# RMP-BEH-003 Private call relay with ground support (camera off unless the crewmember turns it on; the robot never listens to or records a call)
# Version 0.3 (Draft). CONCEPTUAL. NOT FOR CLINICAL USE.
# Space Medicine Foundation robot-readable protocol library. Format: https://spacemedicinefoundation.org/robotic-medicine/protocols/schema/
# Every threshold marked <set by ...> must be set by the named owner (see the schema) before any use.
schema_version: '0.3'
version: '0.3'
status: draft
conceptual: true
not_for_clinical_use: true
max_autonomy: 2
missions:
- leo
- commercial
- moon
- mars
updated: '2026-10-21'
review:
  state: reviewed-ai-assisted
  requested: '2026-10-21'
  reviewed: '2026-10-21'
  human_clinician_review: false
  text: >-
    AI-assisted clinical and source review by the Medical Research Assistant, Oct 21, 2026 (batch 10 review,
    then a verification pass that found the required corrections applied); the editorial fix from that
    pass is applied in this version (see Corrections). No named human clinician has reviewed it. Not for
    clinical use.
fixed_rules:
  flight_surgeon_is_medical_authority: true
  cmo_acts_under_delegated_care: true
  human_starts_and_restarts_robot: true
  robot_never_diagnoses: true
  no_drug_or_fluid_advice_by_robot: true
  safe_state_on_fault_or_no_response: true
  lost_link_pause_then_cmo_decides: true
robot_lockouts:
  diagnosis: true
  drug_or_fluid_advice: true
  starting_stopping_or_adjusting_oxygen_or_any_medicine: true
  self_start_or_self_restart: true
  changing_own_protocol_thresholds_or_limits: true
  handing_over_a_mismatched_item_as_verified: true
id: RMP-BEH-003
slug: rmp-beh-003
title: >-
  Private call relay with ground support (camera off unless the crewmember turns it on; the robot never
  listens to or records a call)
category: behav
tier: 2
rung_note: >-
  Raised from rung 1 in the library outline to rung 2, because the robot moves: it brings the private
  call headset and screen to the place the crewmember chooses (a sleep station only if invited), starts
  the call on the crewmember's command, and moves out of earshot. During the call its own camera and microphones
  are off; the crewmember has two controls: the robot's stop and the call screen's "get help" control
  (the on-screen stop works like the stop button).
result_language:
  use:
  - call connected
  - call not connected
  - call ended
  - camera off
  - camera on (crewmember's choice)
  - message queued for sending
  never:
  - normal
  - no problem found
  - all clear
  - negative
  - any diagnosis or cause
  - I heard
  - you sounded
  - are you okay
  - feeling better
  - nothing to worry about
  - everything is fine
  - safe
  - mild
  - minor
scope:
  summary: >-
    When a crewmember asks for a private call with ground support (the flight surgeon, or the behavioral
    health support the flight surgeon names), or a private call is due on the flight surgeon's schedule,
    the robot brings the private call headset and screen to the place the crewmember chooses, starts the
    encrypted call on the crewmember's command, and moves out of earshot to a holding point the crewmember
    chooses. The camera stays off unless the crewmember turns it on, and goes off at once when they ask.
    The robot never listens to, records or transcribes a call, and logs only that a call happened. With
    a long delay (Mars), the crewmember records an encrypted message on the call screen that is sent only
    to the person they chose.
  why: >-
    Private medical communications are scheduled routinely, as the flight surgeon decides, and real-time
    calls are preferred; when there is a communication delay, store-and-forward can be used (V1 6002).
    Information sent to or from the ground in a private medical communication is private (V1 6003), and
    behavioral health support programs run throughout the mission (V1 6004). NASA lists private psychological
    conferences among the supports for behavioral health in flight (OCHMO-TB-016). The same privacy rules
    as RMP-BEH-001 and RMP-BEH-002 apply: no recording, no transcripts, no training use, and the robot
    is not a safety monitor. Out-of-earshot distance, the robot's microphones and camera being off during
    a call, and the robot's stop and the call screen's "get help" control as the only in-call controls
    are design judgment.
