The sick

  In the event of any sickness that makes people feel unwell, a person is allowed not to fast. The basis for this is the aayah (interpretation of the meaning): “… and whoever is ill or on a journey, the same number [of days on which one did not observe sawm must be made up] from other days…” [al-Baqarah 2:185]. But if the ailment is minor, such as a cough or headache, then it is not a reason to break one's fast.

If there is medical proof, or a person knows from his usual experience, or he is certain, that fasting will make his illness worse or delay his recovery, he is permitted to break his fast; indeed, it is disliked (makrooh) for him to fast in such cases. If a person is seriously ill, he does not have to have the intention during the night to fast the following day, even if there is a possibility that he may be well in the morning, because what counts is the present moment.

 If fasting will cause unconsciousness, he should break his fast and make the fast up later on. (al-Fataawa, 25/217). If a person falls unconscious during the day and recovers before Maghrib or after, his fast is still valid, so long as he was fasting in the morning; if he is unconscious from Fajr until Maghrib, then according to the majority of scholars his fast is not valid. According to the majority of scholars, it is obligatory for a person who falls unconscious to make up his fasts later on, no matter how long he was unconscious. (Al-Mughni ma’a al-Sharh al-Kabeer, 1/412, 3/32; al-Mawsoo’ah al-Fiqhiyyah al-Kuwaytiyyah, 5/268). Some scholars issued fatwaas to the effect that a person who falls unconscious or takes sleeping pills or receives a general anaesthetic for a genuine reason, and becomes unconscious for three days or less, must make up the fasts later on, because he is regarded as being like one who sleeps; if he is unconscious for more than three days, he does not have to make up the fasts, because he is regarded as being like one who is insane. (From the fataawa of Shaykh ‘Abd al-‘Azeez ibn Baaz, issued verbally).

 If a person feels extreme hunger or thirst, and fears that he may die or that some of his faculties may be irreparably damaged, and has rational grounds for believing this to be so, he may break his fast and make up for it later on, because saving one’s life is obligatory. But it is not permissible to break one's fast because of bearable hardship or because one feels tired or is afraid of some imagined illness. People who work in physically demanding jobs are not permitted to break their fast, and they must have the intention at night of fasting the following day. If they cannot stop working and they are afraid that some harm may befall them during the day, or they face some extreme hardship that causes them to break their fast, then they should eat only what is enough to help them bear the hardship, then they should refrain from eating until sunset, and they have to make the fast up later. Workers in physically demanding jobs, such as working with furnaces and smelting metals, should try to change their hours so that they work at night, or take their holidays during Ramadaan, or even take unpaid leave, but if this is not possible, then they should look for another job, where they can combine their religious and worldly duties. “And whoever fears Allaah and keeps his duty to Him, He will make a way for him to get out (from every difficulty). And He will provide him from (sources) he could never imagine.” [al-Talaaq 65:2-3 – interpretation of the meaning]. (Fataawa al-Lajnah al-Daa’imah, 10/233, 235)

Students’ exams are no excuse for breaking one’s fast during Ramadaan, and it is not permissible to obey one’s parents in breaking the fast because of having exams, because there is no obedience to any created being if it involves disobedience to the Creator. (Fataawa al-Lajnah al-Daa’imah, 10/241).

  The sick person who hopes to recover should wait until he gets better, then make up for the fasts he has missed; he is not allowed just to feed the poor. The person who is suffering from a chronic illness and has no hope of recovery and elderly people who are unable to fast should feed a poor person with half a saa’ of the staple food of his country for every day that he has missed. (Half a saa’ is roughly equivalent to one and a half kilograms of rice). It is permissible for him to do this all at once, on one day at the end of the month, or to feed one poor person every day. He has to do this by giving actual food, because of the wording of the aayah – he cannot do it by giving money to the poor (Fataawa al-Lajnah al-Daa’imah, 10/198). But he can give money to a trustworthy person or charitable organization to buy food and distribute it to the poor on his behalf.

