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Nancy Neveloff Dubler, Mediator for Life’s Final Moments, Dies at 82

A bioethicist, she pioneered bedside methods for helping patients, their families and doctors deal with anguishing life-and-death decisions in a high-tech age.

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A woman wearing a sleeveless dark blouse holding the outstretched hand of an older man in a short-sleeve shirt sitting beside a hospital bed. The patient in the bed is not in the frame.
Nancy Dubler, director of the bioethics division at Montefiore Medical Center in the Bronx, spoke in 2005 with Fred Haber, who was at his wife’s bedside after a mediation session.Credit...James Estrin/The New York Times

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.

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Modern medical technology, Ms. Dubler wrote in her 1992 book, “lets us take a body with a massive brain hemorrhage, hook it up to a machine, and keep it nominally ‘alive,’ functioning organs on a bed, without hope of recovery.”Credit...Harmony Books/Crown Publishers

“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-and-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.


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