Monday, August 10, 2009

Medical ethics in space

It is great that NASA now has a chief of bioethics. As humans start having a permanent presence in space and start thinking about a mission to Mars (yes, yes - we have to go!!), we have to get ready to face difficult ethical questions and perhaps to think in ways we are not used to. Here is an interview with NASA's chief of bioethics, Paul Root Wolpe:

Q. MOST BIOETHICISTS WORK IN HOSPITALS. HOW IS THE NASA JOB DIFFERENT?

A. In an earth-based medical situation, the priority is the health and well-being of the patient. On a spaceship, that has to be balanced with the health and well-being of the other crew members and the success of the mission itself. Ethics in space are more of a balancing act. You need to weigh a series of priorities and figure out which is paramount.

Imagine you had a severely injured astronaut on the surface of Mars — or a dead body. American soldiers will put themselves at great risk to retrieve a dead body. On Mars, you have a different situation. You might be endangering the entire mission by trying to retrieve the body. In that case, you might recommend that it be left behind, even if that is against our ethical traditions.

Or what do you do if someone has a psychotic episode while in space?

I’ve written that there has to be medication and restraints on the craft. If you have to restrain the person for a long period of time, you have to do it. You can’t thank the person for their service to the country and put them out into space. You can’t medicate them to insensibility for a year and a half. You have to find a reasonable way to manage the situation.

For a mission to Mars, lasting at least a year and a half, astronauts will definitely encounter difficult medical questions. I think there is plenty of room for an excellent screenplay to explore some of these issues. Anyone? Anyone?

And then here is an answer that brings up religion directly:

Q. WHAT WAS THE MOST UNUSUAL QUESTION NASA HAS POSED TO YOU?

A. It wasn’t an ethical question, it was a religious one. My father, the late Gerald Wolpe, was a rabbi, as are two of my brothers. There had been an Israeli on the crew of the Columbia shuttle. After it broke up, NASA wanted to know about Jewish religious standards in regard to gathering and interring remains. NASA teams were recovering pieces of bodies on the ground in Texas and Louisiana, much of it unidentifiable. And NASA wanted to know if the Israeli government would want only Ilan Ramon’s flesh returned to it because, if so, NASA would have to do genotyping of every piece of tissue. That would take months.

I told them there were countervailing values. In Judaism you bury the body as soon as possible. I didn’t think the Israelis would want to have months and months pass.

I’ve since heard that a lot of the tissue buried in the various graves of these astronauts was unidentified. There’s something touching that some of what is buried in each of their resting places is tissue from all of them.

This actually made me think of Sagan's bit on us all being ultimately made up of star-stuff. Recycled matter recycling again.

Read the full interview here.

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