Operational Considerations for Crew Fatality on the International Space Station.

BACKGROUND: While catastrophic spaceflight events resulting in crew loss have occurred, human spaceflight has never suffered an on-orbit fatality with survival of other crewmembers on board. Historical plans for management of an on-orbit fatality have included some consideration for forensic documentation and sample collection, human remains containment, and disposition of remains; however, such plans have not included granular detailing of crew or ground controller actions. The NASA Johnson Space Center Contingency Medical Operations Group, under authority from the Space and Occupational Medicine Branch, the Space Medicine Operations Division, and the Human Health and Performance Directorate, undertook the development of a comprehensive plan, including an integrated Mission Control Center response for flight control teams and Flight Surgeons for a single on-orbit crew fatality on the International Space Station (ISS) and subsequent events. Here we detail the operational considerations for a crew fatality should it occur during spaceflight onboard the ISS, including forensic and timeline constraints, behavioral health factors, and considerations for final disposition of decedent remains. Future considerations for differential survival and crewmember fatality outside of low-Earth orbit operations will additionally be discussed, including consideration of factors unique to planetary and surface operations and disposition limitations in exploration spaceflight. While the efforts detailed herein were developed within the constraints of the ISS concept of operations, future platforms may benefit from the procedural validation and product verifications steps described. Ultimately, any response to spaceflight fatality must preserve the goal of handling decedent remains and disposition with dignity, honor, and respect. Stepaniak PC, Blue RS, Gilmore S, Beven GE, Chough NG, Tsung A, McMonigal KA, Mazuchowski EL II, Bytheway JA, Lindgren KN, Barratt MR. Operational considerations for crew fatality on the International Space Station . Aerosp Med Hum Perform. 2023; 94(9):705-714.