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CME Information


Statement of Need
CLINICAL ETHICS FOR UROLOGISTS is an online curriculum that introduces and challenges you to appreciate more fully and therefore, respond more effectively to the ethical dimensions of medical practice in urology. Properly understood and regardless of specific specialty, the practice of medicine as a profession inevitably generates ethical questions for physicians, patients, their families, and society at large. Indeed, the fundamental question encountered by physicians in caring for their patients is not what can be done to help and heal them but rather what should be done. To answer this question requires considerations of a scientific, clinical, and ethical nature.

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Activity Description
The original Ethics curriculum, released in 2008, was developed in association with the Society of University Urologists and Society of Urology Chairs and Program Directors. It consists of 17 modules, which provide a means for driving achievement of the specific objectives for the core competencies in professionalism. The Ethics' curriculum is structured to develop a knowledge base of the "ethical principles" and of other matters important to the ethical practice of urology and other specialties of contemporary medicine. For example, instructional modules include the legal aspects of such topics as informed consent and the various approaches to thinking through ethical dilemmas at (as well as beyond) the bedside. In addition to knowledge of clinical ethics, however, the curriculum is designed to foster in you an appreciation of the moral history of the profession and of the current state of debate about a range of ethical issues--from assisted suicide and euthanasia to medical futility. In 2011, module 18 – expert witness, developed by the Judicial and Ethics Committee, was added to educate urologists in providing quality expert witness testimony regarding standard of care.

The current curriculum consists of 18 modules, each of which

  • specifies the relevant learning objectives for the module
  • frames the ethical challenges relevant to the topic of the module with brief clinical scenarios
  • describes the relevant historical, legal and ethical background
  • identifies points of agreement and controversy in addressing the ethical challenges relevant to the topic of the module
  • presents a case, suitable for self-directed or small group-based activities with questions for discussion, analysis and reflection
  • lists additional resources for continued learning
  • ends with a posttest

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Utilizing the Modules
It is best--although not absolutely necessary--to begin with modules 1 through 7 and to work through each in sequential order before moving on to modules 8 through 18.

  • Modules 10 and 11 (on Advance Care Planning and Advance Directives and on Decision Making in the Care of Patients with Serious or Terminal Illness) should be worked through in sequence.
  • Module 13 focuses on a salient feature of contemporary practice, i.e., clinical practice in contemporary health care is a collaborative, interdisciplinary endeavor, as is the process of deciding what should be done for the patient.
  • Module 14 introduces the learner to an important but often neglected resource for ethical wisdom and experience, the organizational ethics committee.
  • Although the curriculum is weighted toward the ethical challenges encountered in clinical practice, module 15 (on Conflicts of Interest) and module 17 (on research ethics) address issues arising at the intersections between the urologist's role as clinician and his or her role as an investigator, administrator, etc.
  • Module 18 emphasis is on expert witness testimony as a professional responsibility and the essential qualifications to be a good expert witness as well as give a good expert testimony

In their range and diversity, the modules are intended to convey something of the complexity and the richness of the ethical dimensions of contemporary urology.

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Global Learning Objectives
After completing each module, participants should be able to:

  • assess their knowledge of clinical ethics in the practice of urology
  • demonstrate an increased knowledge base in the ethical practice of urology
  • apply increased knowledge to improve quality of patient care
  • integrate professionalism in the practice of urology

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Target Audience
Residents, practicing urologists, and allied health professionals.

Clinical Ethics for Urologists is designed for the novice in clinical ethics as well as for more experienced physicians. You need not have any previous knowledge of clinical ethics.

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Accreditation
The American Urological Association Education and Research, Inc. (AUAER) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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Credit Designation
The American Urological Association Education and Research, Inc. (AUAER) designates this enduring material for a maximum of 9.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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International Physicians
International physicians may also earn AMA PRA Category 1 Credits™ by participating in CME activities certified through American organizations accredited by the Accreditation Council for Continuing Medical Education (ACCME). Accredited providers may designate activities for AMA PRA Category 1 Credits™ regardless of the location of the activity. A physician participating in such an activity would receive credit directly from the accredited provider. For a list of accredited providers, visit www.accme.org.