If a sick person does not fast in Ramadaan, waiting to recover so that he can make the days up later, then he finds out that his sickness is chronic, he has to feed a poor person for every day that he did not fast. (From the fataawa of Shaykh Ibn ‘Uthaymeen). If a person is waiting to recover from his illness and hopes to get better, but then dies, there is no “debt” owed by him or his heirs. If a person’s sickness is considered to be chronic, so he does not fast and feeds the poor instead, then advances in medical science mean that there is now a cure, which he uses and gets better, he does not have to make up the fasts he has missed, because he did what he had to do at the time. (Fataawa al-Lajnah al-Daa’imah, 10/195)

  If a person is sick, then recovers, and is able to make up the missed fasts but does not do so before he dies, then money should be taken from his estate to feed a poor person for every day that he missed. If any of his relatives want to fast on his behalf, then this is OK, because it was reported in al-Saheehayn that the Messenger of Allaah [an error occurred while processing this directive] (peace and blessings of Allaah be upon him) said: “Whoever dies owing some fasts, let his heir fast on his behalf.” (From Fataawa al-Lajnah al-Daa’imah, volume on Da’wah, 806).

( From the book Al-Siyaam 70 Matters Related to Fasting by Sheikh Muhammed Salih Al-Munajjid    )

 

 Questions and answers on fasting and illness

 

Question:

I have diabetes typeII which is NIDM non insulin depend diabetes, I don't use any medicine, I only control diet and I do little physical exercise to keep in right level of my sugar (blood).
I have this decease one year and two months. Last Ramadan I fasted some days but I could not continue do to my low level of sugar blood). This year I feel good (Alhamdu Lillaah ONLY feel pain in my brain during fasting!? So my question is, is it my DUTY to fast despite my disease? Can test my blood during fasting times; "causing blood to come from my fingers"?

Answer:
Praise be to Allaah.  

It is prescribed for sick people not to fast in Ramadaan, if fasting will cause harm or make the sickness worse, or if they need treatment during the day in the form of medicine or pills that must be swallowed, because Allaah says (interpretation of the meaning): 

“and whoever is ill or on a journey, the same number [of days which one did not observe Sawm (fasts) must be made up] from other days" [al-Baqarah 2:185] 

And the Prophet [an error occurred while processing this directive](peace and blessings of Allaah be upon him) said: “Allaah loves people to avail themselves of His concessions (rukhsah) just as He hates them to commit sin.” According to another version, “As He loves His commands to be obeyed.” 

With regard to taking blood from veins for testing etc., the correct view is that this does not break the fast, but if it is done often, it is better to leave it until night-time. If it is done during the day then to be on the safe side that day should be made up, because this is akin to cupping.”

(Fatwa of Shaykh Ibn Baaz (may Allaah have mercy on him), from Fataawa Islamiyyah, vol. 2, p. 139) 

Sickness is of various kinds: 

1 – That which does not affect the fast, such as a light cold or mild headache or toothache, and the like. In this case it is not permissible to break the fast, even though some of the scholars permitted that because of the aayah (interpretation of the meaning): 

“and whoever is ill…”[al-Baqarah 2:185] 

But we say that this ruling is based on a reason, which is that not fasting is easier. If that is the case, then we would say that not fasting is better, but if fasting does not have an effect on him then it is not permissible to break the fast, and he has to fast. 

2 – If fasting is difficult for the sick person, but it does not harm him, then it is makrooh for him to fast and it is Sunnah for him to break his fast. 

3 – If fasting is difficult for him and will cause him harm, such as a man who has kidney disease or diabetes and similar cases where fasting will cause harm. In this case fasting is haraam. Hence we may see that some mujtahids and sick people make a mistake when fasting is difficult for them and may harm them, but they refuse to break their fast. We say that they are mistaken because they refuse to accept the kindness of Allaah and the concession that He has given to them, and they are harming themselves, although Allaah says (interpretation of the meaning): 

“And do not kill yourselves”[al-Nisa’ 4:29] 

al-Sharh al-Mumti’ by Shaykh Ibn ‘Uthaymeen, vol. 6, 352-254.

