Letters Fasting during Ramadan

What should doctors do about fasting during Ramadan?

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e5629 (Published 24 August 2012) Cite this as: BMJ 2012;345:e5629
  1. Fareed Iqbal, research fellow1
  1. 1Academic Department of Surgery, School of Cancer Sciences, Denis Howell Building University of Birmingham, Birmingham B15 2TT, UK
  1. F.Iqbal{at}bham.ac.uk

Although agreeing with the general sentiments expressed in Panju’s insightful article on patients who fast in Ramadan,1 I think this discussion should address an often overlooked issue: Should doctors fast while caring for patients? As a practising Muslim, I have found it extremely difficult to provide patients with optimal surgical care while fasting for 12 hours a day. Doctors working in specialties that perform high risk invasive procedures, such as surgery and anaesthetics, should avoid it. The Fiqh council of Birmingham (an Islamic committee of clerics that addresses modern religious issues) suggested to me that if doctors think that they are compromising patient care then they are excused from fasting, but the fast should be made up later when they are not working.

Studies exploring the effects of fasting in healthy adults have concluded that it is a safe practice and perhaps even life-prolonging.2 3 Investigators from Denmark addressed this issue in a small cohort of surgeons and found that surgical skills were not negatively affected by fasting.4 However Dolu et al concluded that reaction times to an auditory stimulus increased and continuous attention decreased.5

The effects of fasting on doctors’ performance requires further study. Until strong evidence is available to support fasting, doctors should avoid it while caring for patients.


Cite this as: BMJ 2012;345:e5629


  • Competing interests: None declared.


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