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Non-physician Health Professionals
AUAER is not accredited to offer credit for non-physician health professionals. However, AUAER will issue documentation of participation that states that the activity was certified for AMA PRA Category 1 Credits™.

The AUA takes responsibility for the content, quality, and scientific integrity of this CME activity.

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Method of Participation
Begin with modules 1 through 7 and work through each in sequential order before moving on to modules 8 through 18. Each module is worth AMA PRA Category 1 Credits™. To earn credit/hours of participation for each module:

  1. read the module's objectives and contents
  2. relate the content materials to the objectives
  3. pass the posttest with a minimum score of 80% and complete the evaluation

Click on the "Status" button in the menu at the left to view a summary of your credits earned and obtain your certificate(s).

Estimated time to complete each module
.5 Hours

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Media Used
Internet

Minimum Hardware and Software Requirements

  • PC-compatible computer running Windows XP
  • Macintosh computer running OS X 10.1 or later
  • Linux computer capable of running Mozilla Firefox 3.0 or later
  • Processor speed of 800 MHz (1GHz preferred)
  • A minimum of 128 MB of RAM (more preferred)
  • A modem speed of at least 56k (broadband preferred)
  • Internet browser should be one of the following: Internet Explorer 8.0 or later, Firefox 3.0 or later, Chrome 4.0 or later, or Safari 4.0 or later
  • Software requirement: Adobe Acrobat Reader 9 or newer

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Original Release Date
January, 2008

Expiration Date
January, 2017

Peer Reviewed
This activity was peer reviewed on 1/10/2011.
This activity was peer reviewed on 1/10/2014.

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AUAER Disclosure Policy
As a provider accredited by the ACCME, the AUAER must ensure balance, independence, objectivity and scientific rigor in all its activities.

All persons in a position to control the content of an educational activity (i.e., activity planners and presenters) provided by the AUAER are required to disclose to the provider any relevant financial relationships they have with any commercial interest. The AUAER must determine if an individual's financial relationships may influence the educational content with regard to exposition or conclusion, and resolve any conflicts of interest prior to the commencement of the educational activity. The intent of this disclosure is not to prevent individuals with relevant financial relationships from serving as planners or presenters, but rather to provide the audience with information on which they can make informed judgments about the material presented.

Resolution of Identified Conflict of Interest
All disclosures will be reviewed by the program/course directors or editors for identification of conflicts of interest. Peer reviewers, working with the program directors and/or editors, will document the mechanism(s) for management and resolution of the conflict of interest and final approval of the activity will be documented prior to implementation. Any of the mechanisms below can/will be used to resolve conflict of interest:

  • Peer review for valid, evidence-based content of all materials associated with an educational activity by the course/program director, editor, and/or Education Content Review Committee or its subgroup
  • Limit content to evidence with no recommendations
  • Introduction of a debate format with an unbiased moderator (point-counterpoint)
  • Inclusion of moderated panel discussion
  • Publication of a parallel or rebuttal article for an article that is felt to be biased
  • Limit equipment representatives to providing logistics and operation support only in procedural demonstrations
  • Divestiture of the relationship by faculty

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Author of Modules 1-17

F. Daniel Davis, PhD
Director of Bioethics
Geisinger Health System
Danville, PA
Disclosures: Nothing to Disclose

Faculty

Deborah J. Lightner, MD, Activity Co-Director
Professor of Urology
Department of Urology
Mayo Clinic
Rochester, MN
Disclosures: Nothing to disclose
Activity Co-Director

Adam P. Klausner, MD, Activity Co-Director
Associate Professor
Director of Neurourology, Female Urology and Voiding Dysfunction
Division of Urology
Department of Surgery
School of Medicine Virginia Commonwealth University
Richmond, VA
Disclosures: Allergan, Inc.: Investigator

Contributors Disclosures

Robert C. Flanigan, MD
Professor
Department of Urology
Loyola University Medical Center
Loyola University Chicago Stritch School of Medicine
Maywood, IL
Disclosures: National Cancer Institute: Investigator; NIDDK (NIH): Consultant or Advisor; WJ Weiser: Employee (Family)

