Islamic Rulings on Modern Medical Treatments While Fasting: A Guide for Muslims
Modern Medical Issues Regarding Fasting
Islam is a complete way of life, and it provides guidance for all aspects of human existence. This is why the life of Muslims, compared to other nations, is better and clearer. In fact, when a Muslim faces any issue related to any aspect of life, its solution is found in the Qur’an and Hadith. Today, the world has progressed significantly, and many things that were unknown just fifty years ago have now become commonplace, thanks to advancements in science and technology. These developments have introduced numerous discoveries, provided ease in various fields of life, and opened new doors for treatment. Many diseases that were once considered incurable or whose treatments were extremely difficult have now seen great improvements and progress. Islam is not opposed to science and progress; rather, it allows the use of modern resources, provided they do not contradict the teachings of Islam. In matters of treatment, it is not permissible to use prohibited substances, but if the treatment is free from haram (forbidden) elements, then it is permissible to use all kinds of available methods and medicines.
The month of Ramadan is a time of immense joy and blessings for Muslims. Therefore, in this blessed month, the Muslim community is seen to be more cautious, energetic, filled with religious zeal, eager for reward, hastening towards good deeds, fasting during the day, and illuminating the nights with Taraweeh prayer.
As science and technology have introduced new advancements and electrical inventions and discoveries, Muslims have needed to understand the religious stance on these matters. This brief article discusses the Islamic perspective on modern medical issues that a Muslim, especially a patient, may face.
(1) Miswak and Toothbrush & Paste: Using a miswak at any time during the night or day is a Sunnah for those fasting. Aisha (may Allah be pleased with her) reported that the Prophet (peace be upon him) said: السواک مطھرۃ للفم مرضاۃ للرب (رواہ البخاری)
Translation: “The miswak cleans the mouth and pleases the Lord.”
Sheikh Ibn Uthaymeen (may Allah have mercy on him) stated that if the flavor or effect of the miswak enters the throat, the fasting person should not swallow the taste or the saliva (Fatawa al-Siyam).
However, when using a toothbrush and paste, we must consider whether the paste has a strong effect or a mild one, as both types are available in the market.
- If the paste is strong, meaning it reaches the stomach, such a paste should not be used.
- If the paste only reaches the throat and not the stomach, then there is no harm in using it.
(2) Use of Drops: There is no harm in using eye or ear drops out of necessity, as they do not break the fast. The effect of these drops does not reach the stomach. Even if it is assumed that the drops somehow reach the stomach, the amount that might enter from the eyes or ears would be very small and would not affect the fast. Scholars in Arab countries also give fatwas of permissibility regarding this, but the fatwa for nasal drops is that they are not allowed. This is based on the hadith:
وبالِغْ في الاستنشاقِ إلا أن تكون صائمًا (صحيح أبي داود: 142)
Translation: “Exaggerate in sniffing water during wudu, except when you are fasting.”
Some scholars give fatwas allowing drops in the nose, but as a precaution, it is better to delay the use of these drops until the night.
(3) Anesthesia: Sometimes a person may become unconscious due to various reasons, such as an accident or medical treatment. The rulings in this regard are as follows:
- Inhalation of gas or acupuncture to numb certain parts of the body does not invalidate the fast.
- Administering a quick-acting injection to put the patient into temporary unconsciousness does not break the fast.
- If a person intends to fast before becoming unconscious and regains consciousness before sunset, their fast remains valid. However, if they regain consciousness after sunset, their fast is invalid, and they should make up the fast.
- If unconsciousness lasts for a long period (such as a month or two), it is considered similar to insanity, and the person is not required to make up the missed fasts. Allah does not burden a soul beyond its capacity.
(4) Cupping, Incision, and Nosebleeds: There are two types of hadiths regarding cupping: some narrations mention that cupping breaks the fast, while others state that the Prophet (peace be upon him) underwent cupping while fasting (Sahih Bukhari), and he also allowed others to do it (Tabarani, Darqutni). Some scholars consider the hadiths stating cupping invalidates the fast to be abrogated, and those allowing cupping during fasting to be the final ruling. Therefore, in the case of cupping, it does not invalidate the fast. However, most scholars hold the view that cupping does invalidate the fast, so it is preferable to delay it until the night.