Sheikh Muhammed Salih Al-Munajjid (www.islam-qa.com)


Question :

I have diabetes and I have to inject myself with insulin twice a day. Hence I do not fast and I pay the fidyah in cash for the number of days I do not fast. It is permissible to pay the fidyah in this way, i.e., in cash, especially since I break my fast in the restaurant and I am not married? Can this fidyah be distributed to three or more poor people, because I cannot find anyone who needs to be fed at the time of iftaar?.

Answer :
Praise be to Allaah.  

 

If you are able to fast, then you must fast, and in this case it is not permissible for you to break your fast and feed others. Insulin injections do not break the fast; you can fast and take the insulin injections. And you have to make up the fasts that you have missed. 

But if fasting will harm you, or it will cause you great difficulty, or you need to take medicine during the day, then it is permissible for you not to fast in that case. If you will never be able to make up the fasts in the future, then you have to feed one poor person for each day. 

It is not permissible for you to pay the fidyah in cash, rather you have to give food, because Allaah says (interpretation of the meaning): 

“And as for those who can fast with difficulty, (e.g. an old man), they have (a choice either to fast or) to feed a Miskeen (poor person) (for every day)”

[al-Baqarah 2:184] 

So you have to look for poor people so that you can do what is required of you, or give money to someone who can buy food and make sure it reaches the poor on your behalf. 

And Allaah knows best.


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I have a problem with my stomach that makes it extremely difficult for me to fast... I give out money at the beginning of Ramadan to feed a Muslim each day till the end of Ramadan... Is there anything else I can do for not fasting?.

Answer :
Praise be to Allaah.  

 

If this sickness that is preventing you from fasting is something that is incurable, then what you have done is correct, because the one who is suffering from an incurable sickness has to feed one poor person for each day, and he does not have to do anything else. 

But if the sickness is one from which you hope to recover, then if you get better you have to make up the days that you did not fast, and in this case it is not permissible for you to feed the poor when you are able to make up the fasts.


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Question :

I am going to have some diagnostic imaging done at the hospital, and this means that I cannot fast on that day. If I do not do this imaging now, I will not get another appointment for several months. Is it permissible for me to break my fast in order to do this imaging?.

Answer :
Praise be to Allaah.  

 

It is permissible for one who is sick to break his fast, and he has to make up the days that he does not fast because of sickness, because Allaah says (interpretation of the meaning): 

“and whoever is ill or on a journey, the same number [of days which one did not observe Sawm (fasts) must be made up] from other days”

[al-Baqarah 2:185] 

The kind of sickness which means that a person is allowed not to fast is severe sickness which causes hardship or harm to the person if he fasts, or which it is feared will make the sickness worse or delay recovery because of fasting. The scholars also said that this applies if it is feared that a person may become sick because of fasting. 

If your sickness falls into any of these categories (as appears to be the case), it is permissible for you not to fast, because diagnostic imaging helps to determine the sickness and thus prevent it getting worse or delaying recovery. 

But if your sickness does not fall into any of these categories, then it is not permissible for you to break your fast, and you should try to do the imaging at night if you can, or wait until Ramadaan is over. 

Shaykh Muhammad al-Saalih al-‘Uthaymeen said: 

The person who is sick with a temporary illness falls into one of three categories: 

1 – Those for whom fasting is not difficult and does not cause hardship. They have to fast and are not excused. 

2 – Those for whom fasting is difficult but does not cause harm. It is makrooh for them to fast because that means they are rejecting a concession granted to them by Allaah, as well as being hard on themselves.  

3 – Those for whom fasting is harmful. It is haraam for them to fast because that means they are bringing harm upon themselves. Allaah says (interpretation of the meaning): 

“And do not kill yourselves”

[al-Nisa’ 4:29] 

“and do not throw yourselves into destruction”

[al-Baqarah 2:195] 

According to the hadeeth, the Prophet [an error occurred while processing this directive] (peace and blessings of Allaah be upon him) said: “There should be neither harming nor reciprocating harm.” Narrated by Ibn Maajah and al-Haakim. Al-Nawawi said: it has isnaads which strengthen one another. Whether or not fasting is harmful for a sick person is known either from the person feeling that himself or a trustworthy doctor telling him of that. 

