Section 09 · Robotic Medicine · Outline

Capabilities at a glance

What a care robot might do in each area of care, at each level of autonomy. This replaces the longer ladder in Part 1 with a single board. It is a thought experiment, not a recommendation.

How to read the board

Feasible now The robot skill has been shown in space or on Earth. A medical version would still need testing.

Near-term Plausible with current technology, but not yet shown for medical care in space. Needs validation.

Speculative / out of reach No validation data, or it conflicts with the safety rules. Research only.

Rung 1 Ground-steered: A person controls each motion.

Rung 2 Supervised: Human starts it, watches, can stop it.

Rung 3 Conditional: Robot proposes; human approves; robot hands back.

Care domains by autonomy level
Care domain	Rung 1 · Ground-steeredA person controls each motion	Rung 2 · SupervisedHuman starts it, watches, can stop it	Rung 3 · ConditionalRobot proposes; human approves; robot hands back
Logistics & inventory	Feasible now Fetch a kit on command. Station robots already move and inventory items.^[2]	Near-term Track medical supplies, expiry dates and storage; restock.	Near-term Predict shortages and propose resupply or substitutes; a human approves.
Monitoring & routine exams	Near-term Hold a camera or sensor while crew or ground direct the exam.	Near-term Run scheduled checks (vital signs, photos) and log them for human review.	Speculative / out of reach Decide on its own what a finding means: out of reach. The robot never diagnoses.
Diagnostics & imaging (diagnostic ultrasound only)	Near-term Hold the probe while a ground expert steers. Remote guidance already works with human crew, and software alone guided untrained crew.^[3][4]	Near-term Take standard views with image-quality checks (the kidney protocol pattern). Therapeutic modes locked out.	Speculative / out of reach Suggest the next view and flag findings for a human. A scan without findings is "non-diagnostic", never "normal".
First response & emergencies	Near-term Bring the defibrillator and oxygen; stream video to the ground.	Speculative / out of reach Chest compressions and helping restrain patient and rescuer: speculative, no validation data. The CPR guideline covers human rescuers only.^[7]	Speculative / out of reach Robot-run cardiac arrest: out of reach. Rung 3 needs human approval and a human must start the robot [V2 10174].^[8]
Procedures & wound care	Near-term Hold a limb steady; pass supplies; photograph the wound.	Speculative / out of reach Apply a splint or dressing to a marked area: no validation data yet.	Speculative / out of reach Choose a dressing from photos: speculative. Infection signs always go to a human.
Surgery assist	Near-term Hold a camera or retractor; pass instruments. A small surgical robot did simulated tasks on the station in 2024 (not surgery).^[5]	Speculative / out of reach Suturing a marked line: shown only in animals on Earth.^[6]	Speculative / out of reach Out of reach. Would need validation far beyond today’s evidence.
Hazard & spacewalk (EVA) response	Feasible now Carry tools and inspect inside the station; a humanoid did simple station tasks from 2011.^[1]	Near-term Enter a smoky, contaminated or high-radiation area first so people don’t have to.	Speculative / out of reach Help an injured spacewalker back through the airlock: speculative.
Behavioral & crew support	Near-term Relay a private call with ground support; camera off on request.	Near-term Run scheduled mood, sleep and workload check-ins; log for the flight surgeon.	Speculative / out of reach Act as counselor or judge a crewmember’s mental state: out of reach.
Documentation & telemedicine relay	Feasible now Stream video to the ground for remote-guided care. Station robots already film, and ground-guided exams work.^[2][3]	Near-term Time-stamp every input, action and hand-off; store as private medical data.^[8][9]	Near-term When the link is down, package images and logs for the flight surgeon at the next contact.

Applies to every cell

The flight surgeon is the medical authority. The crew medical officer acts under delegated care, and uses a pre-approved checklist when there is no link.
A human starts the robot, can stop it at any time, and restarts it after any emergency stop.
The robot never diagnoses, and gives no drug or fluid advice.
Imaging is diagnostic only. Therapeutic ultrasound and needle guidance are locked out.
On a fault, a lost link or no human response, the robot goes to its stopped (safe-state) position and waits.

Medical authority: NASA medical operations brief [10]. Human start, override and safe default: NASA-STD-3001 Volume 2, [V2 10165], [V2 10173] and [V2 10174] [8].

What the markings rest on

Robots in the station: a humanoid robot flew in 2011 [1] and was returned to Earth in 2018 after a wiring fault that would have been very hard to repair in orbit [11]. Free-flying robots have handled inventory and filming since 2019 [2].
Guided ultrasound: a crewmember with minimal training did a ground-guided exam in 2005 [3], and software alone guided untrained crew through kidney and bladder scans [4]. Both were done by people, not robots.
Surgery: a small surgical robot did simulated tasks on the station in 2024 [5]. Autonomous suturing has been shown only in animals on Earth [6].
Resuscitation: the microgravity CPR guideline is written for human rescuers [7]. We found no study of robot chest compressions in weightlessness (search not exhaustive).
Cells without a citation are the foundation’s own judgment and are marked near-term or speculative, never feasible now.

Go to the protocol library →

References 11

NASA. Robonaut 2. www.nasa.gov/robonaut2/
NASA. Astrobee. www.nasa.gov/astrobee/
Sargsyan AE, et al. FAST at MACH 20: clinical ultrasound aboard the International Space Station. J Trauma. 2005;58(1):35–39. PMID 15674147. doi.org/10.1097/01.ta.0000145083.47032.78
Ebert D, et al. Autonomous Medical Officer Support software technology demonstrations on the International Space Station. Telemed J E Health. 2026;32(6):608–616. PMID 41778279. doi.org/10.1177/15305627261422798
NASA Johnson Space Center. Houston We Have a Podcast, episode 339: Robotic Surgery in Space (2024). www.nasa.gov/podcasts/houston-we-have-a-podcast/robotic-surg…
Shademan A, et al. Supervised autonomous robotic soft tissue surgery. Sci Transl Med. 2016;8(337):337ra64. PMID 27147588 (in living pigs). doi.org/10.1126/scitranslmed.aad9398
Hinkelbein J, et al. Cardiopulmonary resuscitation during spaceflight: a guideline for CPR in microgravity. Scand J Trauma Resusc Emerg Med. 2020;28:108. PMID 33138865. doi.org/10.1186/s13049-020-00793-y
NASA. NASA-STD-3001, Volume 2: Human Factors, Habitability, and Environmental Health, Revision F (2026), Section 10.6 Automated and Robotic Systems. standards.nasa.gov/standard/NASA/NASA-STD-3001_VOL_2
NASA. NASA-STD-3001, Volume 1: Crew Health, Revision C (2023). www.nasa.gov/wp-content/uploads/2023/11/nasa-std-3001-vol-1-…
NASA OCHMO. Medical Operations. Technical Brief OCHMO-TB-044 (2025). Crew surgeon keeps medical authority under delegated care; crew medical officers train on the JSC 48522 medical checklist. www.nasa.gov/wp-content/uploads/2025/08/ochmo-tb-044-medical…
NASA Technical Reports Server. Robonaut’s return to ISS (NTRS 20190025367). ntrs.nasa.gov/api/citations/20190025367/downloads/2019002536…

Checked on 2026-10-20: each link returned HTTP 200 (or redirected to the publisher), DOIs and PubMed IDs were matched in Crossref and PubMed, and each claim was checked against the source text.