Nancy Neveloff Dubler, a medical ethicist who pioneered using mediation at hospital bedsides to navigate the complex dynamics among headstrong doctors, anguished family members and patients in their last days, died on April 14 at her home on the Upper West Side of Manhattan. She was 82.
The cause was heart and lung disease, her family said.
A Harvard-educated lawyer who won her college student presidency by campaigning to dissolve the student government, Ms. Dubler was a revolutionary figure in health care who sought, in her words, to “level the playing field” and “amplify nonmedical voices” in knotty medical situations, especially when deciding next steps for the sickest of patients.
In 1978, Ms. Dubler founded the Bioethics Consultation Service at Montefiore Medical Center in the Bronx. Among the first such teams in the country, the service employed lawyers, bioethicists and even philosophers who, like doctors on call, carried pagers alerting them to emergency ethical issues.
“My colleagues and I spend most of our time working with doctors, nurses, and social workers,” Ms. Dubler wrote with her co-author, David Nimmons, in “Ethics On Call: A Medical Ethicist Shows How to Take Charge of Life-or-death Choices” (1992). “We start where they get stuck, in the web of rights and responsibilities that ensnares all patients and caregivers.”
Bioethics consultants emerged as a medical subspecialty following groundbreaking advances in technology, pharmaceuticals and surgical techniques.
