David Liskowsky, Director, Medical Policy and Ethics, NASA

 

2:10 – 2:30 p.m.

Ethics of Standard Setting – Paul R. Wolpe, Bioethicist, NASA

 

2:30 – 3:15 p.m.

Discussion

 
3:15 – 3:30 p.m.

Break

 
3:30 – 5:00 p.m.

Specific Health Issues

 

3:30 – 4:15 p.m.

Radiation – Francis A. Cucinotta, Chief Scientist, NASA Space Radiation

 

4:15 – 5:00 p.m.

Ocular and Intracranial Pressure –

Dave Francisco, Program Integration Manager, Human Health and Performance, NASA

Terrance Taddeo, Chief, Space and Clinical Operations Division, NASA

 
5:00 – 5:30 p.m.

Revisit the Statement of Task and Questions for NASA Staff

 
5:30 p.m. Adjourn
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×

COMMITTEE ON ETHICS PRINCIPLES AND GUIDELINES
FOR HEALTH STANDARDS FOR LONG DURATION AND
EXPLORATION SPACEFLIGHTS

National Academy of Sciences Building, Room 120
2101 Constitution Avenue, NW
Washington, DC 20001

OPEN SESSION – July 25, 2013

8:00 – 8:05 a.m. Welcome
Jeffrey Kahn, Committee Chair
 
8:05 – 8:30 a.m.

Decision Making in the Context of Uncertainty

Harvey V. Fineberg, Institute of Medicine

 
8:30 – 9:25 a.m.

Panel 1: Risk Acceptance and Risk Management at NASA

Facilitator: Carol Scott-Conner, Committee Member

 

8:30 – 8:35 a.m.

Panel Introductions

 

8:35 – 8:50 a.m.

Evolution of Risk Management at NASA–Homayoon Dezfuli, NASA

 

8:50 – 9:05 a.m.

External Regulatory Framework for NASA Health Standards–David Liskowsky, NASA

 

9:05 – 9:25 a.m.

Discussion with the Committee

 

Panel Questions:

•   How has risk management evolved at NASA over the years?

•   What is the external regulatory framework under which NASA develops health standards?

Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×

•   How do OSHA, NRC, and other standards and regulations impact NASA standards and decision making?

•   Are risk considerations different for long duration and exploration missions? Does the risk management approach change?

 
9:25 – 10:35 a.m.

Panel 2: Perspective from the Astronaut Corps

Facilitator: Bonnie Dunbar, Committee Member

 

9:25 – 9:30 a.m.

Panel Introductions

 

9:30 – 10:10 a.m.

Perspectives on Risk Management and Risk acceptance

Peggy Whitson, NASA (via video conference)

Mike Barratt, NASA

Shannon Walker, NASA

Robert Behnken, NASA

 

10:10 – 10:35 a.m.

Discussion with the Committee
 

Panel Questions:

•   Are risk considerations different for long duration and exploration missions? Does the risk management approach change?

•   In light of the unknowns and uncertainties, how much risk can be taken? Who makes those decisions? What data and considerations go into those decisions?

•   What input do astronauts have into decisions regarding risk and health standards? What are the processes for that input?

 
10:35 – 10:50 a.m. Break
 
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
10:50 – 12:20 p.m.

Panel 3: Ethics Framework for Considering Health Standards for Long Duration and Exploration Spaceflights

Facilitator: Jonathan Kimmelman, Committee Member

 

10:50 – 10:55 a.m.

Panel Introductions
 

10:55 – 11:25 a.m.

Perspectives on an Ethics Framework–Laurie Zoloth, Northwestern University, and Paul Root Wolpe, Emory University/NASA (via video conference)
 

11:25 – 11:40 a.m.

Ethics, Risk, and Individual Differences–Alta Charo, University of Wisconsin–Madison (via video conference)
 

11:40 – 11:55 a.m.

Informed Consent in High-Uncertainty Contexts–David Wendler,National Institutes of Health
 

11:55 – 12:20 p.m.

Discussion with the Committee
 

Panel Questions:

•   What ethical principles and considerations should guide establishment and application of health standards concerning uncertain health effects of long duration and exploration spaceflight? What ethical framework can guide development and interpretation of such standards?

•   How does the nature of activities (e.g., exploration, directed mission, routine tasks) alter ethical evaluation of risk exposure in spaceflight? How should spaceflight agencies weigh the risks and benefits? Are there absolute limits on acceptable risk?

Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×

•   How can health standards be established in light of large uncertainties? Should current health standards be broadened for exploration missions? If so, what are the ethical considerations regarding how much risk can be taken?

•   What are the ethical considerations about the role of individual susceptibilities setting and applying health standards (e.g., age, gender, genetics)?

•   What issues regarding informed consent should the committee consider?

 
12:20 – 1:15 p.m. Working Lunch
 
1:15 – 2:30 p.m. Panel 4: Decision Making and Uncertain Risk: Learning from Other Occupations
Facilitator: Larry Palinkas, Committee Member
 

1:15 – 1:20 p.m.

