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Discussion Guide and Transcript
Season Two - Episode One
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Research Ethics Reimagined Season Two - Episode One “Ethics in Orbit with Rachael Dempsey”
- In this episode of PRIM&R's podcast, "Research Ethics Reimagined, Ethics in Orbit" we explore the frontiers of space health research. Our guest is Rachael Dempsey, Chief Operations and Communications Officer at the Translational Research Institute for Space Health (TRISH), who discusses the ethical challenges and scientific opportunities of human space exploration. (Transcript available) Listen on Spotify | Listen on Apple| Listen on Amazon
Discussion Questions
- 1.) Human Health in Space Exploration
- Rachael Dempsey describes the unique challenges of sending humans on long-duration missions beyond Earth orbit. What are the most significant health risks astronauts face during extended space travel, and how are researchers working to address them?
- As commercial spaceflight opens opportunities for "normal" humans rather than just highly trained astronauts to travel to space, what new research questions arise about how different bodies respond to microgravity?
2.) Research Ethics in Space
- The EXPAND program collects health data from civilian space travelers. What ethical considerations are important when conducting research with this unique population, and how does TRISH balance privacy concerns with scientific advancement?
- Dempsey describes establishing a joint IRB specifically for the EXPAND program. How might research oversight for space-based studies differ from traditional Earth-based research, and what lessons might traditional IRBs learn from this model?
3.) Benefits Beyond Space: Lessons for Healthcare on Earth
- How might the health monitoring technologies developed for space exploration benefit medical care and public health on Earth?
- What examples demonstrate how space health research contributes to solving terrestrial challenges?
Key Terms and Acronyms
TRISH (Translational Research Institute for Space Health): A NASA-funded consortium led by Baylor College of Medicine with consortium partners Caltech and MIT, focused on developing health solutions for humans in space.
EXPAND Program: A TRISH initiative that collects health data from civilian participants in commercial spaceflights to increase understanding of how different human bodies respond to space conditions.
Microgravity: The condition in which people or objects appear weightless, experienced during spaceflight when gravitational force is significantly reduced.
Radiation Exposure: A significant health risk in space exploration that occurs when astronauts are exposed to cosmic rays and solar radiation, potentially causing cellular damage, increased cancer risk, and other health issues.
EXPAND Program: A TRISH initiative that collects health data from civilian participants in commercial spaceflights to increase understanding of how different human bodies respond to space conditions.
Microgravity: The condition in which people or objects appear weightless, experienced during spaceflight when gravitational force is significantly reduced.
Radiation Exposure: A significant health risk in space exploration that occurs when astronauts are exposed to cosmic rays and solar radiation, potentially causing cellular damage, increased cancer risk, and other health issues.
Additional Resources
- Translational Research Institute for Space Health - Official website for TRISH with information about space health research initiatives.
- How the Human Body Changes in Space - For years, TRISH has supported research projects and studies that aim to solve the challenges of human exploration in space. To understand how to solve those challenges, we first must know the risks to human health during space travel. Understanding these risks and finding solutions or countermeasures is essential for a return to the moon in NASA’s Artemis missions and, eventually, crewed missions to Mars.
- NASA Human Research Program - NASA program focused on investigating and mitigating the greatest risks to human health during space exploration.
- International Space Station Research and Development - Information about research conducted on the International Space Station.
- PRIM&R's Research Ethics Timeline - A resource for exploring the milestones of research ethics, including developments in space research.
Transcript
Transcript, Season Two - Episode One: “Ethics in Orbit with Rachael Dempsey”
Host: Robert Nobles, PhD
Guest: Rachael Dempsey, TRISH
A transcript generator was used to help create written show transcript. Written transcript of podcast is approximate and not meant for attribution.
Robert Nobles: Good day, everyone. Welcome to this edition of Research Ethics Reimagined, a podcast by the Public Responsibility in Medicine and Research. I'm your guest host, Dr. Robert Nobles. I serve as the vice president for research administration at Emory University and had a wonderful six years serving on the board of PRIM&R, just leaving at the end of 2024. I'm very happy to be your guest host today and to welcome our speaker from the PRIM&R Annual Conference.
Today, we are venturing beyond our usual conversations into the cosmos—literally. Our guest is Rachael Dempsey, the chief operations and communications officer at the Translational Research Institute for Space Health, also known as TRISH. TRISH is at the forefront of safeguarding human health in space science, working alongside NASA and leading institutions like the Baylor College of Medicine, MIT, and Caltech to tackle the challenges of long-duration space travel. Many of our institutions have engaged in space exploration through human subjects trials to better understand what the human body can endure.
Rachael shared a lot of information as a keynote speaker in Seattle at the PRIM&R Annual Conference this past November. She plays a key role in bridging science, research, and communication to ensure that as humanity reaches for the stars, we do so ethically, safely, and with the well-being of all explorers in mind. Today, we'll break down some of the big questions about the future of space travel—how we keep our astronauts healthy on journeys into deep space and how private individuals are now venturing into space. We’ll also explore how space exploration helps us here on Earth and the ethical considerations of this next frontier.
So without further ado, let me welcome you, Rachael Dempsey, to this podcast and give you an opportunity to tell the audience a little bit about yourself before we jump into the questions.
Rachael Dempsey: Thank you so much for that introduction. I'm so happy to be here. I was really excited when you reached out and wanted to keep the conversation going in this podcast format so we can dive deeper into some of these topics—and also say hi to all the people I didn’t get to meet in Seattle. Robert Nobles: That’s awesome. I think what’s on a lot of people’s minds is: What got you into the field? What drew you to space health research?