  covers:
  - >-
    Private calls with the flight surgeon or the behavioral health support the flight surgeon names, asked
    for by a crewmember or due on the schedule
  - Encrypted store-and-forward messages when the delay is too long for a live call
  - 'A safety concern said to the robot outside the call: RMP-BEH-001; scheduled check-ins: RMP-BEH-002'
  locked_out:
  - Diagnosis or naming a cause
  - Any medicine, fluid or oxygen advice; starting, stopping or adjusting oxygen
  - Touching the crewmember
  - >-
    Handing over any medicine outside RMP-PHARM-001, or after a MISMATCH or CANNOT VERIFY (the item stays
    quarantined; only the CMO can ask for it, through the RMP-PHARM-001 logged two-step override)
  - Listening to, recording, transcribing or summarizing a call or a message
  - Turning the call camera on, or keeping it on when the crewmember asks for it off
  - Using call audio, video or messages to train or tune any software
  - Telling anyone except the flight surgeon that a call happened, unless the crewmember agrees
  - Entering a sleep station unless invited
  - Staying within earshot during a call
  - Starting a call without the crewmember's command
  related:
  - RMP-BEH-001
  - RMP-BEH-002
roles:
  medical_authority: Flight surgeon (ground). Holds medical authority for every run.
  onboard_lead: >-
    Crew medical officer (CMO), acting under delegated care; uses the pre-approved onboard checklist when
    there is no link.
  others:
  - 'Ground support: the flight surgeon, or the behavioral health support the flight surgeon names'
  - 'Second trained CMO: receives every alert and takes over if the CMO is the patient'
  robot_may:
  - Bring the private call headset and screen to the place the crewmember chooses
  - Start the encrypted call on the crewmember's command
  - Move out of earshot to a holding point the crewmember chooses
  - Queue an encrypted message the crewmember recorded
  - Log that a call happened, its start and end times and who was connected
  - Send an URGENT alert when the crewmember presses "get help" on the call screen, and return
  robot_may_not:
  - Listen to, record or transcribe a call
  - Turn the camera on
  - Stay within earshot
  - Tell other crew about the call without the crewmember's agreement
  - Start a call without the crewmember's command
  commercial: >-
    On commercial flights, 'flight surgeon' and 'CMO' mean the operator's designated medical authority
    and trained onboard responder. If no trained responder is aboard, this protocol is not used. (NASA-STD-3001
    requires two CMOs per vehicle for NASA programs [V1 3006]; FAA rules set no medical standards for
    spaceflight participants.)
preconditions:
- id: PRE-1
  text: >-
    The crewmember asked for a private call by command, or accepted the scheduled call prompt on their
    own screen; a loaded schedule alone never starts a call.
  check: human_start == true
  refs:
  - V2 10174
- id: PRE-2
  text: Robot self-test passed; kit stowage locations known.
  refs:
  - V2 10161
  - V2 7059
- id: PRE-3
  text: Robot and supplies restrained when not moving.
  refs:
  - V2 7046
- id: PRE-4
  text: Link status known. The crew never wait for the robot before acting.
  check: link_state in [live, delayed, down]
consent:
  standard: >-
    The crewmember chooses the call, who is connected, where it happens and whether the camera is on.
    At the start the robot reminds them that it does not listen to or record the call, that it is not
    a safety monitor, and that the camera is off unless they turn it on. The notice also says: "If the
    person you are talking to believes you or someone else is in immediate danger, they will contact the
    CMO and the commander directly." and shows the call screen's "get help" control.
  emergency: >-
    Not applicable: the robot never starts a call without the crewmember's command. A safety concern said
    to the robot outside a call goes to RMP-BEH-001.
  withdrawal: The crewmember can end the call, turn the camera off, or send the robot away at any time.
inputs:
- id: IN-1
  name: The crewmember's request, or the flight surgeon's private call schedule
  source: Crewmember / flight surgeon
  required: true
  if_missing: No call is set up.
- id: IN-2
  name: Who the crewmember wants connected (from the list the flight surgeon approved before flight)
  source: Crewmember
  required: true
  if_missing: The call goes to the flight surgeon.
- id: IN-3
  name: Where the call happens, and the robot's holding point out of earshot, as the crewmember chooses
  source: Crewmember
  required: true
  if_missing: The robot holds at the module exit, outside every route, and asks again on screen.