If a sick person breaks his fast, he has to make up the number of days that he missed when he recovers. If he dies before recovering, then that obligation no longer applies because the command is to make up the fasts from other days, but he did not live to see those other days. 

Fusool fi’l-Siyaam wa’l-Taraaweeh (part 3). 

And Allaah knows best.


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Question :

How should a person who suffers kidney failure and who has dialysis three times a week fast?.

Answer :
Praise be to Allaah.  

 

The Standing Committee was asked: 

Does kidney dialysis affect a person’s fast? 

They replied: 

We wrote to the Director of the King Faisal Specialist Hospital and the Director of the Armed Forces Hospital in Riyadh to find out more about what is involved in kidney dialysis and whether chemical substances are used, and whether it is regarded as a kind of nourishment. 

They replied as follows: kidney dialysis involves taking the patient’s blood into a machine (an artificial kidney) which cleans it then returns it to the body. It also adds some chemical and nutrients such as sugars and salts etc. to the blood. 

After studying the matter and discovering the nature of kidney dialysis with the help of some experts in the field, the Standing Committee issued a fatwa stating that kidney dialysis invalidates the fast. 

And Allaah is the Source of strength. May Allaah send blessings and peace upon our Prophet Muhammad and his family and companions. 

Shaykh Ibn ‘Uthaymeen (may Allaah have mercy on him) was asked about a person who undergoes kidney dialysis – does having his blood removed during the procedure invalidate his wudoo’? How should he fast and pray whilst having dialysis done, if that coincides with the time of prayer? 

He replied: 

With regard to wudoo’, it does not invalidate wudoo’, because the correct scholarly view is that what comes out of the body does not invalidate wudoo’ unless it comes out of either the front or back passage. Whatever comes out of those two passages invalidates wudoo’, whether it is urine, stools or wind. Everything that comes out of the two passages invalidates wudoo’. 

With regard to that which comes out of anywhere other than the two passages, such as a nosebleed that comes out of the nose, or blood that comes out of a wound, and so on, it does not invalidate wudoo’ whether in small or large quantities. Based on this, kidney dialysis does not invalidate wudoo’. 

With regard to prayer, the patient can join Zuhr and ‘Asr, and Maghrib and ‘Isha’. He can plan his schedule with his doctor, to make sure that the dialysis will not take more than half the day, so that he will not miss praying Zuhr and ‘Asr on time. He can say to him, for example: Schedule the dialysis in the early afternoon, giving me enough time to pray Zuhr and ‘Asr, or bring it forward so that I will be able to pray Zuhr and ‘Asr (afterwards), before the time for ‘Asr ends. What matters is that it is permissible to combine the prayers without delaying them. Based on this it is essential to plan one’s schedule with one’s doctor. 

With regard to fasting, we are not sure about that. Sometimes I would say that it is not like cupping, because with cupping blood is taken and not returned to the body, and this invalidates the fast as it says in the hadeeth. In dialysis blood is taken from the body, cleaned and returned to the body. But I am concerned that dialysis involves some nutrients which take the place of food and drink. If that is the case then it does invalidate the fast. In that case if this is a lifelong condition with no hope of recovery, then he should feed one poor person for each day. But if it happens intermittently, then he should not fast when he is undergoing dialysis and make up that day later on. 

But if the substances that are mixed with the blood do not include nutrients, rather they simply cleanse the blood, then this does not break the fast. In this case he may use dialysis even if he is fasting. He should refer to the doctors about this matter.

 Majmoo’ Fataawa Ibn ‘Uthaymeen, 20/113. 

In conclusion: 

A person who is suffering from kidney failure should not fast on the days when he has dialysis, then if he can make up the fast he should do so. If he cannot make up the fasts because he is elderly and cannot fast, then he should not fast and should feed one poor person for each day.


