Medical ethics of spaceflight should be based on ethical theories and include the non-ethical context

We are grateful for the opportunity to respond to the recently submitted commentary engaging with our review article, Medical Ethics of Long-Duration Spaceflight. Scholarly critique is an essential part of developing sound ethical frameworks in this nascent and rapidly evolving field. We offer this reply to clarify several philosophical misinterpretations and respond to critiques that, in our view, reflect a misunderstanding of both our intentions and the scope of our article.