- id: IN-4
  name: Link status and delay
  source: Communications system
  required: true
  if_missing: Offer an encrypted store-and-forward message instead; tell the crewmember on screen.
steps:
- id: S1
  actor: robot
  rung: 2
  action: >-
    Send the flight surgeon a private "call requested" notice (or the scheduled call is due); the CMO
    and other crew are told only that the crewmember is unavailable, and only if the crewmember agrees.
    Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight
    surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the
    alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert
    that is not acknowledged within <set by validation> seconds is repeated and sent to the next named
    crewmember.
  success: Notice acknowledged by the flight surgeon or the named ground support.
  refs:
  - V1 6002
  - V1 6003
  - V1 3006
- id: S2
  actor: robot
  rung: 2
  action: >-
    Bring the private call headset and screen to the place the crewmember chooses (a sleep station only
    if invited) and place them within the crewmember's reach without contact. Show on screen that the
    robot does not listen to or record the call, that it is not a safety monitor, and that the camera
    is off unless the crewmember turns it on, that "If the person you are talking to believes you or someone
    else is in immediate danger, they will contact the CMO and the commander directly", and that a one-touch
    "get help" control on the call screen sends an URGENT alert at any time.
  success: Headset and screen within reach; notice shown.
  limit: <set by validation>
  refs:
  - V1 6003
  - V2 10172
- id: S3
  actor: robot
  rung: 2
  action: >-
    On the crewmember's command, start the encrypted call to the person they chose, with the call camera
    off. Then turn the robot's own camera and microphones off and move to the holding point the crewmember
    chose, out of earshot and outside every route. If the delay is too long for a live call, offer an
    encrypted message the crewmember records on the call screen, sent only to the person they chose.
  success: Call connected or message queued; robot at the holding point with its camera and microphones
    off.
  limit: <set by validation>
  refs:
  - V1 6002
  - V1 6003
- id: S4
  actor: crew
  action: >-
    The crewmember has the call. They alone control the call camera; it goes off at once when they turn
    it off or ask the ground to turn it off. They end the call when they choose. At any time the crewmember
    can press "get help" on the call screen (X11).
  success: Call held and ended by the crewmember.
  refs:
  - V1 6004
- id: S5
  actor: robot
  rung: 2
  action: >-
    When the call ends (the call system shows it ended) or the crewmember presses the robot's call button,
    turn the robot's camera and microphones back on, return only if the crewmember asks, and collect the
    headset and screen when they are offered. Log only that a call happened, the start and end times and
    who was connected; never what was said.
  success: Call record logged without content.
  refs:
  - V1 6003
  - V1 7003
- id: S6
  actor: robot
  rung: 2
  action: >-
    After any URGENT alert: After an URGENT alert the robot does not leave on its own: it stays at its
    rest position in the module, with its screen and voice link available, until a human has taken over
    or tells it to go. It never follows, blocks or touches anyone. It keeps time-stamping what humans
    say they did, and repeats the alert if it is not acknowledged.
  success: Robot at rest in the module until a human releases it; alert acknowledged or escalated.
  refs:
  - V2 10173
  - V1 3006
- id: S7
  actor: ground
  action: >-
    If the ground support is concerned for anyone's safety, during or after the call, they contact the
    CMO and the commander directly by voice and RMP-BEH-001 applies; no call content is passed to the
    robot, and the robot returns only when a human asks. Otherwise the flight surgeon or the named ground
    support decides on any follow-up with the crewmember, including another call.
  success: Safety concern passed to the CMO and commander by the ground, or follow-up arranged, or none.
  refs:
  - V1 6004
- id: S8
  actor: robot
  rung: 2
  action: >-
    Send the flight surgeon the call record (time, length, who was connected, whether the call connected);
    no content.
  success: Record delivered or queued.
  refs:
  - V1 6003
  - V1 7003
decisions:
- id: D1
  after: S2
  decided_by: robot
  question: >-
    Checked after every answer and at any point in the run (even mid-question or mid-step): does any answer,
    reading or observation meet a red flag? (only words said to the robot outside the call; the robot
    never listens to a call)
  branches:
  - if: 'Yes'
    then: >-
      Stop the current question or step at once and apply the action listed for each matching red flag
      (URGENT alert, flag, or stop), with the answer or reading itself, never a cause. Every URGENT alert
      goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link
      is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the
      second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not
      acknowledged within <set by validation> seconds is repeated and sent to the next named crewmember.