Rachael Dempsey: It’s been an interesting path. I come from the communications sector—I was a journalist and led nonprofits, working in communications and strategic business. Our executive director reached out and said, “I don’t know if you ever knew this was a job, but we need a communications person to work in space health.” My eyes were just blown open. I didn’t know we needed space doctors, never thought about it before, and never thought too hard about the research that goes into it.
It was a real conversation internally—am I up for the challenge? Things are progressing so rapidly that we need all sorts of careers and people to solve these big challenges. I’ve got a 14-year-old who has never seen a day without humans living and working in space. The jobs he might go for one day probably don’t even exist yet.
Robert Nobles: Absolutely. The world is changing so fast. It reminds me of a time when I was with my kids—I have three boys—and we were leaving a hotel room. The youngest one said, “Hey, can you pause the TV so we can finish watching this when we come back?” The oldest one had to explain that it was regular TV—we couldn’t pause it. They were so confused!
It’s amazing how much space exploration has influenced everyday technology. So that brings me to a question: What has surprised you the most in your years working in space health and exploration? What’s the story you share with family and friends that makes them say, “Wow, I had no idea”?
Rachael Dempsey: People generally love the concept of space—it sparks the imagination and drives innovation. But people often don’t think about their own bodies in that context. What does it mean to put a fragile human body into space? We are the weakest part of the machine, yet one day one of us will be the first to put footprints on Mars. We’re about to send more humans back to the moon. It’s crucial to understand what space does to the body and how we can protect those future explorers.
Robert Nobles: Absolutely. It makes me wonder—have you ever heard of astronauts asking, “Are we there yet?” because those capsules are so small. It’s like driving cross-country in a golf cart.
Rachael Dempsey: Exactly! It’s a long, cramped, and sometimes boring journey. It’s as safe as we can make it, but I personally would need a lot of entertainment for a three-year mission to Mars.
Robert Nobles: So how is space changing for human exploration?
Rachael Dempsey: Humans have been living and working in space for over 20 years thanks to the International Space Station and its predecessors. We have a good understanding of what happens to the body in low Earth orbit for up to a year. We know how to solve most of those challenges, and if there’s ever an emergency, we can bring astronauts back down to Earth for medical care.
But when we start thinking about longer-duration missions—going back to the moon or heading to Mars—we face new challenges. What supplies do we take? How many band-aids? How much aspirin? Will the medications we bring be damaged by radiation? We’re moving into entirely new radiation environments and tackling questions we haven’t answered yet. Research is doing its best to keep pace, addressing known challenges while staying open to the unknowns that will inevitably arise.
Robert Nobles: It’s all about anticipating future needs.
Rachael Dempsey: Exactly. We list the risks, prioritize them based on likelihood and consequence, and tackle the most critical ones first. But there will always be unknowns. How do we train future astronaut medical officers to handle everything once they’re off Earth? If there’s no coming back to see a specialist, how do we ensure they’re prepared for every possible medical situation?
Robert Nobles: How are you and your colleagues thinking about commercial spaceflight and the shifting frontier of getting individuals who are not trained astronauts into space?
Rachael Dempsey: It’s such an exciting time right now. The growth in exploration and the renewed interest and excitement around space travel are incredible. What we’re seeing is a dramatic increase in the number of commercial sector launches, providing greater access to space for more people than ever before.
We’re now able to send more “normal” humans—people who aren’t your typical astronaut candidates. These aren’t necessarily the perfectly fit, super-healthy individuals traditionally selected for space travel. We’re opening the door for people with more diverse physical profiles, and that raises fascinating questions: What does space do to a normal body? How does microgravity affect people with pre-existing conditions?
Historically, space programs have had the obligation to prioritize safety. They’ve been able to choose the fittest candidates—people without pre-existing conditions, who don’t need medication for blood pressure or sleep. But are those individuals really representative of all humankind? Certainly not.
At Trish, we recognized the opportunity to learn more about how different kinds of bodies respond to microgravity and how they adapt once they return to Earth. We want to gather as much data as we can from these missions, even if they’re shorter than the usual trips to the International Space Station (ISS).
Robert Nobles: That’s fascinating. I’m curious—and I’m sure our audience is too—about the work you’re doing at Trish. Could you provide some examples of the scientific questions you’re exploring with astronauts and civilian participants? What kind of data are you collecting?
Rachael Dempsey: Absolutely! There’s a whole field of research dedicated to this. NASA and other international space programs conduct a lot of science in space, and astronaut crews often volunteer for human research studies. In many ways, they become their own test subjects, contributing invaluable data.
At Trish, we launched a program called Expand, which aims to increase our understanding of the human body in space through commercial spaceflights involving civilian participants. We start by collecting baseline data from participants who consent to research—things like cognition tests—and we measure these at multiple stages: pre-flight, post-flight, and immediately after landing. This lets us track changes across multiple missions and flyers.
We compile all this data into a research database and compare it to what NASA measures with their government astronauts. This apples-to-apples comparison helps us grow our knowledge about how different bodies react to space.
We’re also studying cognitive performance—how the brain handles stress, for instance. Space travel is inherently stressful: it’s dangerous, you’re working all the time, and your sleep gets disrupted because you see multiple sunrises and sunsets every day. All of this impacts cognitive function, and we track these changes through daily surveys.