John H. Lynch , MD
Professor and Chairman
Department of Urology
Georgetown University Hospital
Washington, DC
Disclosure: Theralogix: Investment Interest

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Planners
American Urological Association Judicial & Ethics Committee Disclosures

Gopal Badlani, MD
Winston Salem, NC
Disclosures: Allergan: Investigator; Lithotripsy group: Piedmont Stone & Physician Discovery: Investment Interest; Olympus: Investigator

Lisa T. Beaule, MD
South Portland, ME
Disclosures: Nothing to disclose

James F. Borin, MD
Baltimore, MD
Disclosures: Cook Medical: Consultant or Advisor

Mark Campobello, CPA
Linthicum, MD
Disclosures: Nothing to disclose

John M. Corman, MD
Seattle, WA
Disclosures: Amgen: Investigator; Astra Zeneca: Investigator; Dendreon: Investigator; Epigenomics: Investigator; Glaxo Smith Kline: Investigator; Roll International: Investigator; Wilex: Investigator

John D. Denstedt, MD
London, ON, Canada
Disclosures: American Medical Systems: Consultant or Advisor; Boston Scientific: Consultant or Advisor

Martin L. Dresner, MD
Tucson, AZ
Disclosures: American College of Surgeons: Board Member, Officer, Trustee; Society of Government Service Urologists: Board Member, Officer, Trustee; Western Section American Urological Association: Board Member, Officer, Trustee

Sushil S. Lacy, MD
Lincoln, NE
Disclosures: AACU: Board Member, Officer, Trustee

Patrick H. McKenna, MD
Springfield, IL
Disclosures: North Central Section of the AUA: Board Member, Officer, Trustee; Society of University Urologists: Board Member, Officer, Trustee

Harris M. Nagler, MD
New York, NY
Disclosures: Nothing to disclose

Dennis A. Pessis, MD
Highland Park, IL
Disclosures: ForTec Litho: Other; HIFU: Investigator

Charles R. Pound, MD
Jackson, MS
Disclosures: Nothing to disclose

Michael A. Pretl, Esq.
Linthicum, MD
Disclosures: Given Imaging, Inc: Investment Interest; Maryland Citizens Health Initiative: Board Member, Officer, Trustee; Omega Healthcare Investors: Investment Interest; Teva Pharmaceutical Industries, Ltd.: Investment Interest

Harriette M. Scarpero, MD
Nashville, TN
Disclosures: Allergan: Meeting Participant or Lecturer; American Medical Systems (AMS): Consultant or Advisor; Pfizer, Inc.: Scientific Study or Trial

Michael T. Sheppard, CPA, CAE
Linthicum, MD
Disclosures: Nothing to disclose

Drew Shifflet, CAE
Linthicum, MD
Disclosures: Flabbergasted Incorporated: Consultant or Advisor

Stephen E. Strup, MD
Lexington, KY
Disclosures: Nothing to disclose

John A. Taylor, III, MD
Farmington, CT
Disclosures: Nothing to disclose

Anthony J. Thomas, Jr., MD
Westlake, OH
Disclosures: Nothing to disclose

Vijaya M. Vemulakonda, MD
Aurora, CO
Disclosures: UpToDate: Other

Nancy Waid
Linthicum, MD
Disclosures: Nothing to disclose

Steve W. Waxman, MD
Overland Park, KS
Disclosures: Nothing to disclose

American Urological Association Education Council Committee Members' Disclosures

Christopher L. Amling, MD
Portland, OR
Disclosures: Sanofi-Aventis: Meeting Participant or Lecturer

Gopal Badlani, MD
Winston Salem, NC
Disclosures: Allergan: Investigator; Lithotripsy group: Piedmont stone & physician discovery: Investment Interest; Olympus: Investigator

Peter R. Carroll, MD
San Francisco, CA
Disclosures: Abbott Pharmaceuticals: Investigator; Department of Defense: Investigator; Genomic Health: Investigator; Myriad Genetics: Investigator; NIH: Investigator