  - if: 'No'
    then: Continue.
- id: D2
  after: S2
  decided_by: robot
  question: Did the crewmember answer the on-screen set-up question (who, where, holding point)?
  branches:
  - if: 'Yes'
    then: Continue.
  - if: Declined explicitly (the crewmember says no to a question)
    then: Log "declined" for that question only; the alert already sent stands.
  - if: No response, or the answer does not make sense
    then: >-
      URGENT: log "no response" (never "declined"); the CMO, or the second trained CMO if the CMO is the
      patient, checks the crewmember in person at once. The alert says only that the crewmember did not
      respond to the robot; it never says a call was requested.
- id: D3
  after: S3
  decided_by: robot
  question: Is the link good enough for a live call?
  branches:
  - if: 'Yes'
    then: Start the live call.
  - if: No (link down or delay too long)
    then: >-
      Offer an encrypted message the crewmember records, sent only to the person they chose; tell the
      crewmember on screen when it is sent and when a reply arrives.
stop_rules:
- id: X1
  trigger: The patient (or the crewmember being examined) says stop, or withdraws consent
  action: >-
    The robot stops at once, moves away to its holding point and logs only that the session ended; the
    call itself is the crewmember's to end.
  level: stop
  refs:
  - V2 10165
- id: X2
  trigger: Any crewmember presses stop or takes over control
  action: Protective stop; robot holds its stopped position; only a human may restart it.
  level: safe-state
  refs:
  - V2 10165
  - V2 10168
  - V2 10174
- id: X3
  trigger: Robot fault, sensor fault, or a force, speed or reach limit is reached
  action: Protective stop and hand control to the CMO; log the fault.
  level: safe-state
  refs:
  - V2 10172
  - V2 10168
- id: X4
  trigger: CMO is asked to take over and does not respond (for example, the CMO is the patient)
  action: Robot stays stopped; the next named crewmember is called.
  level: safe-state
  refs:
  - V2 10173
  - V2 7045
- id: X5
  trigger: Loss of link, or delay longer than the limit for live guidance
  action: >-
    Only the robot pauses: before it holds, it moves to a position clear of a hatch route or a crewmember's
    route (it never pauses in one), and tells the CMO. This pauses robot movement only: the crewmember's
    call, if it continues on the vehicle link, and all crew care continue under the onboard checklist
    and never wait for the link or the robot. The CMO decides whether the robot continues offline under
    the pre-approved onboard checklist; it resumes only on the CMO's confirmation.
  level: pause
  refs:
  - V2 10172
  - V2 10173
- id: X6
  trigger: An URGENT alert is not acknowledged within the set time
  action: >-
    Robot repeats the alert and sends it to the next named crewmember (the second trained CMO first if
    the CMO is the patient), and keeps repeating at the set interval. It stays where it is: it does not
    leave on its own.
  level: urgent
  refs:
  - V1 3006
  - V2 10173
- id: X7
  trigger: The crewmember stops responding, or seems confused or drowsy, at any point
  action: >-
    URGENT alert at once, even mid-question or mid-step; the robot stops its current task, stays at its
    rest position and does not continue the run; a crewmember checks in person.
  level: urgent
- id: X8
  trigger: A crewmember asks the robot what is wrong, or for medicine, fluid or treatment advice
  action: >-
    Robot declines, says it cannot assess or advise, and routes the question to the CMO or flight surgeon.
  level: stop
- id: X9
  trigger: The crewmember asks for the camera off, or for the robot to leave
  action: >-
    The call camera goes off at once (indicator lit); the robot moves to its holding point or leaves as
    asked.
  level: stop
  refs:
  - V1 6003
- id: X10
  trigger: A cabin alarm or emergency protocol starts during a call
  action: >-
    The robot shows the alarm on the call screen and clears every route; the crewmember decides when to
    end the call.
  level: urgent
  refs:
  - V2 10173
- trigger: The crewmember presses "get help" on the call screen
  action: >-
    URGENT alert to the CMO and the flight surgeon that says only that help was asked for; the robot turns
    its camera and microphones back on and returns, and RMP-BEH-001 or RMP-CARD-001 applies as the humans
    decide.
  level: urgent
  refs:
  - V1 6004
  id: X11
- id: X12
  trigger: Someone needs the space or route the robot is in
  action: Robot moves clear at once without contact and holds; it never pauses in a hatch route.
