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In Reply: We welcome further elaboration about Islam and Ramadan. The purpose of our letter was to raise physician awareness about Ramadan practices and to share our experiences in caring for a large, diverse, Muslim population. We encourage physicians to discuss Ramadan with their patients and to become knowledgeable about patients' religious practices and their potential health care ramifications. We completely agree that fasting is not meant to impose hardship and believe that medical professionals should take an active role in discussing with their patients which situations may exempt one from fasting. We seek guidance from religious leaders along with our patients about questions or concerns that may arise while observing the holy month of Ramadan.

Financial Disclosures: None reported.

Sandra S. Crosby, MD
scrosby@bu.edu
Boston Medical Center

Elizabeth J. Rourke, MD
Massachusetts General Hospital

Mohamed A. Warfa
Boston Medical Center
Boston, Mass

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295:498.

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