How inclusive can spaceflight be, John McFall?

Spaceflight is one of the most safety-critical systems in the world. It is precisely within this environment that John McFall is challenging long-standing assumptions about who can be considered fit for mission. As a member of the ESA Astronaut Reserve, he contributed his expertise to the "Fly!" feasibility study, which explored how participation in spaceflight could become possible within existing systems. In an interview with the REHACARE eMag, John McFall speaks about safety requirements, limited experience with disability, and why inclusion is often less about prejudice than about exposure and understanding.

In brief: who can go to space – and how

ESA is investigating for the first time how people with disabilities could take part in long-duration space missions
Safety requirements remain a central cornerstone of human spaceflight
According to John McFall, lack of experience is often a greater barrier than prejudice

John McFall and his team members are studying the effects of gravity during a parabolic flight

Parabolic flights allowed ESA to gather practical experience with microgravity and physical disability under conditions similar to those encountered in space. © ESA / Novespace

"We haven’t changed the requirements" – how ESA designed the Fly! study

When the European Space Agency (ESA) launched the feasibility study "Fly!", the goal was not to relax existing requirements for people with disabilities. Instead, the focus was on understanding whether and how established safety procedures and operational processes could also be fulfilled reliably by someone with a physical disability.

"We haven’t changed the requirements," John McFall says in his interview with the REHACARE eMag. Instead, much of the study focused on "collecting the evidence" needed to demonstrate that participation is possible within the existing framework.

McFall joined the ESA astronaut reserve in 2022 and became subject matter expert in the Fly! feasibility study. Among other aspects, the study examined how his leg prosthesis could be integrated into existing systems and operational procedures – including mobility, safety requirements, and emergency scenarios during a mission.

A key objective was not to create a special solution for one individual, but to evaluate established processes under realistic conditions. As McFall explains, the study aimed to determine whether someone with a physical disability could "live and work as a fully integrated crew member" on the International Space Station (ISS).

The ESA "Fly!" study at a glance

Feasibility study conducted by the European Space Agency (ESA)
Focus: participation of people with physical disabilities in long-duration space missions
Examined areas included:
- safety requirements
- onboard operational procedures
- integration of prosthetic devices and assistive technology
- medical fitness for missions
John McFall participated as a member of the ESA astronaut reserve
Objective: determine whether existing astronaut requirements can also be fulfilled by people with physical disabilities
The final study report was officially released in 2025

Learn more about the "Fly!" study

"Safety is one of the cornerstones" – why spaceflight works differently

John McFall checking the fit of his prosthesis

As part of the Fly! Study, ESA investigated how a prosthesis fit behaves under conditions designed to simulate the effects of microgravity. © ESA / DLR

According to John McFall, human spaceflight is not about somehow managing individual tasks. What matters is whether all operational procedures continue to function reliably under extreme conditions – including emergencies or technical failures onboard a mission.

"Safety is one of the cornerstones of human spaceflight," says McFall. Astronauts are therefore never assessed in isolation, but always as part of a highly complex system involving technology, operational procedures, and shared crew responsibility.

Within the Fly! study, ESA examined how McFall’s prosthesis could be integrated into existing procedures – for example during movement in confined modules, stabilization processes, or potential emergency scenarios.

One particularly interesting aspect, McFall explains, was that many of these questions had simply never been investigated before. For example, it remains unclear how important his prosthesis would actually be during a long-duration mission.

"It may turn out that I use it far less in space than I do on Earth," McFall says. Many operational questions can only be answered under real mission conditions.

"It often comes from lack of experience – not prejudice" – when uncertainty becomes a barrier

John McFall does not see the biggest barriers in his prosthesis itself. More often, the challenge lies in how other people respond to situations they simply have no prior experience with.

"Very often it comes not from prejudice, but from lack of exposure and experience," McFall says. Many people, particularly in highly specialized environments such as the space sector, have simply never worked closely with someone who has a physical disability before.

This, McFall explains, is precisely why the Fly! study was so important. The project was not only about technical or medical findings, but also about reducing uncertainty and creating real operational experience. In human spaceflight, nothing is left to chance. New situations must first be understood, tested, documented, and evaluated in detail before they can become part of existing systems.

McFall also compares these experiences to other parts of his life. Neither as a surgeon nor as a professional athlete did he ever feel that he had to prove his fundamental capability because of his disability. "This is actually the first time," McFall says.

For him, this illustrates how strongly social perception is shaped by experience and exposure. People often place others into categories – especially when they lack real contact with disability in everyday life or professional environments.

What spaceflight can reveal about inclusion

John McFall runs on a treadmill during a parabolic flight

For John McFall, the significance of the Fly! study extends far beyond spaceflight itself. While the requirements of human space exploration are exceptionally complex, many of the underlying questions also apply to society more broadly: How open are existing systems to different physical conditions? And how much is truly limited by technical barriers – and how much simply by lack of experience?

McFall therefore sees the study as an opportunity to create new perspectives on disability, capability, and participation. In his view, the initiative is not only about a single mission or one individual astronaut. What matters most is building long-term experience and reducing uncertainty through real-world evidence and exposure.

What role people with disabilities may play in future space missions remains open. But for McFall, the discussion should no longer end with whether inclusion is theoretically possible. The more important question is how participation can realistically function within existing operational systems and safety frameworks.

He does not see himself as an exception, but rather as part of a broader learning process within the space sector. The real goal, he says, is to demonstrate how participation can work even in highly specialized and safety-critical environments.

This, ultimately, is where McFall sees the long-term value of the Fly! study – not only for human spaceflight, but also for the broader understanding of disability, safety, and human capability.

This is actually the first time I’ve felt that I had to prove myself because of my disability.

Very often it comes not from prejudice, but from lack of exposure and experience.

The study was never about changing the requirements, but about collecting the evidence to show that participation is possible within existing systems.

Nadine Lormis smiles in to the camera; Copyright: Victoria Emanuel

Author: Nadine Lormis | REHACARE eMag

Nadine Lormis has been writing about (digital) developments in the assistive technology sector, self-determined living and inclusion for over 15 years. As editorial director of the REHACARE eMag, she is closely networked with the community of people with disabilities and chronic illnesses – both professionally and personally.

Published on: May 29, 2026