SPACE MEDICINE AND THE LAW The beauty of the cosmos continually inspires wonder and curiosity. Throughout history, space has provided humanity with both practical benefits and fertile grounds for the imagination. Together with future generations, we will be the next explorers to unravel the mysteries of the universe [United Nations, 1999]. SpaceCurrent Developments inMedicine Air and Space Law and the Law Dr. Lily Srivastava* Space medicine involves understanding and dealing with physiological and psychological effects on human in space environment and to adopt the necessary counter-measures. Medically significant aspects of space travel include weightlessness, strong inertial forces during liftoff and re-entry, radiation exposure, absence of the day and night, and existence in a closed environment. Space medicine is concerned, for instance, with osteoporosis caused by weightlessness and the resultant increased risk of fracture.1 Space Medicine is a developing area of health care that has roots in aerospace medicine but that is focused on the health of individuals so that they can perform in, and return in good health from, increasingly distant extreme space environments, for example, from short-duration space flights, long-term space station flights, missions to the Moon, and in the next stages, exploration- class missions beyond Earth orbit, including missions involving planetary colonization [“Safe Passage”.2 Space medicine has at its core the purpose of supporting the mission of human flight into and exploration of space.3 In this paper, the terms space tourist, space passenger, private space explorer, and spaceflight participant will be used interchangeably, except where specifically denoted. Definition of Space Medicine in an Astrosociological Context Space medicine requires another complementary dimension. In the area of space medicine, then, a focus on biology and physiology alone misses the social dimension that includes ethics and social inequality. Space medicine represents one side of a single coin on which medical astrosociology exists on the other side. The two brought together create a complete perspective in space research, just as terrestrial medicine and medical sociology belong together on Earth... Medical astrosociology turns the attention of those interested in space medicine from a social-scientific perspective to a single new specialization.4 In 1948, nine years before Sputnik I, Col. Harry G. Armstrong, convened a panel to discuss “Aero medical Problems of Space Travel.” The panel discussion included presentations by Hubertus Strughold and Heinz Haber, two of the German physicians, and commentary from six noted university and military * Dr. Lily Srivastava, Assistant Professor in Law, S.J.N.PG College, Lucknow, contact at [email protected]. Space Medicine and the Law 285 scientists. At this panel, Strughold first coined the term “space medicine in 1948. Later, through the excellence of his work, Dr. Hubertus Strughold (1898-1986) is nicknamed as the “Father of Space Medicine.” He was a co-founder of the Space Medicine Branch of the Aerospace Medical Association in 1950. In 1963, the Space Medicine Branch initiated the “Hubertus Strughold Award,” which is given each year for the greatest achievement in space medicine.5 Recently, physician/astronaut, Dr. Joe Ker win, a former executive at Wyle who flew aboard the 28-day Skylab 2 mission in 1973 is honored by the Aerospace Medical Association (AsMA) at its annual conference in Phoenix in May 2010 for his works advances in the understanding of human physiology during spaceflight and innovation in the practice of space medicine.6 Aviation medicine It is the study of the biological and psychological effects of aviation. Medically significant aspects of aviation travel include exposure to changing temperatures, large inertial forces, oxygen deprivation, and air sickness, as well as pilot fatigue. Aviation medicine is concerned, for instance, with the spread of disease by air travel and the adverse effects of noise and air pollution. Aerospace medicine The fields of medicine concerned with the maintenance of health, safety, and performance of those in aviation and space travel. Aerospace medicine is the sum of aviation medicine and space medicine-health in flight both inside and outside the Earth’s atmosphere. Aerospace medicine is a sub discipline of preventive and emergency medicine that ties together physics, life support, and medicine to protect aircrew and patients in the realm of aerospace.7 The ambient environment quickly becomes hostile to humans. From the earliest physiologic observations of balloonists in the 1700s to Paul Bert’s altitude chamber experiments in 1878 to the latest 2008 reports from the US Air Force School of Aerospace