Rulings on Medical Issues and Similar Matters Related to Fasting

الحمد لله رب العالمين، وصلى الله وسلم على نبينا محمد وعلى آله وأصحابه أجمعين، أما بعد

 

The rulings on bleeding whilst fasting and extracting blood

 

Q: A fasting person bleeds, should he break his fast or complete it?

Shaikh ‘Abdul-‘Azeez bin Baaz (rahimahullaah) said: “Blood emanating from the fasting person does not harm – except for cupping.” (Majmu’ Fataawa 17/271)

 

Q: Does the blood which comes out from between the teeth by mistake break ones fast or not? And if it was due to other than the individual himself – meaning from another person who hits him by mistake?

The scholars of the Lajnah ad-Daa-imah (rahimahumullaah) said: “The blood that comes out from between the teeth does not break the fast, whether it comes out by itself or due to a person’s having struck it.” (Fataawa Al-Lajnah Ad-Daa-imah 10/267)

 

Q: What is the general rule for blood coming out of the body that would invalidate the fast? And how does it invalidate the fast?

Shaikh ‘Uthaimeen (rahimahullaah) said:

“Bleeding which invalidates the fast is the blood which comes out because of cupping, due to the saying of the Prophet (sallallaahu ‘alaihi wa sallam):

أفطر الحاجم والمحجوم

((The one who cups and the one who receives the cupping break their fast))[1]

 

Likewise correlated to cupping there is that which takes its meaning from that which the person does – by his own choice, so a large amount of blood comes out from him which effectuates weakness upon the body – that nullifies the fast the like of cupping.

As for that which comes out of the person unintentionally such as due to a nosebleed or such as a wound on the body from a knife when cutting meat or his treading on glass or that which is similar to that, then that does not invalidate the fast – even if a large amount of blood comes out from him.

Likewise if a small amount of blood comes out, it does not have the affect such as the affect of cupping, such as the blood which is extracted for analysis, then it too does not invalidate the fast.” (Majmu’ Fataawa 19/239-240)

 

The ruling on using eye, ear or nose drops

 

Shaikh bin Baaz said: “The fasting person does not break his fast due to taking eye and ear drops in that which is more correct from the two statements of the scholars. Yet if he finds the taste of the drops in his throat, then making up (the fast) is a more cautious measure – and it is not obligatory. Since neither of them are openings (passageways) for food and drink.[2]

As for the drops in the nose – then it is impermissible because the nose is an opening (passageway). It is due to this that the Prophet (sallallaahu ‘alaihi wa sallam) said (concerning the wudhu):

وَبَالِغْ فِي الاِسْتِنْشَاقِ إِلاَّ أَنْ تَكُونَ صَائِمًا

((And exert in Istinshaaq [breathing in the water into the nose] – unless you are fasting[3]))[4]

 

Whoever does that then he has to make up (for it) due to this hadeeth.” (Majmu’ Fataawa 15/261)

 

Shaikh ‘Uthaimeen said: “There is no harm upon the fasting person if he uses kohl, and that he uses drops in his eyes and that he likewise uses drops in his ears – even if he finds its taste in his throat – he does not break his fast due to it, as it is not eating and drinking nor does it take the meaning of eating and drinking. The proof has come in prohibition of food and drink, so there should be no attachment with them to that which does not have their meaning, this is what we mentioned was the preferred opinion of Shaikh ul Islaam Ibn Taymiyyah (rahimahullaah) – and it is correct.

As for if one enters drops in his nose and so it enters his interior (abdomen); then he break his fast if he intended that due to the saying of the Prophet (sallallaahu ‘alaihi wa sallam):

بالغ في الاستنشاق إلا أن تكون صائماً

((Exert in Istinshaaq [breathing in the water into the nose] – unless you are fasting))

 

(Majmu’ Fataawa 19/205)

 

The ruling of a fasting person using salve (ointment) to expel the dryness from the lips

 

Shaikh ‘Uthaimeen said: “There is no harm if the person uses that which moistens the lips and the nose from salve, or that he moistens (dampens) them with water or with a rag or what resembles that. However; he should be cautious from anything of this which removes the roughness from reaching his interior (abdomen). So if anything reaches it unintentionally; then there is nothing upon him, such as if one was to rinse the mouth and so the water reached his interior unintentionally – then he should not break his fast due to this.” (Majmu’ Fataawa 19/224)

 

The ruling on using a suppository when fasting during the day in Ramadhaan when the fasting person is unwell

 

Shaikh ‘Uthaimeen said: “There is no harm for the fasting person to use suppositories which are placed in the back passage if one is sick, since this is not eating or drinking nor is it from the meaning of eating and drinking.” (Majmu’ Fataawa 19/203-204)

 

The ruling concerning the one who takes medicine after the adhaan of Fajr or the one who has to take medication every twelve hours

 

Q: My mother took her medication after the adhaan of Fajr – by a short time in Ramadhaan and I alerted her that if she drinks her medicine in this time that there will be a day upon her (to make up for)?

