By Slma Shelbayah, CNN
(CNN) This Ramadan, Amina Jabbar faced a difficult decision.
The University of Toronto medical student’s rotation at Sunnybrook Health Sciences Centre began around July 9, the start of the Muslim holy month.
That meant working unpredictable shifts for as long as 26 hours while fasting from eating and drinking during the day.
The fast-paced hospital environment was already challenging Jabbar’s ability to keep up with colleagues and patients. As a new physician, she felt more “error prone” and said fasting would increase her anxiety on the job.
Ramadan requires “slowing down,” Jabbar said, an impossible task for a first-year medical resident whose job requires fast decisions and clear thinking to save lives.
The 29-year-old Muslim was torn.
Should she fulfill her professional duties, eating regular meals so hunger would not distract her from patients’ critical needs? Or should she honor her religious obligations by observing the fast, a practice considered a “pillar” of Islam?
“I am spending 60-80 hours (at the hospital) and I don’t get to slow down for Ramadan,” Jabbar said. “It felt unfair to my colleagues and patients to tell them to slow down for me.”
At the same time, Jabbar said she feared that fellow Muslims would criticize her if she didn’t fast. “There’s a certain amount of shame when we talk about people not fasting,” she said.
The decision not to fast during Ramadan, the holiest month in the Muslim calendar, is somewhat taboo in the Muslim community.
READ MORE: The Belief Blog Guide to Ramadan
In Islam, Ramadan commemorates the time when the angel Gabriel imparted the Quran to the Prophet Mohammed.
Many Muslims throughout the world commemorate the month by fasting, refraining from sex and smoking, and dedicating more time than usual to praying and reading the Quran.
Some exceptions are generally allowed during Ramadan, which ends August 8. Pregnant women, travelers and sick people are not expected to observe the fast, for example.
But for many other Muslims, especially first responders and others with stressful jobs, the choice of whether to fast can cause its own kind of anxiety.
When Jabbar blogged about her decision not to fast, she received a mix of reactions.
One Muslim accused her of looking for an “excuse” to shirk her religious duties. Some questioned her devotion to Islam, asking if she performs other required Islamic rituals such as daily prayers.
“Of course I pray," Jabbar said. "I am just choosing not to fast. We have a lot of pressure to demonstrate to our community that we’re Muslim.”
Imam Khalil Abdur-Rashid, head of the Iqra Mosque in Brooklyn and Muslim Chaplain of Columbia University, said that observing the fast during Ramadan is a religious obligation for every Muslim who is considered mature, mentally sane, healthy and not traveling.
There are no fatwas – or religious rulings – that grant fasting exemptions for first responders, he added. But, Abdur-Rashid said, one is definitely needed. In fact, he generated one immediately after speaking with CNN.
"The purpose of the fast is not to place the fasting person in the face of harm, but to teach self-restraint,” Abdur-Rashid said.
“And the moment the fast becomes dangerous, or external conditions place the fasting person in harm's way," he said, "then the fasting person is not only permitted, but in many cases, religiously obliged to break their fast.”
Abdur-Rashid's new fatwa may be especially valuable to Muslims like New Yorker Ahmed Sabree, who battles fires while wearing heavy equipment during the searing summer heat.