The hope is that what we learn from space travel could eventually help people on Earth. For example, we could apply this knowledge to high-performing teams in extreme environments—like submarines or oil rigs—by developing tools to monitor their cognitive health and performance under stress.
Robert Nobles: That’s such a crucial connection—what we explore in space often has applications here on Earth. What techniques do astronauts and civilian participants use to stay balanced and maintain their well-being in space?
Rachael Dempsey: When you’re on the ISS, you have certain advantages. You can call home, even have video calls. NASA has an entire office dedicated to supporting astronaut well-being—they set up special calls and unique opportunities to keep morale high. Cargo resupply missions bring fresh food, like oranges or M&Ms, and personal letters from loved ones—those small comforts make a huge difference.
But as we look toward more distant missions, like going to Mars, we’ll lose some of those support systems. That’s why it’s so important to study how humans cope with isolation, stress, and extreme environments now, so we can develop strategies to support future space travelers.
We're definitely going to lose the opportunity for fresh food and resupply, so if you scratch a couple of things that really help your mental health when you're on the space station for a really long time, what are you going to fill that gap with?
Robert Nobles: Very true. Are they growing their own food?
Rachael Dempsey: They do at the International Space Station, yeah—lettuces, plants, lots of different things. But how is that going to work for Mars? Especially when you have to look at the constraints of mass, power, volume, how much water you’re going to have to bring, and making sure all of it can be recycled.
It's really interesting—and we haven’t even picked what vehicle is going to go. I don’t know what rocket is going to take them, so I can't even tell you what the space constraints are going to look like. For example, we know you're going to have to exercise for an hour and a half to two hours a day. But what kind of exercise machine will we be able to fit? Will it be stretches? Jogging?
Robert Nobles: Both? But, you know, how do we come up with new ways to solve that challenge? It’s really interesting.
Rachael Dempsey: Exactly—and keeping your muscles and your bones strong is critically important. There’s a device now called the ARED machine—the Advanced Resistive Exercise Device. You’re pulling against resistance bands, you're kind of strapped down to the station, and using resistance to keep your muscles and bones in good working condition to the best of your ability.
Because keep this in mind—if you're on a really long mission and say you’re exercising only an hour and a half a day and your muscle tone starts to slip a little bit over time—what do you do when you land? You get to be that first person on Mars, and now it's time to throw open the hatch. You’ve got to walk. You’ve got to get out somehow. How do we make sure you're ready to plant your foot and stay stable when you get there?
You’ve been living three solid years as a human with no gravity, and now you're back. It’s a different gravitational effect, but it’s still going to be different.
Robert Nobles: I would imagine we would be heavy on our feet.
Rachael Dempsey: Exactly. You see this when astronauts come back from stays at the International Space Station. They literally do a test where they walk a straight line—blue tape on the floor, one foot in front of the other—and they record it to see how quickly their balance returns. They’re often swinging wildly because they’ve adapted to microgravity and lost the signals their bodies use to move in normal gravity. Now they’ve got to learn how to adjust back.
Robert Nobles: That is so true. Okay, all right—so let's...
Rachael Dempsey: We got in the weeds!
Robert Nobles: No, no—I love it! It makes me wonder: if you were going to take your son to space—if you got the golden ticket—how would you prepare him and yourself? What would be the top five things you’d want to be prepared for? What would you tell him?
Rachael Dempsey: That’s a great question because you have to think like that. What do you pack? What do you prepare for? One thing we’re thinking about—and I’d definitely want to get into my son’s hands—is a system like HAL. We want to make a computer system that can passively monitor the health of individuals. We already have so many health sensors and matrices on Earth. We want to deploy more of those in space—and we want them to be passive, using cameras and sensors to track your gait, body composition, temperature.
We want a system that passively alerts you when something’s off—like if it looks like you’ve got a fever, need to take vitamins, or are starting to lose too much weight. That way, we’re not entirely reliant on calling mission control. Once you're on your way to Mars, you’re your own planet. There’s no turning around. You have to be prepared to handle everything that could go wrong right there on the ship. How do we give that crew the medical training and decision support they’ll need?
I think having a system like that would be huge—even on Earth. I’d love a system that monitors me and tells me when I should see a doctor. Imagine using it in hospital rooms—helping nurses by passively tracking patients' vitals and flagging when something’s wrong.
Robert Nobles: 100% agree. I have an Oura ring just for that—to monitor stats at night.
Rachael Dempsey: Exactly! And it has to be passive. It can’t get in your way—it just has to happen automatically, flagging issues when things start going wrong. That’s one less thing you’d have to worry about.
Robert Nobles: That makes a lot of sense. What trinket would you bring to ground you—to remind you that you're a space explorer but still keep you connected to home?
Rachael Dempsey: Oh my gosh—if my son were going, I’d send him with Mouse Mouse. It’s a now-16-year-old, beat-up raccoon doll—his very favorite childhood item. I think it’s got to be something like that. Something that works on a behavioral health level and reminds you of the people who can’t come with you—and maybe won’t even be able to talk to you. There’ll be communication delays—and maybe entire blackouts.
Imagine knowing with 100% certainty that there are no humans anywhere near you—and you’re the farthest human from the rest of us. That’s kind of wild.
Robert Nobles: It really is. I’m trying to think of places on Earth where you’d feel that isolated—maybe some national parks?
Rachael Dempsey: Yeah—some national parks.
