The Islamic Holy Month of Ramadan this year coincides with some of the hottest and longest days of summer.

Fasting in such conditions could create health risks for people with certain medical conditions.

Although the Qur’an says, “God does not require a person more than his abilities,” some Muslims, who should not fast for medical reasons, still choose to observe Ramadan.

Imam Mohammad Ali Elahi, the spiritual leader of the Islamic House of Wisdom, explains that if a Muslim personally fears for his health, or if a doctor tells him that fasting is harmful, he is not required to fast in Ramadan.

If unable to fast during the Holy Month, Muslims are mandated by their religion to make up those days by fasting during a different time of the year. However, if a Muslim has a chronic medical condition and cannot fast at all, he should feed a poor person for every day of Ramadan that he does not fast, which is the equivalent of paying $5 to $10 to charity, according to Elahi. Muslims who are poor themselves are relieved of that fee.

“Ramadan is supposed to make us healthier,” Elahi said. “If fasting harms your health, then you have no obligation to fast.”

Dr. Samuel Fawaz, an internal medicine MD, said that some of his patients fast against his recommendations. 

Fawaz works at Beaumont Hospital in Royal Oak and does not see many Muslim patients, but he says that during his 9-year medical career he has seen many cases where patients, who are not supposed to fast, suffer dehydration and end up in the hospital because of their decision to observe Ramadan, regardless.

Fawaz cautions some of his patients, respectfully, against fasting, but explains that sometimes they choose to follow the advice of clergy in the community, who suggest that they should observe the Holy Month.

“As a rule of thumb, people with serious health conditions, like heart disease, or any sort of cancer, or kidney problems should not fast,” he said. “Elderly people, who are already prone to dehydration, should not fast either.”

Fawaz added that the age when a person should stop fasting varies from one individual to another, depending on the person’s health. But generally he would recommend that people over the age of 75 not fast.

Elahi agrees that the elderly are not required to fast, but explains that no set age is mandated in Islam for older Muslims to stop fasting. It depends on the individual and his health situation, he said.

Fawaz said his medical opinions are his own, and that other doctors may disagree with him, as health issues are open to debate and interpretation.

A Dearborn doctor, who wished for his name not to be published, agreed that all the health conditions mentioned by Fawaz constitute situations where people should not fast.

The Dearborn doctor, whose patients are mostly Muslim, added diabetes to the list of medical conditions that should deter people from fasting.

“Diabetics urinate more than the average person, so they run a higher risk of dehydration,” he said.

According to Elahi people who fast and ignore their health are doing something “haram” (religiously prohibited), because Islam bans self-harm.

“They might be doing it out of faith and with the best of intentions,” he said. “But it is a kind of extremism. You are not supposed to harm yourself. We say that all the time.”

Fawaz added that it may also not be healthy for children, under the age of 14, to fast, because their smaller physical builds do not contain a lot of water, and their physiology has not matured enough, so their systems have a higher risk of collapse under stress.

“There is also the mental aspect,” the doctor said. “It is hard to tell children not to play outside in the sun when they are fasting. Kids are not mature enough to stay home and save their bodies’ water and energy.”

Elahi said that boys in Islam are required to fast from the age of 15, or from the time they reach puberty. But the age of fasting for a girl is “controversial.” Some scholars say that girls must start fasting at 9, while others say at 13 or 14. But, no matter which scholar people choose to follow, if a young girl finds it too difficult to fast, she should not be fasting, Elahi adds.

Elahi said hardship is a component of fasting. People in Ramadan should go through the internal struggle of fasting to gain discipline and determination and to also understand the pain of poverty and hunger, so as to feel solidarity with the poor.

However, he added, if people are at risk of losing their jobs, or compromising their health, as a result of fasting, exceptions can be made, because Islam is a religion of reason and rationality.