Guidance Notes on the Muslim Fast during Ramadan

The Muslim fast during the month of Ramadan provides an opportunity for health professionals to promote health improvement among Muslims by offering lifestyle advice on topics such as diet and smoking cessation.

It is important to recognise that the Muslim community, like any other, is diverse. This results in differences of perception and practice among Muslim patients. The start of Ramadan advances 11 days every year as it is based on a lunar calendar and will sometimes fall in the summer months, resulting in a more onerous fast than when it is in the winter months.

Fasting during Ramadan is intended as a discipline and requires abstinence from anything taken orally during the hours of daylight, each consecutive day for a month. This includes water and smoking. Bleeding will also preclude the fast for that day. Fasting is a requirement after puberty for all able-bodied Muslims of sound mind and good health, but there are concessions for those who are on a journey or who are ill, as well as for women during menstruation, pregnancy or breastfeeding. The concessions range from a complete exemption from fasting, for example for insulin-dependent diabetics, to a requirement to make up the fast at a later date in the case of those who are travelling or who have their periods. A charitable contribution as compensation can serve as an alternative to keeping the fast later.

Since the month of Ramadan is an important time across the community, many patients will endeavour to keep their fasts during this time. With some conditions, this can clearly be harmful. The concessions exist specifically to ensure that people do not fast where it would be detrimental to their health, and this is very reasonable advice to give to patients.

Each situation needs to be judged on its own merits, in the context of the patient’s observance of Ramadan. A comprehensive guide is not possible, but the examples above serve to illustrate that there is Islamic guidance to ensure that fasting is not prejudicial to a patient’s health.