Robert Nobles: I used to go on cruises just to have no Wi-Fi and no communications. But then they built Wi-Fi and communications on cruises.
Rachael Dempsey: It’s lovely when you can disconnect like that!
Robert Nobles: Ha! So true. Okay—let’s talk about risks: microgravity, radiation, isolation, and the human impacts of being in space. What are the biggest questions researchers are trying to answer now as we prepare for longer journeys—like going to Mars?
Rachael Dempsey: Right now, the name of the game is extending what we know and coming up with solutions for the challenges we can anticipate. Radiation is a good example. Once you get past the Van Allen Belt and Earth’s magnetic shield, you’re exposed to radiation levels we haven’t seen since the Apollo missions to the moon. It’s been so long—we need fresh data there.
We also need new ways to shield against radiation because long-term exposure can damage your cardiovascular system, harm your cells, increase lifetime cancer risks, and affect cognition. It’s all this radiation bombarding you—and we need to figure out how to protect space travelers.
As we look toward more distant missions—like going to Mars—we’ll lose some of the support systems we rely on now. That’s why it’s so important to study how humans cope with isolation, stress, and extreme environments, so we can develop strategies to support future space travelers.
I would say that’s one of the biggest challenges — balancing the mechanistic understanding of how radiation works, how it affects the human body, and how it impacts different individuals — with the engineering component of protecting astronauts. How do we shield? What do we shield? How do we build a ship around our human cargo that helps alleviate those risks? For example, where do we put the water, since water is actually really good at shielding radiation?
Robert Nobles: Right. But lead is heavy.
Rachael Dempsey: Exactly — and lifting heavy materials costs a lot of money in rocket fuel just to get it off the ground. It’s a fascinating challenge.
Robert Nobles: I’m sure you use dosimeters, right? We use them here on Earth for radiation protection as well.
Rachael Dempsey: Yes, we’ve done studies with planes taking polar routes — flying over the ice caps — where the magnetosphere is thinner. We send dosimeters on those flights to measure radiation exposure. We’ve also used them in our EXPAND program, capturing radiation data on shorter-duration commercial space missions. Polaris Dawn, I believe, went the farthest so far and included a spacewalk. Taking a dosimeter on that mission provided us with an invaluable new radiation data point.
Robert Nobles: That’s amazing. Given our audience’s interest in ethics, I’m curious about how Trish approaches ethical review. When you collaborate with academic institutions, do you typically use their institutional review boards (IRBs), or does Trish have its own ethical review infrastructure for internal research?
Rachael Dempsey: Trish is primarily a research funding agency, so most of our work involves academics submitting proposals that are reviewed by their home institutions' IRBs. That’s the standard approach, and it works well. But when we launched the EXPAND program — which was entirely novel — we had to create new ethical frameworks. We established a joint IRB for all EXPAND research, ensuring consistent oversight by reviewers familiar with the constraints of spaceflight. This structure also makes it easier to adapt studies as new opportunities arise and different crews consent in or opt out of various research elements.
Standing up the EXPAND program was an incredible feat — we did it in just 22 or 23 months. The amount of work we accomplished to get our first study onto the Inspiration4 mission was extraordinary. Now, we’re sitting on a wealth of data contributed by commercial crews who’ve voluntarily participated in expanding scientific knowledge. Managing that data ethically is a top priority for us. We’ve established a data review board composed of experts to ensure that access to these samples is granted responsibly and that we make the best possible research decisions while moving forward quickly and ethically.
Robert Nobles: With all this data from space travelers, I imagine there are challenges around privacy. Eventually, someone gets sick or experiences discomfort, and not everyone is comfortable sharing that kind of information. How do you manage participants’ health data, keep them informed, and balance ethical oversight with scientific discovery?
Rachael Dempsey: That’s a critical part of our process. Preparing for space travel is a long journey, and part of that includes detailed conversations between Trish, the commercial crews, and the providers. We explain what participating in this research entails — how their data will be used, how we’ll keep it private, what controls they’ll have, and the guarantees we can offer. We also lay out the risks and limitations. Participants take the time to review all of this, reflect on it, and then decide whether to consent.
We’re incredibly grateful that more and more civilians are choosing to contribute their data and samples in the name of science. We do everything possible to anonymize and code their information so we can’t easily tie specific data points — like a heart rate spike — to a particular individual.
Robert Nobles: That’s admirable. It’s wonderful to see people’s altruism and willingness to contribute to something bigger than themselves.
Rachael Dempsey: Absolutely. It’s inspiring. And we owe it to them to handle their data with the utmost care and responsibility.
Robert Nobles: Let’s talk about funding. Trish’s work is clearly ambitious and expensive. Where does your funding come from, and what potential funding sources are you looking at to support future space exploration?
Rachael Dempsey: Great question. Research is expensive, and that often flies under the radar. Trish is funded through a cooperative agreement with the NASA Human Research Program, which covers our core academic research initiatives. But when we saw the opportunity to launch the EXPAND program and build a commercial research database, we partnered with commercial providers who donate their time and effort to integrate research into their missions.
Some of these missions are privately funded — like the Polaris program founded by Jared Isaacman, who flew on the Inspiration4 mission and recently on Polaris Dawn. It’s a mix of funding sources, and we’re always looking for ways to collaborate with commercial providers to ensure that every spaceflight carries meaningful scientific research.
Robert Nobles: It would be a wasted opportunity otherwise.
