Medical policy development for human spaceflight at NASA: an evolution.

Codification of medical policy for the National Aeronautics and Space Administration (NASA) did not occur until 1977. Policy development was based on NASA's human spaceflight efforts from 1958, and the need to support the operational aspects of the upcoming Space Shuttle Program as well as other future activities. In 1958, the Space Task Group (STG), a part of the National Advisory Committee on Aeronautics (NACA), became the focal point for astronaut selection, medical support, and instrumentation development in support of Project Mercury. NACA transitioned into NASA in 1958. The STG moved to Houston, TX, in 1961 and became the Manned Spacecraft Center. During these early years, medical support for astronaut selection and healthcare was provided through arrangements with the U.S. military, specifically the United States Air Force, which had the largest group of subject matter experts in aerospace medicine. Through most of the 1960s, the military worked very closely with NASA in developing the foundations of bioastronautics and space medicine. This work was complemented by select individuals from outside the government. From 1958 to 1977, there was no standard approach to medical policy formulation within NASA. During this time, it was individualized and subjected to political pressures. This manuscript documents the evolution of medical policy in the NASA, and provides a historical account of the individuals, processes, and needs to develop policy.