Medicine, our understanding of aerospace medicine has advanced exponentially. The US led War in Iraq and recent hurricanes and earthquakes have necessitated rapid advances in the technology and strategies available to rapidly evacuate critically wounded soldiers and large numbers of non ambulatory patients.8 The Indian Society of Aerospace Medicine was founded in 1952 with a charter to (a) advance the science and art of Aviation and Space Medicine, (b) establish and maintain co-operation between medical and other sciences concerned with aero medical development and progress and (c) promote, protect and maintain safety in Aviation and Space ventures. Towards furthering this cause the Society promotes the specialty by organizing annual conferences, facilitating its members to interact with specialists across the world, publishing a 286 Current Developments in Air and Space Law biannual Indian Journal of Aerospace Medicine and sponsoring research work to foster the spirit of the subject.9 Astro-scientist Prof. K. Kasturirangan has called for introducing Space medicine as a subject in medical courses in view of the tremendous potential in the field, he stated “In a space environment, the human beings face micro-gravity condition, it makes the flow of body fluids such as blood different from what we are accustomed to on the surface of the earth. This in turn alters the quantity and distribution of body fluid, being free of the gravitational effect.’’10 To provide necessary support to the Human Space Programme (HSP) of ISRO, the Institute of Aerospace Medicine IAF Bangalore has defined the following areas of work.11 (a) Selection of Vehicle Crew and Training. (b) Environment Control and Life Support System (ECLSS). (c) Human Engineering Work Station Design for Crew Module. (d) Isolation and Psychological Management. (e) Human Factors considerations in Manned Space programme. (f) Microgravity Research. (g) Gravitational Stress Management in various Phases of Space Flight. (h) Clinical Space Medical and Surgical Management. (j) Radiation Protection. (k) Toxicology in Space. (l) Emergency Survival System Design. (m) Space Station Life Support System. (n) Extra Vehicular Activity (EVA) Design. (o) Heat Stress Management. (p) Operational Space Medicine. (q) Scientific and Technical Manpower Management. (r) Infrastructure Development related to aero medical Support. NASA and Aerospace Medicine The successful launch of Earth’s first artificial satellite by the Soviet Union on October 4, 1957, was the initial step in a series of events that made the State of Texas the home of the United States manned space-exploration program, for a combined total presence in space of more than 70 years.12 Sputnik I provided the impetus for President Dwight D. Eisenhower to propose and Congress to approve the National Aeronautics and Space Act, which was signed into law on July 29, 1958.After World War II, 130 German scientists and engineers, led by Space Medicine and the Law 287 Werner von Braun, were brought to the United States and stationed at Fort Bliss in El Paso, Texas, to continue their work on rockets. Aerospace Medicine and Manned Space flight Project Mercury provided confidence in the ability of the astronaut to perform satisfactorily in the weightless environment and in the capability of the spacecraft environmental-control system to support life in space. In 1963, at the height of Project Mercury, had grown to 2,500 civil-service employees, but only about 500 supported Project Mercury. The rest of the employees were involved in preparing for the Gemini and Apollo projects. Project Gemini included twelve manned space flights. The Gemini spacecraft, launched by a modified Titan missile, carried two astronauts. The two longer flights, Gemini V (eight days) and Gemini VII (almost fourteen days), included nine medical experiments designed to investigate the problems identified during the Mercury missions. These experiments provided an opportunity for the medical community outside NASA to participate in the space-flight experiment program. The biomedical results of Apollo were impressive. The Skylab missions, which occurred between May 1973 and February 1974, differed significantly from all previous manned missions. From its inception, Skylab was intended to be a science program. The final flight of an Apollo spacecraft took place on July 15, 1975. The Apollo-Soyuz Test Project was a nine-day international mission; the first shuttle orbital flight was launched on April 12, 1981. Commanded by John W. Young with pilot Robert L. Crippen, this mission was a flight test of the Space Shuttle Columbia. The shuttle program was an outstanding success. Its performance was even better than anticipated until January 27, 1986, when the shuttle