Rachael Dempsey: Exactly. It feels irresponsible to spend billions on space travel without contributing knowledge that benefits humanity.
Robert Nobles: And the benefits of space research reach far beyond space.
Rachael Dempsey: They really do. Every dollar spent on space research is spent here on Earth, and everything we learn has real-world applications. Studying radiation in space, for example, helps us better protect radiation workers on Earth — like radiologists and cell tower technicians. Our research on behavioral health and stress in space can inform support for people working in high-stress environments on Earth, like remote medical teams or people working in isolated conditions.
Robert Nobles: Even water recycling technology from space has Earth-based benefits.
Rachael Dempsey: Exactly. The innovations we develop for astronauts often lead to breakthroughs that improve life on Earth.
Robert Nobles: What excites you most about the future of space exploration and health research?
Rachael Dempsey: The pace of progress and the sheer number of flights happening now are incredibly exciting. It feels like we’re witnessing the start of a new era of exploration — the opportunity to be first at so many things all over again. I’m also thrilled to be part of important conversations about the ethics of space exploration. How do we ensure the knowledge we gain benefits all of humanity and isn’t limited to just one nation?
On a personal note, I’ve been fascinated by the development of space law — like the Artemis Accords and the International Astronaut Compact. The idea that there are professionals whose careers revolve around shaping legal frameworks for space exploration is just so cool.
Robert Nobles: That’s incredible. So, if you had to make one final pitch for why space exploration and health research are vital, what would it be?
Rachael Dempsey: We do this because humans are explorers. We push boundaries — where we live, where we work, what we discover. Space exploration teaches us what our bodies are capable of and how to protect and support human life as we venture farther. Solving these challenges today enables everything that will come tomorrow. It opens the door to possibility.
Robert Nobles: It gives us so much hope. Thank you, Rachael, for sharing your insights and passion. And to our podcast community — thank you for joining us on this journey of imagination and discovery. I’m Robert Nobles, signing off with heartfelt gratitude and appreciation for the work Rachael and Trish are doing to move us forward. Thank you all.
Today, we are venturing beyond our usual conversations into the cosmos—literally. Our guest is Rachael Dempsey, the chief operations and communications officer at the Translational Research Institute for Space Health, also known as TRISH. TRISH is at the forefront of safeguarding human health in space science, working alongside NASA and leading institutions like the Baylor College of Medicine, MIT, and Caltech to tackle the challenges of long-duration space travel. Many of our institutions have engaged in space exploration through human subjects trials to better understand what the human body can endure.
Rachael shared a lot of information as a keynote speaker in Seattle at the PRIM&R Annual Conference this past November. She plays a key role in bridging science, research, and communication to ensure that as humanity reaches for the stars, we do so ethically, safely, and with the well-being of all explorers in mind. Today, we'll break down some of the big questions about the future of space travel—how we keep our astronauts healthy on journeys into deep space and how private individuals are now venturing into space. We’ll also explore how space exploration helps us here on Earth and the ethical considerations of this next frontier.
So without further ado, let me welcome you, Rachael Dempsey, to this podcast and give you an opportunity to tell the audience a little bit about yourself before we jump into the questions.
Rachael Dempsey: Thank you so much for that introduction. I'm so happy to be here. I was really excited when you reached out and wanted to keep the conversation going in this podcast format so we can dive deeper into some of these topics—and also say hi to all the people I didn’t get to meet in Seattle. Robert Nobles: That’s awesome. I think what’s on a lot of people’s minds is: What got you into the field? What drew you to space health research?
Rachael Dempsey: It’s been an interesting path. I come from the communications sector—I was a journalist and led nonprofits, working in communications and strategic business. Our executive director reached out and said, “I don’t know if you ever knew this was a job, but we need a communications person to work in space health.” My eyes were just blown open. I didn’t know we needed space doctors, never thought about it before, and never thought too hard about the research that goes into it.
It was a real conversation internally—am I up for the challenge? Things are progressing so rapidly that we need all sorts of careers and people to solve these big challenges. I’ve got a 14-year-old who has never seen a day without humans living and working in space. The jobs he might go for one day probably don’t even exist yet.
Robert Nobles: Absolutely. The world is changing so fast. It reminds me of a time when I was with my kids—I have three boys—and we were leaving a hotel room. The youngest one said, “Hey, can you pause the TV so we can finish watching this when we come back?” The oldest one had to explain that it was regular TV—we couldn’t pause it. They were so confused!
It’s amazing how much space exploration has influenced everyday technology. So that brings me to a question: What has surprised you the most in your years working in space health and exploration? What’s the story you share with family and friends that makes them say, “Wow, I had no idea”?
Rachael Dempsey: People generally love the concept of space—it sparks the imagination and drives innovation. But people often don’t think about their own bodies in that context. What does it mean to put a fragile human body into space? We are the weakest part of the machine, yet one day one of us will be the first to put footprints on Mars. We’re about to send more humans back to the moon. It’s crucial to understand what space does to the body and how we can protect those future explorers.
Robert Nobles: Absolutely. It makes me wonder—have you ever heard of astronauts asking, “Are we there yet?” because those capsules are so small. It’s like driving cross-country in a golf cart.
Rachael Dempsey: Exactly! It’s a long, cramped, and sometimes boring journey. It’s as safe as we can make it, but I personally would need a lot of entertainment for a three-year mission to Mars.
Robert Nobles: So how is space changing for human exploration?
