Nancy Neveloff Dubler, a mediator in the final moments of life, has died at the age of 82

A bioethicist, she has pioneered methods to help patients, their families, and physicians make agonizing life and death decisions in the high-tech age.

Nancy Neveloff Dubler, a medical ethicist who pioneered the use of hospital bedside mediation to resolve the complex relationship dynamics between determined physicians, distressed relatives and patients in their final days, died April 14 at her home on Manhattan's Upper West Side. She was 82 years old.

According to her family, the cause was heart and lung disease.

A Harvard-educated lawyer who won the college presidency through a campaign to dissolve 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 confusing medical situations, especially in deciding how to proceed with the sickest patients.

In 1978, Ms. Dubler founded the Bioethics Advisory Service at Montefiore Medical Center in the Bronx. One of the first in the country, the service employed lawyers, bioethicists and even philosophers who, like doctors on call, wore pagers alerting them to urgent ethical problems.

"My colleagues and I spend most of our time working with physicians, nurses, and social workers", Ms. Dubler wrote, co-authored with 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 entangles all patients and their caregivers".

Bioethics counselors emerged as a medical subspecialty following revolutionary advances in technology, pharmaceuticals, and surgical techniques.