People often drift toward public sector jobs because there’s some element of stability, alongside the knowledge that they’ll be working to benefit their fellow citizens. For those who work for the National Aeronautics and Space Administration (NASA), there’s the added opportunity to make a real difference in humanity’s understanding of the universe as well as our own planet.
But what happens when employees of agencies are the victims of medical malpractice or negligence? When committing every inch of themselves to the betterment of their fellow humans, there may well be the risk that they could be injured, the consequences of which could mean long term discomfort and unemployment. It would be nice to assume that the government would treat those victims with the same level of commitment and support that those workers had provided. Does the reality of medical malpractice and negligence when it comes to the public sector reflect this, though? In particular, how can it apply to the groundbreaking work of NASA employees in space, and beyond their employment?
We shook off the gravitational shackles of our planet nearly 60 years ago, and much in the industry has changed. However, it remains true that space is still very difficult to reach, as such maintaining the medical needs of astronauts continues to be a challenge for NASA. It’s not as though residents of the International Space Station (ISS) are able to simply call an ambulance in an emergency.
A good proportion of NASA’s space research involves medical sciences, and there has even been research into the medical issues that we’ll face in the future such as pregnancy in space. However, NASA currently addresses its medical responsibilities for its astronauts by providing them with the knowledge and tools to handle most emergencies themselves. Part of the training involves 40 hours of medical education that includes life savings skills, and even techniques for safely extracting teeth. There has not yet been a medical emergency aboard the ISS, but is this training sufficient to ensure NASA isn’t negligent in the care of its field personnel?
Medical negligence occurs when the standard of medical care received fails to meet that required. This can range from failure to diagnose conditions, to errors during treatment. In the private sector, there are clear mechanisms in place to bring lawsuits against negligent doctors. These most often involve lawsuits that investigate the damage ostensibly caused by negligent practices, the extent to which the doctor is responsible, and assesses the hardships that the patient has incurred in order for doctors (or their insurers) to compensate accordingly. But it is more difficult for government employees such as military service members who ineffective treatment in the field.
A 1950 supreme court ruling prevents active duty service members from suing the federal government for medical malpractice. This is generally considered to be an extension of Sovereign Immunity, meaning that the military as an extension of the state cannot commit a legal wrong. It has also been asserted that many of the compensatory elements gained through negligence lawsuits — such as medical costs and loss of income — are already accounted for under the Department of Veterans Affairs benefits legislation. That said, there are still many examples of cases in which victims of government-mandated medical service malpractice have insufficient recourse for action as a result of the ruling.
Our digital era has brought with it many advantages, one of which is the ability to communicate with people from around the globe. For NASA astronauts, this obviously extends much farther. This connectivity has resulted in a major advantage in medical fields: the ability to provide telemedical services to those outside of easy reach.
NASA tests advanced medical equipment in space, and they were early adopters of telemedicine services for their astronauts. Crew members regularly consult with flight surgeons back on earth and are monitored during hazardous activities such as spacewalks. Of course, telemedicine can be risky; without direct contact, there is the potential for a skilled physician to misdiagnose or misinterpret symptoms. If the patient received injury or illness as a result of the physician’s inability to meticulously examine them, or as a result of them instructing patients to undertake medical procedures themselves for which they are not capable, this could be considered medical negligence.
So where do government employees stand when faced with negligence through telemedicine? Well, the rules are treated in much the same way as any other government medical service, such as the US Department of Veterans Affairs (VA) hospitals which also offer telemedical services. For the majority of cases, the rule of Sovereign Immunity applies. However, if the telemedical service was provided by an independent contractor working within a government facility, Sovereign Immunity doesn’t apply, and a normal state medical malpractice claim can be pursued.
Space travel is often considered to be an exciting and heroic endeavor. While there is a fascinating element of discovery and exploration, the realities of life as an astronaut are certainly not simple. Space can be a punishing environment on the human body, and activities undertaken — including medical procedures — while in service may not appear problematic until some time afterward.
This can be difficult when it comes to cases of medical malpractice. By definition, malpractice occurs when an injury is caused by the medical professional treating you. The statute of limitations for such cases can last up to 10 years. If an astronaut, or any other government employee, received such injuries that weren’t evident within that time frame, they may have no recourse.
In the past, there have been examples of high-level government employees whose families have received settlements, but a degree of secrecy has been employed in order to save face. In 2019, it was reported that Neil Armstrong’s family had received a settlement of nearly $6 million for alleged medical errors caused during heart bypass surgery prior to his death in 2012. While an out-of-court agreement was made, not all government employees may expect the same outcome; Armstrong’s historical status, and the embarrassment factor the hospital would face during public proceedings, could well have been a factor.
Medical malpractice and negligence can often be complex areas when it comes to government employees. This can be exacerbated when those employees are not receiving easily deliverable medical care, like NASA’s astronauts on the ISS. It’s important to understand how partaking of government-funded medical services can affect malpractice lawsuits; from the statute of limitations, to whether doctors are federal employees or private contractors.