Rachael Dempsey: Humans have been living and working in space for over 20 years thanks to the International Space Station and its predecessors. We have a good understanding of what happens to the body in low Earth orbit for up to a year. We know how to solve most of those challenges, and if there’s ever an emergency, we can bring astronauts back down to Earth for medical care.
But when we start thinking about longer-duration missions—going back to the moon or heading to Mars—we face new challenges. What supplies do we take? How many band-aids? How much aspirin? Will the medications we bring be damaged by radiation? We’re moving into entirely new radiation environments and tackling questions we haven’t answered yet. Research is doing its best to keep pace, addressing known challenges while staying open to the unknowns that will inevitably arise.
Robert Nobles: It’s all about anticipating future needs.
Rachael Dempsey: Exactly. We list the risks, prioritize them based on likelihood and consequence, and tackle the most critical ones first. But there will always be unknowns. How do we train future astronaut medical officers to handle everything once they’re off Earth? If there’s no coming back to see a specialist, how do we ensure they’re prepared for every possible medical situation?
Robert Nobles: How are you and your colleagues thinking about commercial spaceflight and the shifting frontier of getting individuals who are not trained astronauts into space?
Rachael Dempsey: It’s such an exciting time right now. The growth in exploration and the renewed interest and excitement around space travel are incredible. What we’re seeing is a dramatic increase in the number of commercial sector launches, providing greater access to space for more people than ever before.
We’re now able to send more “normal” humans—people who aren’t your typical astronaut candidates. These aren’t necessarily the perfectly fit, super-healthy individuals traditionally selected for space travel. We’re opening the door for people with more diverse physical profiles, and that raises fascinating questions: What does space do to a normal body? How does microgravity affect people with pre-existing conditions?
Historically, space programs have had the obligation to prioritize safety. They’ve been able to choose the fittest candidates—people without pre-existing conditions, who don’t need medication for blood pressure or sleep. But are those individuals really representative of all humankind? Certainly not.
At Trish, we recognized the opportunity to learn more about how different kinds of bodies respond to microgravity and how they adapt once they return to Earth. We want to gather as much data as we can from these missions, even if they’re shorter than the usual trips to the International Space Station (ISS).
Robert Nobles: That’s fascinating. I’m curious—and I’m sure our audience is too—about the work you’re doing at Trish. Could you provide some examples of the scientific questions you’re exploring with astronauts and civilian participants? What kind of data are you collecting?
Rachael Dempsey: Absolutely! There’s a whole field of research dedicated to this. NASA and other international space programs conduct a lot of science in space, and astronaut crews often volunteer for human research studies. In many ways, they become their own test subjects, contributing invaluable data.
At Trish, we launched a program called Expand, which aims to increase our understanding of the human body in space through commercial spaceflights involving civilian participants. We start by collecting baseline data from participants who consent to research—things like cognition tests—and we measure these at multiple stages: pre-flight, post-flight, and immediately after landing. This lets us track changes across multiple missions and flyers.
We compile all this data into a research database and compare it to what NASA measures with their government astronauts. This apples-to-apples comparison helps us grow our knowledge about how different bodies react to space.
We’re also studying cognitive performance—how the brain handles stress, for instance. Space travel is inherently stressful: it’s dangerous, you’re working all the time, and your sleep gets disrupted because you see multiple sunrises and sunsets every day. All of this impacts cognitive function, and we track these changes through daily surveys.
The hope is that what we learn from space travel could eventually help people on Earth. For example, we could apply this knowledge to high-performing teams in extreme environments—like submarines or oil rigs—by developing tools to monitor their cognitive health and performance under stress.
Robert Nobles: That’s such a crucial connection—what we explore in space often has applications here on Earth. What techniques do astronauts and civilian participants use to stay balanced and maintain their well-being in space?
Rachael Dempsey: When you’re on the ISS, you have certain advantages. You can call home, even have video calls. NASA has an entire office dedicated to supporting astronaut well-being—they set up special calls and unique opportunities to keep morale high. Cargo resupply missions bring fresh food, like oranges or M&Ms, and personal letters from loved ones—those small comforts make a huge difference.
But as we look toward more distant missions, like going to Mars, we’ll lose some of those support systems. That’s why it’s so important to study how humans cope with isolation, stress, and extreme environments now, so we can develop strategies to support future space travelers.
We're definitely going to lose the opportunity for fresh food and resupply, so if you scratch a couple of things that really help your mental health when you're on the space station for a really long time, what are you going to fill that gap with?
Robert Nobles: Very true. Are they growing their own food?
Rachael Dempsey: They do at the International Space Station, yeah—lettuces, plants, lots of different things. But how is that going to work for Mars? Especially when you have to look at the constraints of mass, power, volume, how much water you’re going to have to bring, and making sure all of it can be recycled.
It's really interesting—and we haven’t even picked what vehicle is going to go. I don’t know what rocket is going to take them, so I can't even tell you what the space constraints are going to look like. For example, we know you're going to have to exercise for an hour and a half to two hours a day. But what kind of exercise machine will we be able to fit? Will it be stretches? Jogging?
Robert Nobles: Both? But, you know, how do we come up with new ways to solve that challenge? It’s really interesting.
Rachael Dempsey: Exactly—and keeping your muscles and your bones strong is critically important. There’s a device now called the ARED machine—the Advanced Resistive Exercise Device. You’re pulling against resistance bands, you're kind of strapped down to the station, and using resistance to keep your muscles and bones in good working condition to the best of your ability.
