Fasting in the month of Ramadan is obligatory on all adult Muslims. Many patients and staff will be fasting or wanting to fast in Ramadan, which is expected to commence this year from around the 13th of September 07. It is important for NHS staff to be aware of and respect this important religious obligation and how such beliefs may affect the different elements of care. This is more important in hospitals where the services of a Muslim chaplain are not available.
Below is a brief summary of the issues relevant to doctors, staff and patients:

WHAT IS A FAST?
The Fast lasts between dawn and sunset. It is compulsory for all healthy adult Muslims on reaching puberty; it is a total fast, with complete abstinence from food and drink.

WHO IS EXEMPTED FROM THE FAST?
1. All those who are ill (physical or mental illness) or frail.
2. Pregnant and menstruating women.
3. Lactating women who have concerns about their own, or their child's health.
4. Travellers
(Despite being in the above categories, some prefer not to miss these Fasts with the possibility of greater reward, as the rewards for fasts are limitless.)

WHEN IS THE FAST RENDERED VOID (BROKEN)?
1. Eating or drinking intentionally
2. Taking oral medication
3. smoking
4. Using vaginal and rectal pessaries

WHAT DOES NOT BREAK THE FAST?
1. Injections (intravenous, intramuscular and subcutaneous).
2. Bloods taken (thumb prick or intravenous).
3. Eye and ear drops.
4. Eating and drinking out of forgetfulness.

THE PATIENT'S PERSPECTIVE
1. The patient's choice should be respected and advice should be offered on medical grounds.
2. If possible, hospital appointments should be given at appropriate times (i.e. outside prayer times – the Muslim patient will be aware of these times) or at the ending of the fast.
3. Arrangements for breaking of Fast – availability of quiet prayer space at prayer times would be appreciated.