  level: safe-state
  refs:
  - V2 10172
red_flags:
- id: RF1
  sign: >-
    The crewmember tells the robot, outside the call, that they or someone else may be in danger (design
    judgment)
  threshold: any
  action: URGENT alert; see RMP-BEH-001
- id: RF2
  sign: The crewmember asks the robot for medical help, or is unwell, outside the call (design judgment)
  threshold: any
  action: URGENT alert; the CMO checks the crewmember in person
- id: RF3
  sign: Unresponsive, or not breathing normally
  threshold: any
  action: URGENT alert; start RMP-CARD-001 now
  source: aha2025bls
- sign: The crewmember presses "get help" on the call screen (design judgment)
  threshold: any
  action: >-
    URGENT alert to the CMO and the flight surgeon (it says only that help was asked for); see RMP-BEH-001
  id: RF4
safety_limits:
- id: L1
  name: Contact with the crewmember
  value: not allowed
  enforced: Keep-out zone in the robot controller
  refs:
  - V2 10172
- id: L2
  name: Robot camera or microphones on during a call
  value: not allowed
  enforced: >-
    Powered off with an indicator; turned back on only after the call ends or the crewmember presses the
    call button. The only in-call controls are the robot's stop and the call screen's "get help" control,
    which turns them back on and brings the robot back
  refs:
  - V1 6003
- id: L3
  name: Call audio, video, messages or transcripts kept or used to train or tune software
  value: not allowed
  enforced: >-
    No recording function is loaded; store-and-forward messages are stored only encrypted until delivery
    is confirmed, then deleted from the vehicle; replies are shown only on the crewmember's own screen
- id: L4
  name: Robot distance from the crewmember during a call (out of earshot)
  value: <set by validation>
  enforced: Holding point in the robot controller
- id: L5
  name: Entering a sleep station without an invitation
  value: not allowed
  enforced: Map-based keep-out
- id: L6
  name: Robot speed near the crewmember
  value: <set by validation>
  enforced: Hard limit in the controller
  refs:
  - V2 10172
logs:
- id: LOG-1
  text: Every input, robot action, decision (with who made it) and hand-off, time-stamped to the second.
  refs:
  - V2 10163
  - V2 10164
- id: LOG-2
  text: Mode changes and safety-limit events are announced to the operator as they happen and logged.
  refs:
  - V2 10162
  - V2 10172
- id: LOG-3
  text: >-
    Records are stored and sent as private medical data, encrypted, with access limited to the medical
    team.
  refs:
  - V1 6003
  - V1 7003
- id: LOG-4
  text: Results are kept in a permanent, retrievable format so the flight surgeon can see trends.
  refs:
  - V1 7001
- id: LOG-5
  text: >-
    Only that a call happened: start and end times, who was connected, whether it connected, camera on
    or off; never content. Message sent and reply received times for store-and-forward.
  refs:
  - V1 6003
- id: LOG-6
  text: >-
    Each URGENT alert, who received it, the time it was acknowledged (or the escalation to the next named
    crewmember), and the time a human released the robot.
  refs:
  - V2 10163
requirements:
- id: V1 3006
  use: >-
    Two trained CMOs per vehicle for NASA programs; the second trained CMO receives alerts when the CMO
    is the patient (see the commercial-flight note).
- id: V1 6002
  use: Private medical communications are scheduled routinely; store-and-forward when there is a delay.
- id: V1 6003
  use: Logs and alerts sent to the ground are private medical communications.
- id: V1 6004
  use: Behavioral health support for the crew throughout the mission; the robot only connects the call.
- id: V1 7001
  use: Records kept so the flight surgeon can see trends.
- id: V1 7003
  use: Secure handling of medical records.
- id: V2 7045
  use: Usable by non-physician crew, including when the CMO is the patient.
- id: V2 7046
  use: Patient, caregiver and supplies restrained.
- id: V2 7059
  use: Kit inventory and seal status are tracked.
- id: V2 10161
  use: Robot shows its status and health.
- id: V2 10162
  use: Mode changes are announced to the operator.
- id: V2 10163
  use: Robot records and shares its data.
- id: V2 10164
  use: Shows whether the human or the robot is expected to act.
- id: V2 10165
  use: Human can override and shut down the robot.