Because keep this in mind—if you're on a really long mission and say you’re exercising only an hour and a half a day and your muscle tone starts to slip a little bit over time—what do you do when you land? You get to be that first person on Mars, and now it's time to throw open the hatch. You’ve got to walk. You’ve got to get out somehow. How do we make sure you're ready to plant your foot and stay stable when you get there?
You’ve been living three solid years as a human with no gravity, and now you're back. It’s a different gravitational effect, but it’s still going to be different.
Robert Nobles: I would imagine we would be heavy on our feet.
Rachael Dempsey: Exactly. You see this when astronauts come back from stays at the International Space Station. They literally do a test where they walk a straight line—blue tape on the floor, one foot in front of the other—and they record it to see how quickly their balance returns. They’re often swinging wildly because they’ve adapted to microgravity and lost the signals their bodies use to move in normal gravity. Now they’ve got to learn how to adjust back.
Robert Nobles: That is so true. Okay, all right—so let's...
Rachael Dempsey: We got in the weeds!
Robert Nobles: No, no—I love it! It makes me wonder: if you were going to take your son to space—if you got the golden ticket—how would you prepare him and yourself? What would be the top five things you’d want to be prepared for? What would you tell him?
Rachael Dempsey: That’s a great question because you have to think like that. What do you pack? What do you prepare for? One thing we’re thinking about—and I’d definitely want to get into my son’s hands—is a system like HAL. We want to make a computer system that can passively monitor the health of individuals. We already have so many health sensors and matrices on Earth. We want to deploy more of those in space—and we want them to be passive, using cameras and sensors to track your gait, body composition, temperature.
We want a system that passively alerts you when something’s off—like if it looks like you’ve got a fever, need to take vitamins, or are starting to lose too much weight. That way, we’re not entirely reliant on calling mission control. Once you're on your way to Mars, you’re your own planet. There’s no turning around. You have to be prepared to handle everything that could go wrong right there on the ship. How do we give that crew the medical training and decision support they’ll need?
I think having a system like that would be huge—even on Earth. I’d love a system that monitors me and tells me when I should see a doctor. Imagine using it in hospital rooms—helping nurses by passively tracking patients' vitals and flagging when something’s wrong.
Robert Nobles: 100% agree. I have an Oura ring just for that—to monitor stats at night.
Rachael Dempsey: Exactly! And it has to be passive. It can’t get in your way—it just has to happen automatically, flagging issues when things start going wrong. That’s one less thing you’d have to worry about.
Robert Nobles: That makes a lot of sense. What trinket would you bring to ground you—to remind you that you're a space explorer but still keep you connected to home?
Rachael Dempsey: Oh my gosh—if my son were going, I’d send him with Mouse Mouse. It’s a now-16-year-old, beat-up raccoon doll—his very favorite childhood item. I think it’s got to be something like that. Something that works on a behavioral health level and reminds you of the people who can’t come with you—and maybe won’t even be able to talk to you. There’ll be communication delays—and maybe entire blackouts.
Imagine knowing with 100% certainty that there are no humans anywhere near you—and you’re the farthest human from the rest of us. That’s kind of wild.
Robert Nobles: It really is. I’m trying to think of places on Earth where you’d feel that isolated—maybe some national parks?
Rachael Dempsey: Yeah—some national parks.
Robert Nobles: I used to go on cruises just to have no Wi-Fi and no communications. But then they built Wi-Fi and communications on cruises.
Rachael Dempsey: It’s lovely when you can disconnect like that!
Robert Nobles: Ha! So true. Okay—let’s talk about risks: microgravity, radiation, isolation, and the human impacts of being in space. What are the biggest questions researchers are trying to answer now as we prepare for longer journeys—like going to Mars?
Rachael Dempsey: Right now, the name of the game is extending what we know and coming up with solutions for the challenges we can anticipate. Radiation is a good example. Once you get past the Van Allen Belt and Earth’s magnetic shield, you’re exposed to radiation levels we haven’t seen since the Apollo missions to the moon. It’s been so long—we need fresh data there.
We also need new ways to shield against radiation because long-term exposure can damage your cardiovascular system, harm your cells, increase lifetime cancer risks, and affect cognition. It’s all this radiation bombarding you—and we need to figure out how to protect space travelers.
As we look toward more distant missions—like going to Mars—we’ll lose some of the support systems we rely on now. That’s why it’s so important to study how humans cope with isolation, stress, and extreme environments, so we can develop strategies to support future space travelers.
I would say that’s one of the biggest challenges — balancing the mechanistic understanding of how radiation works, how it affects the human body, and how it impacts different individuals — with the engineering component of protecting astronauts. How do we shield? What do we shield? How do we build a ship around our human cargo that helps alleviate those risks? For example, where do we put the water, since water is actually really good at shielding radiation?
Robert Nobles: Right. But lead is heavy.
Rachael Dempsey: Exactly — and lifting heavy materials costs a lot of money in rocket fuel just to get it off the ground. It’s a fascinating challenge.
Robert Nobles: I’m sure you use dosimeters, right? We use them here on Earth for radiation protection as well.
Rachael Dempsey: Yes, we’ve done studies with planes taking polar routes — flying over the ice caps — where the magnetosphere is thinner. We send dosimeters on those flights to measure radiation exposure. We’ve also used them in our EXPAND program, capturing radiation data on shorter-duration commercial space missions. Polaris Dawn, I believe, went the farthest so far and included a spacewalk. Taking a dosimeter on that mission provided us with an invaluable new radiation data point.