(5) Inserting Instruments or Pipes into the Body: Sometimes, medical treatment requires the insertion of instruments or pipes into the stomach, rectum, or private parts for internal examination or diagnosis. The key factor here is whether food is introduced through these instruments:
- If food is introduced into the body, the fast is broken.
- If the instrument is used for examination or non-nutritive medical purposes, then the fast is not broken. This is similar to the rulings regarding injections.
(6) Injection:
- Whether the injection is administered into the skin, muscle, or vein, if it does not contain any nutritional material, the fast is valid.
- Insulin injections for diabetic patients are permissible and do not invalidate the fast.
- Similarly, permanent needles inserted into the veins do not invalidate the fast.
(7) Kidney Dialysis: A kidney patient undergoes dialysis, and there are various methods, but in all these methods, nutritional substances are used. From a Shari’ah perspective, dialysis breaks the fast. However, if treatment can be done without using nutritional substances, then the fast will remain valid.
(8) Blood Donation: If necessary, a fasting person can have their blood checked and donate blood to another patient. This process does not affect the fast. This is also the opinion of Sheikh Ibn Baz (may Allah have mercy on him). (Majmua Fatawa Ibn Baz 15/274)
(9) Use of Tablets: For certain heart conditions, doctors prescribe tablets that are placed under the tongue and dissolve quickly in the mouth, providing relief to the patient.
A question was asked to Sheikh Ibn Baz (may Allah have mercy on him) about the ruling on such tablets, which heart patients place under their tongues. The question was about fasting, where the patient follows the doctor’s advice and keeps the fast, but sometimes a few minutes before iftar, they begin to experience chest pain and place the tablet under their tongue for relief.
Sheikh Ibn Baz (may Allah have mercy on him) replied: “Using tablets under the tongue breaks the fast because its taste intentionally reaches the throat.” (Al-Fatawa al-Shariyyah Ala Al-Mushkil Min al-Masail al-Tibiyyah: pp. 54-55)
Other scholars, both Arab and non-Arab, hold the view that since these tablets remain confined to the mouth and do not reach inside, their effect does not penetrate, so it is permissible to use them while fasting. However, this is a matter of difference of opinion. In my view, the correct position is that if the effect of the tablet reaches below the throat, it will undoubtedly break the fast. But if its effect remains only in the mouth and does not reach the throat, the fast will not be invalidated. In this case, it is similar to gargling, where the effect of water does not reach the stomach, and likewise, the effect of the tablet will not invalidate the fast if it does not pass beyond the mouth.
(10) Use of Ointments on the Skin: Whether for medical purposes or personal use, oils, ointments, and creams can be applied to the skin.
“Anything applied to the skin is absorbed through the pores into the bloodstream, but the absorption process is very slow. Therefore, anything applied to the skin does not break the fast.” (Majmua Fatawa Ibn Taymiyyah 25/267)
(11) Cleaning Teeth: Cleaning teeth (such as scaling) or having dental work done, like getting a tooth extracted or repaired, is allowed while fasting. It is advised to postpone such procedures until the evening, or if done during the day, care should be taken that any blood from the gums does not reach the throat. The injections used in dental cleaning do not affect the fast.
(12) Treating Wounds: If a person has a wound, they can treat it while fasting because this process is not comparable to eating or drinking, nor is it considered eating or drinking in common understanding.
(13) Use of Inhalers: Asthma patients may need to use an inhaler (spray), which is a severe necessity for them. Islam has a principle that whatever a person is compelled by necessity to use is permissible. Allah says: “وَقَدْ فَصَّلَ لَكُمْ مَا حَرَّمَ عَلَيْكُمْ إِلَّا مَا اضْطُرِرْتُمْ إِلَيْهِ” (الأنعام:119)
Translation: “And He has made clear to you what He has forbidden to you, except what you are compelled to use.”
Therefore, an asthma patient can use an inhaler while fasting, and their fast remains valid. They do not need to make up for the fast.
Allah has made Islam easy for His servants, according to their capabilities. It is our primary responsibility to practice the religion according to our ability. Just as Allah has granted concessions to travelers, patients, and those with disabilities, it is better to act upon these concessions and to do so without feeling any discomfort in the heart, as sometimes seen among certain groups.
By MAQUBOOL AHMAD SALAFI
Islamic Dawah Center – Taif