Who Does ER in Space?
The Space Diplomacy Newsletter-Event Tracker
There is not, in case you are wondering, an ambulance on standby that rushes up in a medical emergency to take someone speedily to a medical facility nearby or back down on Earth. The first-ever evacuation of astronauts from the International Space Station (ISS) by NASA is an opportunity to reflect on the field of space medicine, which will affect whether visions of millions of people living and working in space in the long run will materialize.
An opportunity to learn came my way last year when I first began to grapple with space medicine and policy, and the role of universities in training young physicians to become space doctors. The process raised broader questions for me about the integration of medical and health systems as well as capable responders in the overall space mission. We know how a civilian agency like NASA will act in an ER situation (it stabilizes and will rescue), and it has demonstrated its prioritization of medical safety and privacy for just one of its ailing astronauts out of a total of four Crew-11 astronauts. But what about private corporations, particularly those poised to replace the aging ISS with commercial space stations in the not-too-distant future?
Take the company Vast, for example, which is projected to be one of the successors to the ISS. Much of what we have to say about the medical and health policy responses of VAST or any of the other projected commercial space station ventures for that matter – Starlab, Axiom station, Orbital Reef, Gravitics – is speculative as none of them have operational space stations with people just yet.
But we can see what they are doing. VAST, which distinguishes between sovereign and private astronauts is scheduled to launch its first “state-of-the-art, human-centric” single-module space station called Haven-1 in May 2026. Vast has given some concrete design thought for people to stay healthy through exercises, and there is some information on the availability of medical monitoring tools on board. The company is also taking steps towards creating an artificial gravity station over time, which should dissipate some of the severe health problems associated with microgravity. But if I am a private astronaut now, I would want to know whether there is going to be a medical facility and care on board in the event of, say, an infection or a sudden cardiac arrest.
One remarkable achievement of the ISS is its record of zero fatalities over 25 years. Hopefully that record continues, but the model of “stabilize and evacuate” may be reaching its limits as is the space station itself. We will need functioning and dedicated medical facilities, manned by physicians up to the task. All this will take time. But thinking through the mechanics of medical care and ER in commercial space stations is worthwhile. It could be a diplomatic selling point in going after those sovereign and private astronauts around the world. So does this mean one of these enterprising private space station companies should consider transforming into a permanent medical and ER location in the interest of a spacefaring community...?