Robert Nobles: That’s amazing. Given our audience’s interest in ethics, I’m curious about how Trish approaches ethical review. When you collaborate with academic institutions, do you typically use their institutional review boards (IRBs), or does Trish have its own ethical review infrastructure for internal research?
Rachael Dempsey: Trish is primarily a research funding agency, so most of our work involves academics submitting proposals that are reviewed by their home institutions' IRBs. That’s the standard approach, and it works well. But when we launched the EXPAND program — which was entirely novel — we had to create new ethical frameworks. We established a joint IRB for all EXPAND research, ensuring consistent oversight by reviewers familiar with the constraints of spaceflight. This structure also makes it easier to adapt studies as new opportunities arise and different crews consent in or opt out of various research elements.
Standing up the EXPAND program was an incredible feat — we did it in just 22 or 23 months. The amount of work we accomplished to get our first study onto the Inspiration4 mission was extraordinary. Now, we’re sitting on a wealth of data contributed by commercial crews who’ve voluntarily participated in expanding scientific knowledge. Managing that data ethically is a top priority for us. We’ve established a data review board composed of experts to ensure that access to these samples is granted responsibly and that we make the best possible research decisions while moving forward quickly and ethically.
Robert Nobles: With all this data from space travelers, I imagine there are challenges around privacy. Eventually, someone gets sick or experiences discomfort, and not everyone is comfortable sharing that kind of information. How do you manage participants’ health data, keep them informed, and balance ethical oversight with scientific discovery?
Rachael Dempsey: That’s a critical part of our process. Preparing for space travel is a long journey, and part of that includes detailed conversations between Trish, the commercial crews, and the providers. We explain what participating in this research entails — how their data will be used, how we’ll keep it private, what controls they’ll have, and the guarantees we can offer. We also lay out the risks and limitations. Participants take the time to review all of this, reflect on it, and then decide whether to consent.
We’re incredibly grateful that more and more civilians are choosing to contribute their data and samples in the name of science. We do everything possible to anonymize and code their information so we can’t easily tie specific data points — like a heart rate spike — to a particular individual.
Robert Nobles: That’s admirable. It’s wonderful to see people’s altruism and willingness to contribute to something bigger than themselves.
Rachael Dempsey: Absolutely. It’s inspiring. And we owe it to them to handle their data with the utmost care and responsibility.
Robert Nobles: Let’s talk about funding. Trish’s work is clearly ambitious and expensive. Where does your funding come from, and what potential funding sources are you looking at to support future space exploration?
Rachael Dempsey: Great question. Research is expensive, and that often flies under the radar. Trish is funded through a cooperative agreement with the NASA Human Research Program, which covers our core academic research initiatives. But when we saw the opportunity to launch the EXPAND program and build a commercial research database, we partnered with commercial providers who donate their time and effort to integrate research into their missions.
Some of these missions are privately funded — like the Polaris program founded by Jared Isaacman, who flew on the Inspiration4 mission and recently on Polaris Dawn. It’s a mix of funding sources, and we’re always looking for ways to collaborate with commercial providers to ensure that every spaceflight carries meaningful scientific research.
Robert Nobles: It would be a wasted opportunity otherwise.
Rachael Dempsey: Exactly. It feels irresponsible to spend billions on space travel without contributing knowledge that benefits humanity.
Robert Nobles: And the benefits of space research reach far beyond space.
Rachael Dempsey: They really do. Every dollar spent on space research is spent here on Earth, and everything we learn has real-world applications. Studying radiation in space, for example, helps us better protect radiation workers on Earth — like radiologists and cell tower technicians. Our research on behavioral health and stress in space can inform support for people working in high-stress environments on Earth, like remote medical teams or people working in isolated conditions.
Robert Nobles: Even water recycling technology from space has Earth-based benefits.
Rachael Dempsey: Exactly. The innovations we develop for astronauts often lead to breakthroughs that improve life on Earth.
Robert Nobles: What excites you most about the future of space exploration and health research?
Rachael Dempsey: The pace of progress and the sheer number of flights happening now are incredibly exciting. It feels like we’re witnessing the start of a new era of exploration — the opportunity to be first at so many things all over again. I’m also thrilled to be part of important conversations about the ethics of space exploration. How do we ensure the knowledge we gain benefits all of humanity and isn’t limited to just one nation?
On a personal note, I’ve been fascinated by the development of space law — like the Artemis Accords and the International Astronaut Compact. The idea that there are professionals whose careers revolve around shaping legal frameworks for space exploration is just so cool.
Robert Nobles: That’s incredible. So, if you had to make one final pitch for why space exploration and health research are vital, what would it be?
Rachael Dempsey: We do this because humans are explorers. We push boundaries — where we live, where we work, what we discover. Space exploration teaches us what our bodies are capable of and how to protect and support human life as we venture farther. Solving these challenges today enables everything that will come tomorrow. It opens the door to possibility.
Robert Nobles: It gives us so much hope. Thank you, Rachael, for sharing your insights and passion. And to our podcast community — thank you for joining us on this journey of imagination and discovery. I’m Robert Nobles, signing off with heartfelt gratitude and appreciation for the work Rachael and Trish are doing to move us forward. Thank you all.
Research Ethics Reimagined guests are esteemed members of our community who generously share their insights. Their views are their own and do not necessarily reflect those of PRIM&R or its staff.