Ilkilic Ilhan, Ertin Hakan
Department of History of Medicine and Ethics, Istanbul University Faculty of Medicine, Hulusi Behçet Kütüphanesi Kat 2, 34093, Istanbul/Capa, Turkey.
Med Health Care Philos. 2017 Dec;20(4):561-570. doi: 10.1007/s11019-017-9777-y.
For an effective treatment of patients, quality-assured safe implementation of drug therapy is indispensable. Fasting during Ramadan, an essential religious practice for Muslims, affects Muslim diabetics' drug use in a number of different ways.
Ethical problems arising from fasting during the month of Ramadan for practicing Muslim patients are being discussed on the basis of extant research literature. Relevant conflicts of interest originating in this situation are being analysed from an ethical perspective.
A number of databases have been searched systematically in view of the stated objectives to identify relevant studies. Starting point for this review are the following questions: What information is available regarding the fasting behaviour of Muslim diabetics during Ramadan? What kind of ethical problems can be identified in the context of this religious practice?
The present review established a number of problems concerning medication adherence and drug use of practising Muslim diabetics during Ramadan, notably insufficient compliance, reduced frequency of consultations with their doctor, and inadequate, not sufficiently goal-oriented doctor-patient conversations about fasting.
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.
为有效治疗患者，确保药物治疗的质量和安全性不可或缺。斋月禁食是穆斯林的一项重要宗教习俗，会以多种不同方式影响穆斯林糖尿病患者的用药。
基于现有研究文献，探讨斋月期间禁食给穆斯林患者带来的伦理问题，并从伦理角度分析由此产生的相关利益冲突。
为实现既定目标，系统检索了多个数据库以识别相关研究。本次综述的起点是以下问题：关于斋月期间穆斯林糖尿病患者的禁食行为有哪些信息？在这种宗教习俗背景下能识别出哪些伦理问题？
本次综述确定了斋月期间穆斯林糖尿病患者在药物依从性和用药方面存在的一些问题，尤其是依从性不足、看医生的频率降低，以及关于禁食的医患沟通不充分、缺乏明确目标。
发现穆斯林患者和医生在斋月禁食的医学及宗教知识方面存在不足，且缺乏敏感性。通过有效的、目标明确的行动计划和项目来解决语言和文化障碍，可改善该领域的依从性管理和用药情况。
