Opening Remarks on Astronaut Health Reports by NASA Deputy Administrator Shana Dale


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July 27, 2007

In the wake of former astronaut Lisa Nowak's arrest in February 2007, the Astronaut Health Care System Review Committee was formed when NASA Administrator Mike Griffin directed the Agency's Chief Health and Medical Officer, Dr. Richard Williams, to conduct a review of the medical and behavioral health services available to NASA astronauts at the Johnson Space Center. The Review Committee, chaired by Air Force Colonel Richard Bachmann, Commander of the US Air Force School of Aerospace Medicine, was comprised of eight representatives of other federal agencies. Let me take a moment to acknowledge the important work done on such short notice, with great dedication and time commitment, by members of the Astronaut Health Care System Review Committee. You'll hear from Col. Bachmann after I speak.

The first major issue is our need to revisit how to most effectively deliver medical and behavioral health care for NASA's astronauts. The Johnson Space Center (JSC) internal review, led by JSC Director Mike Coats, outlined and evaluated the Johnson Space Center's extensive health care programs for our astronauts, which includes their behavioral health, and recommended improvements to those programs, which we are going to implement. A more extensive behavioral health assessment will be added to annual flight physical examinations for all astronauts. We also are emphasizing the importance of behavioral health support to Shuttle crewmembers, and offering time with behavioral health providers before, during, and after flight. And, we are committed to improving the quality and usefulness of our psychological testing and assessment during the astronaut selection.

These enhancements are aimed at improving the psychological care and testing procedures for astronauts, which was the key focus of JSC's internal review. We thank Mike Coats and the team of experts who worked on this review, and we believe the resulting modifications will be good for the Astronaut Corps and for NASA.

NASA's Medical Policy Board, consisting of senior government medical experts from inside and outside NASA, will further assess the medical and behavioral findings and recommendations in the JSC internal review as well as the report of the external Review Committee. The board will provide advice on policy changes that will improve the NASA health care system, and will provide oversight of the implementation of those policies.

The second major area of NASA's focus is undertaken with the recognition that the members of our Astronaut Corps, civilian and military, represent a group of America's most extraordinary and talented individuals, by any standard. We take the recommendation of developing an astronaut code of conduct very seriously. It actually has been under discussion at NASA prior to this report. For almost the entire history of the astronaut corps, our experience has been that NASA's astronauts conduct themselves with integrity, professionalism, and a desire to bring honor to America and our Nation's space program. A written code of conduct, one that is initiated by the astronauts themselves, can only strengthen this commitment. We are looking at how such a process will be collaboratively implemented.

Third, we will examine the structure of the Astronaut Office, as the Review Committee report recommends, with a renewed interest in establishing what are referred to as, "enduring supervisor relationships." We plan to develop an anonymous survey to be completed by members of the Astronaut Corps and flight surgeons to initiate even more feedback on the findings and recommendations of the report in order to optimize supervisory relationships, health care delivery, and mission success. There may be other issues that astronauts are also interested in having resolved or clarified using this approach.

Fourth, we will act immediately on the more troubling aspects of the report, with respect to alcohol use and the anecdotal references to resistance of Agency leadership to accepting advice or criticisms about the fitness and readiness of individuals for space flight. The report does not provide specific information about alcohol-related incidents and the Review Committee has left it to NASA to determine the scope of these alleged incidents.

Let me bring you up to date on this fourth category, and share with you what has been done since the draft report was briefed to NASA senior management.

The Administrator and I have directed NASA's Chief of NASA's Office of Safety and Mission Assurance to undertake an internal safety review. He will gather information, conduct necessary analyses, and determine the facts of the reported alcohol-related incidents. If any incidents occurred, he will determine the causes and recommend corrective actions. He also will review all existing policies and procedures related to alcohol use and space flight crew medical fitness during the immediate preflight preparation period to ensure that any risks to flight safety are dealt with by appropriate medical authorities and flight crew management, and, if necessary, elevated through a transparent system of senior management review and accountability.

In the meantime, NASA's existing T-38 aircraft alcohol use policy that historically has been applied to space flight has been explicitly extended as an interim policy to flight on any spacecraft. This interim policy prohibits alcohol use for 12 hours prior to flight and further states that astronauts will neither be under the influence nor the effects of alcohol at the time of launch. A comprehensive review of alcohol use policy prior to aircraft use or space flight in underway.

Mike Griffin and I will closely monitor progress on these issues. After the review is completed, it is our intention to share the findings with the public, to the maximum extent possible.

One final thought, much of the information contained in this report is, or comes from, anecdotal material. Whatever specific information the Astronaut Health Care System Review Committee obtained in the course of its study, if it is of a health nature, it is subject to rules of medical record privacy. Therefore the Review Committee has stated it cannot disclose this information. Having said that, we do intend to apply the lessons learned from this exercise, and to use this as an opportunity to move our culture closer to the optimum in responsiveness, care, professionalism, and performance integrity that we would all like to see.

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