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Question :

I would like to find out if it is compulsory for a person to fast if he suffers from epilepsy.

Answer :
Praise be to Allaah.  

 

Yes, the one who suffers from epilepsy has to fast in Ramadaan, and he is not exempted from fasting because of that. 

Shaykh Ibn Baaz (may Allaah have mercy on him) was asked: 

A man loses consciousness for a few hours – does he have to fast? 

He answered: 

If he only lost consciousness for a few hours, then he has to fast, like the one who sleeps for a while. The fact that he loses consciousness for a few days during the day or during the night does not mean that he is not obliged to fast. 

Fataawa al-Shaykh Ibn Baaz, 15/210. 

But if he is unconscious for the whole day (i.e., from dawn until sunset), then his fast is not valid and he has to make up that day. But if he wakes up during the day then his fast is valid. 

See also Question no. 


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Question :

A man fell into a coma whilst he was fasting. Is his fast invalidated?.

Answer :
Praise be to Allaah.  

 

The view of Imam al-Shaafa’i and Imam Ahmad is that if a person falls into a coma in Ramadaan, one of the following two scenarios must apply: 

1 – The coma lasts all day, i.e., he is unconscious from before dawn until after the sun sets. In this case his fast is not valid, and he must make up this day after Ramadaan. 

The evidence that his fast is not valid is that fasting means abstaining from things that invalidate the fast, with the intention of doing so, because Allaah says in the hadeeth qudsi that the fasting person “gives up his food, his drink and his desire for My sake.” (Narrated by al-Bukhaari, 1894; Muslim, 1151). So the abstention is connected to the prior intention on the part of the fasting person, and this cannot apply to one who is in a coma. 

The evidence that the fast must be made up later on is the verse in which Allaah says (interpretation of the meaning): 

“and whoever is ill or on a journey, the same number [of days which one did not observe Sawm (fasts) must be made up] from other days”

[al-Baqarah 2:185] 

2 – He is awake for part of the day, if only for a moment. In this case his fast is valid, whether he woke up at the beginning of the day, at the end or in the middle. 

Al-Nawawi (may Allaah have mercy on him) said, mentioning the different scholarly opinions on this matter: 

The most correct view says that this is subject to the condition that he be awake for a part of the day. 

i.e., the soundness of the unconscious person’s fasts depends on his being awake for part of the day. 

The evidence for his fast being sound if he is awake for part of the day is that he has consciously abstained from things that break the fast in general.  

See Haashiyat Ibn Qaasim ‘ala al-Rawd al-Muraaba’, 3/381 

So to sum up, the answer is that if a man is unconscious for the entire day – i.e., from dawn until sunset – his fast is not valid, and he has to make up the fasts he missed.  If he was awake for part of the day, then his fast is valid. This is the view of al-Shaafa’i and Ahmad, and was the view favoured by Shaykh Ibn ‘Uthaymeen (may Allaah have mercy on him). 

See al-Majmoo’, 6/346; al-Mughni, 4/344; al-Sharh al-Mumti’, 6/365 

And Allaah knows best.


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What does a person have to do if he was in a coma when Ramadaan began because of a car accident, and he did not wake up until twenty-two days later?.

Answer :
Praise be to Allaah.  

 

This question was put to Shaykh Muhammad ibn ‘Uthaymeen (may Allaah have mercy on him) and he said: 

According to the most sound opinion, if a person is unconscious and is in a coma because of sickness or otherwise, he is not obliged to pray, so he does not have to make up the prayers he missed. As for fasting, he does have to make up the days that he did not fast whilst he was in a coma. 

The difference between prayer and fasting is that prayer is done repeatedly, so if a person does not make up the prayers he missed, he will pray on the following day. But in the case of fasting, it is not done repeatedly. Hence a woman who menstruates has to make up the fasts she misses but not the prayers.


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More information on fasting on www.shariahway.com and www.muslimconverts.com