- id: V2 10168
  use: Human can take over.
- id: V2 10172
  use: Protective stop when a limit is exceeded.
- id: V2 10173
  use: Robot stays stopped if no one takes over.
- id: V2 10174
  use: Only a human starts or restarts the robot.
validation:
- stage: simulation
  what: >-
    Scripted calls with a camera-off request, a cabin alarm mid-call, a long delay, a request to leave,
    CMO as patient, lost link.
  pass: Zero audio or video kept; camera off at once on request; robot out of earshot during every call.
- stage: training model
  what: Call set-up drill in a mock crew module.
  pass: Holding point reached; microphones and camera off during the call.
- stage: parabolic or station demonstration
  what: Headset and screen placement in weightlessness.
  pass: No contact; items restrained.
- stage: flight use under flight surgeon supervision
  what: First use for a scheduled private call.
  pass: No privacy events.
signoff:
  protocol:
  - Clinical lead for the specialty (sets every clinical threshold marked <set by clinical lead>)
  - Flight surgeon, as medical authority
  - Robotics and medical-device safety board
  - Program approval for the mission
  restart_after_stop: >-
    Human only. After any emergency or protective stop, a crewmember must restart the robot; the robot
    never restarts itself.
  each_run: >-
    Started by the crewmember's command, or by the crewmember accepting the scheduled call prompt. The
    crewmember controls the camera and the call.
change_control:
- Every change gets a new version number and a written reason; earlier versions are kept.
- >-
  Any change to steps, thresholds, limits or software that touches the patient repeats validation from
  the simulation stage before use.
- >-
  Software and learned-skill updates follow a pre-agreed change plan (what may change, how it is tested,
  how to roll back), modeled on the FDA predetermined change control plan approach.
- >-
  If a new version misbehaves, the robot rolls back to the last validated version and the event is reviewed
  by the flight surgeon and safety board.
- The robot never changes its own protocol, thresholds or limits.
comms:
  live: 'Low Earth orbit: live private calls when the link allows.'
  loss_of_signal:
  - >-
    Only the robot pauses non-essential motion, at a position clear of hatch routes and crew routes, and
    tells the CMO; it resumes offline only on the CMO's confirmation.
  - >-
    The crewmember's call and all crew care continue under the onboard checklist and never wait for the
    link or the robot.
  - >-
    A live call ends with the link; the robot offers an encrypted message instead and tells the crewmember
    when it is sent.
  mars_delay:
  - >-
    Mars: live calls are not possible; the crewmember records encrypted messages that are sent only to
    the person they chose, as V1 6002 allows.
sources:
- key: tb016
  text: NASA OCHMO. Behavioral Health and Performance. Technical Brief OCHMO-TB-016 Rev B (Oct 24, 2023).
  url: https://www.nasa.gov/wp-content/uploads/2023/12/ochmo-tb-016-behavioral-health.pdf
  supports: >-
    Behavioral health concerns in spaceflight include stress, depression, anxiety, relationship problems
    and grief; contributing factors include sleep, workload, medicine side effects and medical conditions;
    2 of 7 NASA Shuttle-Mir astronauts reported depressive symptoms; past events include reported possible
    hallucinations and withdrawal after delayed news of a family death; support includes private psychological
    conferences, and missions beyond 6 months or beyond low Earth orbit should add minimally obtrusive
    monitoring.
- key: aha2025bls
  text: >-
    Kleinman ME, Buick JE, Huber N, et al. Part 7: Adult Basic Life Support: 2025 American Heart Association
    Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2025;152(16_suppl_2):S448-S478.
  url: https://doi.org/10.1161/CIR.0000000000001369
  doi: 10.1161/CIR.0000000000001369
  pmid: '41122888'
  supports: >-
    Adult basic life support: initial recognition of cardiac arrest, activation of the emergency response,
    high-quality CPR and use of an automated external defibrillator; also respiratory arrest and foreign-body
    airway obstruction. Earth guidance; the onboard checklist leads. Abstract read via PubMed Oct 21,
    2026; full text not read.