Panel Introductions
 

1:20 – 1:35 p.m.

Professional Sports and High Degrees of Physical Risk–Sean Sansiveri, NFL Players Union (via video conference)
 

1:35 – 1:50 p.m.

Diving in Extreme Environments: The Scientific

Diving Experience–Michael A. Lang, American Academy of Underwater Sciences (via video conference)

1:50 – 2:05 p.m.

Psychological and Physical Health Risks at the

Circumpoles–Peter Suedfeld, University of British Columbia (via video conference)

 

2:05 – 2:30 p.m.

Discussion with the Committee
 

Panel Questions:

•   What is the purpose/benefit of activities in your field?

•   In general, what are the major known and uncertain risks in your field?

Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×

•   How/why do benefits outweigh these risks, justifying societal and individual acceptance of identified risks?

•   Are limits placed on individual acceptance of risk in your field? In other words, what criteria or health standards govern whether individuals are allowed to expose themselves to known or uncertain risks? Briefly describe the major standards/limitations. Do these standards/limitations change in the context of uncertain risk?

•   How are individuals informed about risks and benefits, and what are the processes for informed consent/decision making?

•   How have the risks changed in your field based on new evidence, the ability to detect risk, or improved protections (e.g., technological or engineering)? Give an example of how health standards/criteria have changed in light of new evidence about risk.

•   What lessons can NASA draw from your experiences?

 
2:30 – 2:45 p.m. Break
 
2:45 – 4:10 p.m.

Panel 5: Issues in Health Standard Implementation and Enforcement

Facilitator: Michael Silverstein, Committee Member

 

2:45 – 3:10 p.m.

Perspective on OSHA Standards–John Mendeloff, University of Pittsburgh
 

3:10 – 3:25 p.m.

FAA Medical Standards–Fred Tilton, Federal Aviation Administration

3:25 – 3:45 p.m.

Ethics, Risk, and the Problems with Trimming Radiation-Dose Data–Kristin Shrader-Frechette,
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
University of Notre Dame
 

3:45 – 4:10 p.m.

Discussion with the Committee
 

Panel Questions:

•   What laws and regulations govern health standard implementation and enforcement in your agency? What are these standards?

•   How are risks and benefits weighed in selection of health standards? In other words, what tips the balance between acceptable and unacceptable risk?

•   Are standards universally applied or tailored to individuals, and what are the associated ethical issues?

•   Can existing health standards be modified or waived? If so, under what circumstances can risk exposures exceed set standards and what is the rationale for allowing this?

•   Are there examples of how health standard selection or enforcement criteria have evolved in response to new evidence or shifts in culture?

•   What lessons can NASA draw from your experiences?

 
4:10 – 4:45 p.m. Public Testimony – Registered Speakers
Moderator: Jeff Kahn, Committee Member (3 minutes per speaker)
 
4:45 p.m. Public Session Adjourn
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
Page 155
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
Page 156
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
Page 157
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
Page 158
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
Page 159
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
Page 160
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
Page 161
Suggested Citation:"Appendix A: Meeting Agendas." Institute of Medicine. 2014. Health Standards for Long Duration and Exploration Spaceflight: Ethics Principles, Responsibilities, and Decision Framework. Washington, DC: The National Academies Press. doi: 10.17226/18576.
×
Page 162
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Since its inception, the U.S. human spaceflight program has grown from launching a single man into orbit to an ongoing space presence involving numerous crewmembers. As the U.S. space program evolves, propelled in part by increasing international and commercial collaborations, long duration or exploration spaceflights - such as extended stays on the International Space Station or missions to Mars - become more realistic. These types of missions will likely expose crews to levels of known risk that are beyond those allowed by current health standards, as well as to a range of risks that are poorly characterized, uncertain, and perhaps unforeseeable. As the National Aeronautics and Space Administration (NASA) and Congress discuss the next generation of NASA's missions and the U.S. role in international space efforts, it is important to understand the ethical factors that drive decision making about health standards and mission design for NASA activities.

NASA asked the Institute of Medicine to outline the ethics principles and practices that should guide the agency's decision making for future long duration or exploration missions that fail to meet existing health standards. Health Standards for Long Duration and Exploration Spaceflight identifies an ethics framework, which builds on the work of NASA and others, and presents a set of recommendations for ethically assessing and responding to the challenges associated with health standards for long duration and exploration spaceflight.As technologies improve and longer and more distant spaceflight becomes feasible, NASA and its international and commercial partners will continue to face complex decisions about risk acceptability. This report provides a roadmap for ethically assessing and responding to the challenges associated with NASA's health standards for long duration and exploration missions. Establishing and maintaining a firmly grounded ethics framework for this inherently risky activity is essential to guide NASA's decisions today and to create a strong foundation for decisions about future challenges and opportunities.

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