Ethical conflicts in the treatment of fasting Muslim patients with diabetes during Ramadan

Abstract

Deficiencies in medical as well as religious knowledge about fasting in Ramadan and a lack of sensitivity have been found among Muslim patients as well as among doctors. Compliance management and drug use in this area can be improved by effective, goal-oriented action plans and projects through which linguistic and cultural barriers can be addressed.

Experiences and views of people with diabetes during Ramadan fasting: A qualitative meta-synthesis

“…Religious leaders may not clarify that routines, such as pricking fingers and insulin injection, do not nullify fasting. A large communication gap exists among patients, doctors, and religious leaders, especially the doctor-patient relationship, including the doctor's duty to care and the patient's autonomous decision [48]. Some HCPs made their patients decide whether to fast.…”

RAMCOM: A qualitative study of clinicians’ viewpoints on a tool for communication with Muslim patients considering fasting during Ramadan

“…In fact, they should not be participating in the ritual to prevent self-harm, which is prohibited according to the Qur'an 2:195 "and let not your own hands throw you into destruction." [1] While Muslim patients need not apply for an exemption from a religious authority, literature indicates that some Muslim patients like to "consult imams, religious scholars and clinicians when trying to identify whether they have a religious exemption from fasting or not and which dosage forms may or may not nullify it" [8,9]. This is particularly significant since some differences may exist about the interpretation of exemptions from fasting within and between sects [10,11].…”

Diabetes education and medication adjustment in Ramadan (DEAR) program prepares for self-management during fasting with tele-health support from pre-Ramadan to post-Ramadan

“…This DEAR program was initiated to focus on covering the relevant religious and medical aspects through engaging a religious leader and a Malay Muslim healthcare professional team. As our previous study had shown a knowledge-practice gap among fasting Muslims with diabetes, 16 likely contributed by deficiencies in the knowledge of healthcare professionals or ethical conflicts 18 in a Muslim-minority country like Singapore, the team was introduced to reduce not only religious barriers, but also language, cultural and ethnic barriers, 17 as most of our participants are Malays.…”

“…This DEAR program was initiated to focus on covering the relevant religious and medical aspects through engaging a religious leader and a Malay Muslim healthcare professional team. As our previous study had shown a knowledge–practice gap among fasting Muslims with diabetes, 16 likely contributed by deficiencies in the knowledge of healthcare professionals or ethical conflicts 18 in a Muslim-minority country like Singapore, the team was introduced to reduce not only religious barriers, but also language, cultural and ethnic barriers, 17 as most of our participants are Malays. Considering the patients’ perspectives on fasting, 20–22 a proposed reason is that this minority population appeared to have a better comfort level to discuss and share their concerns and experiences in a smaller focused group with a culturally similar healthcare professional team.…”

“…Factors affecting the healthcare professional could be deficiencies in the doctor's medical or religious knowledge and cultural sensitivity 17 resulting in an ethical conflict, 18 and the lack of support from relevant healthcare professionals, such as pharmacists, due to inadequate knowledge. 19 In contrast, studies looking at the perspective of fasting for people with diabetes found that most regarded fasting as beneficial to their well-being 20 with social pressures influencing the decision to fast.…”