Marc S. Cohen, MD
Bay Pines, FL
Disclosures: Nothing to disclose

Robert C. Flanigan, MD
Maywood, IL
Disclosures: National Cancer Institute: Investigator; NIDDK (NIH): Consultant or Advisor; WJ Weiser: Employee (Family)

Pat Fox Fulgham, MD
Dallas, TX
Disclosures: Urology Clinics of North Texas: Other

Bruce R. Gilbert, MD, PhD
Disclosures: Auxilium: Investigator; Bayer Healthcare Pharmaceuticals Inc.: Investigator; Warner Chilcott: Investigator

David F. Jarrard, MD
Disclosures: Johnson and Johnson: Consultant or Advisor

David Joseph, MD
Birmingham, AL
Disclosures: Centers for Disease Control and Prevention: Investigator; Spina Bifida Foundation: Board Member, Officer, Trustee; Tengion: Scientific Study or Trial

Barry A. Kogan, MD
Disclosures: United Urology: Investigator; Watson Pharmaceuticals: Consultant or Advisor

Benjamin R. Lee, MD
Disclosures: Cook Urological: Consultant or Advisor

Vinata B. Lokeshwar, PhD
Miami, FL
Disclosures: Nothing to disclose

Mary Mathe, RPA-C
Celebration, FL
Disclosures: Nothing to disclose

Elspeth M. McDougall, MD
Orange, CA
Disclosures: Endocare: Other; Ethicon Endo-Surgery: Other; Intuitive Surgical: Other; Karl Storz Endoscopy America:Other; Simbionix:Other

Badar M. Mian, MD
Albany, NY
Disclosures: Nothing to disclose

Arthur P. Mourtzinos, MD
Burlington, MA
Disclosures: Allergan: Investigator; American Medical Systems: Consultant or Advisor; Astellas: Meeting Participant or Lecturer; Coloplast: Meeting Participant or Lecturer; Johnson & Johnson: Consultant or Advisor

J. Kellogg Parsons, MD
La Jolla, CA
Disclosures: AMS: Meeting Participant or Lecturer; Aureon: Consultant or Advisor

Jaspreet S. Sandhu, MD
New York, NY
Disclosures: American Medical Systems: Consultant or Advisor

William D. Steers, MD
Charlottesville, VA
Disclosures: Allergan: Scientific Study or Trial; Food and Drug Administration: Consultant or Advisor; National Institutes of Health: Consultant or Advisor; New England Research Institute (NERI):Consultant or Advisor

John T. Stoffel, MD
Burlington, MA
Disclosures: Nothing to disclose

Chandru P. Sundaram, MD
Indianapolis, IN
Disclosures: Nothing to disclose

Robert M. Sweet, MD
Minneapolis, MD
Disclosures: Allergan: Scientific Study or Trial; American Medical Systems Holding, Inc.: Scientific Study or Trial; Coruthers Health Consulting: Consultant or Advisor; Gyrus ACMI Olympus: Other; Medtronic: Scientific Study or Trial; Red Llama Incorporated: Owner

Zhou Wang, PhD
Pittsburgh, PA
Disclosures: Nothing to disclose

Alan J. Wein, MD, PhD
Philadelphia, PA
Disclosures: Allergan: Consultant or Advisor; Astellas: Consultant or Advisor; ENDO Pharmaceuticals: Consultant or Advisor; Ferring Pharmaceuticals: Consultant or Advisor; Medtronic: Consultant or Advisor; Pfizer: Consultant or Advisor

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Disclaimer
The opinions and recommendations expressed by faculty, authors, and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the AUAER.

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Off-label or Unapproved Use of Drugs or Devices
It is the policy of the AUAER to require the disclosure of all references to off-label or unapproved uses of drugs or devices prior to the presentation of educational content. The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the product prescribing information for full disclosure of approved uses.

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Evidence Based Content
As a provider of continuing medical education accredited by the ACCME, it is the policy of the AUAER to review and certify that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias.

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Copyright
©American Urological Association, 2008, 2011

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AUA Privacy and Confidentiality Policy
www.auanet.org/cme/onlineeduconf.cfm

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Contact Information
Toll Free (U.S. only): 1-866-RING AUA (1-866-746-4282)
Phone: 410-689-3700

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