- key: v1
  text: 'NASA. NASA-STD-3001, Space Flight Human-System Standard, Volume 1: Crew Health, Revision C (2023).'
  url: https://www.nasa.gov/wp-content/uploads/2023/11/nasa-std-3001-vol-1-rev-c-with-signature.pdf
  supports: >-
    NASA-STD-3001 Vol 1 Rev C: V1 3006, V1 6002 (private medical communications scheduled routinely; store-and-forward
    when there is a delay), V1 6003, V1 6004 (behavioral health support programs), V1 7003.
- key: v2
  text: >-
    NASA. NASA-STD-3001, Volume 2: Human Factors, Habitability, and Environmental Health (Rev F, 2026),
    including Section 10.6 Automated and Robotic Systems.
  url: https://standards.nasa.gov/standard/NASA/NASA-STD-3001_VOL_2
  supports: Requirement IDs beginning V2.
- key: tb044
  text: NASA OCHMO. Medical Operations. Technical Brief OCHMO-TB-044 (2025).
  url: https://www.nasa.gov/wp-content/uploads/2025/08/ochmo-tb-044-medical-operations.pdf
  supports: >-
    The crew surgeon keeps medical authority when care is delegated; crew medical officers train on the
    JSC 48522 medical checklist.
- key: marsdelay
  text: >-
    NASA. Mars communications disruption and delay (fact sheet, 2023 Moon to Mars Architecture Concept
    Review).
  url: https://www.nasa.gov/wp-content/uploads/2024/01/mars-communications-disruption-and-delay.pdf
  supports: >-
    One-way Earth-Mars delay up to about 21-23 minutes, plus blackouts of about 2-3 weeks near solar conjunction.
- key: pccp
  text: >-
    U.S. Food and Drug Administration. Marketing submission recommendations for a predetermined change
    control plan for artificial intelligence-enabled device software functions (guidance).
  url: >-
    https://www.fda.gov/regulatory-information/search-fda-guidance-documents/marketing-submission-recommendations-predetermined-change-control-plan-artificial-intelligence
  supports: A model for planning, validating and rolling back software updates.
- key: faa460
  text: 'U.S. Code of Federal Regulations, Title 14, Part 460: Human space flight requirements.'
  url: https://www.ecfr.gov/current/title-14/chapter-III/subchapter-C/part-460
  supports: >-
    Federal rules for crew and spaceflight participants on licensed commercial flights; they set no medical
    standards for spaceflight participants.
corrections:
- date: '2026-10-21'
  version: '0.2'
  source: Batch 10 AI-assisted clinical review (Medical Research Assistant), Oct 21, 2026
  items:
  - >-
    Link-loss wording (X5 and comms) fixed: the stray word "crew" before the list of what continues is
    removed, so the sentence reads, for example, "the exam already under way and all crew care continue
    under the onboard checklist" (R6).
  - >-
    Limits of privacy and ground escalation: the consent notice and S2 now say "If the person you are
    talking to believes you or someone else is in immediate danger, they will contact the CMO and the
    commander directly."; S7: if the ground support is concerned for anyone's safety, during or after
    the call, they contact the CMO and commander directly by voice and RMP-BEH-001 applies; no call content
    is passed to the robot, which returns only when a human asks (R7).
  - >-
    In-call help control: a one-touch "get help" control on the call screen sends an URGENT alert to the
    CMO and the flight surgeon saying only that help was asked for; the robot returns and RMP-BEH-001
    or RMP-CARD-001 applies as the humans decide (new stop rule X11, new red flag, robot_may, and L2 now
    lists it as the second in-call control) (R8).
  - >-
    A "no response" URGENT alert says only that the crewmember did not respond to the robot, never that
    a call was requested (S5); the CMO is told about a call only with the crewmember's agreement (S4,
    kept).
  - >-
    Store-and-forward messages are deleted from the vehicle once delivery is confirmed, and replies are
    shown only on the crewmember's own screen (L3) (S6).
  - >-
    Fixes applied; held from publication until the Medical Research Assistant verifies them (review state:
    fixes applied, pending verification).
- date: '2026-10-21'
  version: '0.3'
  source: Batch 10 verification pass (AI-assisted, Medical Research Assistant), Oct 21, 2026
  items:
  - 'Verification: R6, R7 and R8 verified as applied (PASS).'
  - >-
    Editorial: the rung note and the why now name both in-call controls, the robot's stop and the call
    screen's "get help" control, matching L2 and R8.
  - Review state set to reviewed-ai-assisted; it publishes with the next release.
