CARING FOR THE MUSLIM PATIENT
A Muslim is a follower of ISLAM which means "submission" to the will of God. Most religious historians view Islam
as having been founded in 622 CE by Mohammad the Prophet (peace be upon him). He lived from about 570 to
632 CE. The religion started in Mecca, when the angel Jibril (a.k.a. Jibreel; Gabriel in English) read the first
revelation to Mohammad (pbuh). Muslims believe in one God, Allah, and in Mohammed, Allah's prophet, or
messenger. Mohammed is believed to be the last in a long line of prophets, which include Abraham, Moses,
David and Jesus. Muslims believe in life after death, and that Allah will judge a person according to what he has
done. Most Muslims in Britain come from Pakistan, Bangladesh, or Kashmir, and there are also quite large
Turkish and Turkish Cypriot Muslim communities. There are different groups of Muslims - Shi'ite and Sunni
Muslims, as well as Ahmaddiya and beliefs and practices differ. The local Iman will be able to offer help and
advice.
SIGNIFICANT TERMS
KORAN - Islamic Holy Book which is the teaching of Mohammed. The Hospital Chaplains can provide a copy of
the Koran if it is needed. It should be treated with great respect and no items placed upon it.
MOSQUE - Muslim centre for worship and religious instruction. It is in the charge of a prayer leader - the IMAN who is elected and supported by the congregation.
SPECIAL CONSIDERATIONS
MODESTY - Muslims follow a strict code of modesty. Treatment by a medical practitioner of the same sex is
strongly preferred. A woman may wish her husband to be present when she is examined.
DIET - Only Halal (ritually slaughtered) meat can be eaten. Both pork and alcohol are forbidden. The taking of
medication during a fast may cause difficulty to patients. The local mosque may offer help.
PRAYER
Muslims pray 5 times a day, facing Mecca (South-East). The times of prayer are dawn, noon, mid afternoon, just
after sunset, and before retiring to bed. Before every act of prayer the Muslim will need to wash - water poured
from a jug would be appreciated. If a Muslim patient is in bed and physically unable to face Mecca it would still be
helpful to indicate the direction to them. Privacy should be offered for prayer by drawing the curtains around the
bed or ideally a quiet room should be provided.
AS DEATH APPROACHES
The dying patient may want to sit, or lie, facing Mecca, and this may entail moving the bed. The family will
probably want to pray at the bedside of their loved one, and perhaps to read to them from the Koran. The Iman is
not required to attend the death of a Muslim, but he is often invited to do so.
LAST OFFICES
After death the patient's body should be wrapped in a plain white sheet. The body should not be washed, nor the
nails cut. The foot of the bed should face Mecca, or the patient should be turned on their right side in order that
they look towards the Holy City. Non-Muslims touching the body must wear gloves. The washing and
preparation of the body should normally be left to the family, or to the Islamic Funeral Directors. In normal
circumstances, when Muslims are carrying out the last offices themselves, they will tie the patient's feet together
with a thread around the toes, and bandage the face in order to keep the mouth closed.
A Muslim is always buried, and immediate (next-day) burial is preferred if at all possible. Muslims may oppose
post-mortems, but there is no objection if this is required by law. Organ donation would usually be allowed with
the permission of all concerned.
RELIGIOUS FESTIVALS
The observance of RAMADAN is one of the 5 pillars of the Muslim faith. Ramadan is held during the ninth month
of the Islamic lunar calendar. Because the lunar calendar has 354 days each year instead of 365, the
observance of Ramadan, like the other festivals, slips back 11 days each year. During Ramadan the Muslim will
eat 90 minutes before sunrise, and then again after sunset. Fasting during Ramadan is expected of all healthy
Muslims over the age of 12 years. Many who are terminally ill feel especially strongly about Ramadan as a
spiritual discipline. The normal rule is that the elderly and the sick do not fast for the whole month, but should fast
a little if they can. It is important to note that, fasting for Muslims would also mean that nothing can be taken into
the body not only through the mouth, but also through the nose, injection, or suppository, from dawn to sunset.
This has implications, especially for pain control, and needs to be carefully discussed with the patient, without
subjecting them to undue pressure.
It is important to note that, fasting for some Muslims can also mean that nothing can be taken into the body not
only through the mouth, but also through the nose, injection*, or suppository, from dawn to sunset. This has
implications, especially for pain control, and makes it essential that this is discussed with the patient, without
subjecting them to undue pressure.
EVERY MUSLIM PATIENT IS AN INDIVIDUAL AND PRACTICES MAY VARY.
RAMADAN FACT SHEET
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 in
2008 from around the 1st September. 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.
Adapted from a draft prepared by Mufti Zubair Butt, Muslim Chaplain at the Leeds Teaching Hospital
* If this injection was nutritional (in any form) then it nullifies the fast whether it is in the vein or other than
that. If, however, it is a tranquiliser or an analgesic for pain pr that which is similar to it then this does not
break the fast. Shaykh Ibn Jibreen / (Fataawa Ramadan, Volume 2/ Page 485/ Fatwa No. 433)
** The fast is not nullified for this (blood analysis), rather it is exempted from. This is because it is a necessity
and not from that which is known, from the pure Sharee'ah, to break the fast.Shaykh Ibn Baaz (Fataawa
Ramadan, Volume 2/ Page 465/ Fatwa No.400). If he donates and a lot of blood is drawn out, then he
breaks his fast as it is regarded as similar to cupping (hijaamah).Shaykh Ibn Fowzaan / (Fataawa Ramadan,
Volume 2/ Page 467, Fatwa No.405)