Shaikh ‘Uthaimeen said: “If the sick person drinks medicine during Ramadhaan after the rising (appearance) of Fajr then this fast of his is not correct. Since he was deliberate in eating and so it is necessary for him to withhold for the rest of the day – except if withholding is difficult for him due to the sickness, then he can eat due to the sickness and it is necessary for him to make it up because he deliberately ate.

It is not permissible for the sick person to take medicine – and he is fasting in Ramadhaan except when there is a necessity, such as we fear death upon him; so we give him a tablet to lighten it from him. In this case he has eaten and there is no harm upon him in eating with the sickness.” (Majmu’ Fataawa 19/120)

 

Q: I have a psychological disorder, I presented myself to the doctor and he gave me doses (of medicine) in the form of tablets which I am to take over a five year period, every twelve hours I am to take one tablet. What should I do and in particular in the month of Ramadhaan in spite of the fact that the length of the fasts in the day reach fifteen hours. If I delay from this appointed time by as little as an hour then this illness recurs back upon me with a seizure?

Shaikh bin Baaz said: “Allaah, The Majestic and Most High states:

فَاتَّقُوا اللَّهَ مَا اسْتَطَعْتُمْ

((So fear Allaah as much as you are able.)) (At-Taghaabun: 16)

 

If the sickness occurs due to the delay of the dose (of medication) from its appointed time; then there is no harm with eating. So if the day is long from these days such as its being fifteen hours long; then there is no harm if he eats a pill which has been specified for it – and he eats with that – and makes up for this day. He eats it and withholds and makes it up because the eating was because of it and so he should withhold and make it up after that. As for if one is able to delay (taking it) and that is not difficult upon him; then it is necessary upon him to delay until he can eat it at night.

As for if he is unable then there is no constraint upon him, and he is able to make up this day during the short days – and they are the cold (winter) days which are less than twelve hours long.” (Fataawa Noorun ‘alad-Darb vol 3/1228)

 

Taking injections when fasting

 

Q: Do needles and injections for treatment during the day in Ramadhaan have an affect upon the fast?

Shaikh ‘Uthaimeen said: “needles (injections) for treatment are of two types:

The first of them: is that which the purpose of which is nourishment and so food and drink can be managed without due to it, so because it takes its meaning; it is therefore that which breaks the fast, because the texts of the legislation – if there is to be found the meaning which is encompassed upon it in a form (aspect) from the forms; then this form will be given the ruling of that text.

The second type: needles (injections) that do not provide nourishment; meaning: that they are not something that food and drink can be managed without over them – so this does not break the fast, since no text has been obtained for it in wording nor in meaning. So it is not eating and drinking, nor does it take the meaning of eating and drinking, and the origin is the soundness of the fast – until there is established that which invalidates it in accordance to legislated proof.” (Majmu’ Fataawa 19/215)

 

Q: What is the ruling on using injections of penicillin by the fasting person to counter fever?

Shaikh ‘Uthaimeen said: “Using injections of penicillin which counter fever are permissible for the fasting person, because they do not break the fast; since they are not food and drink – nor do they correspond to their meaning.” (Majmu’ Fataawa 19/220)

 

Q: What is the ruling on using injections during the day in Ramadhaan? Do they invalidate the fast or not?

Shaikh Ahmad An-Najmee (rahimahullaah) said: “The injections which are given in the vein; these are the ones that the fasting person should abstain from. As for the ones which are given in the muscles; then there is nothing in them – Inshaa Allaah.” (Fataawa As-Siyaam p.38)

 

The ruling on diabetics and taking injections to treat diabetes whilst fasting

 

Q: I am sick with diabetes and ulcers (sores), so if I am unable to fast – what is obligatory upon me to do?

Shaikh bin Baaz said: “Upon you is to consult a specialized doctor, if the specialized doctor determines that fasting will harm you; then eat (i.e. do not fast). So if Allaah restores your health to you then make them up after that.

If the specialized doctors determine that this illness will always be harmed by fasting, and that in accordance to what they know the illness will continue and recovery from it is not anticipated; then you should eat and for each day you should feed a needy person with half a Saa’[5] of foodstuff of the land – the amount of which is a kilogram and a half approximately – and all praise is for Allaah. Likewise there is no fasting upon you due to the saying of Allaah, The Glorified:

فَاتَّقُوا اللَّهَ مَا اسْتَطَعْتُمْ

((So fear Allaah as much as you are able.)) (At-Taghaabun: 16)”

 

(Al-Mawsoo’ah Al-Baaziyyah fil Masaa-il An-Nisaa-iyyah 2/857)

 

Q: I am a person who is ill with diabetes, and for it there is an injection which is administered under the skin, and if this injection is not given then the sugar level goes high…is it permissible for me to take this injection during the month of Ramadhaan?

The scholars of the Lajnah ad-Daa-imah said: “There is no objection upon you in taking the injection mentioned during the day for the purpose of treatment, likewise there is nothing upon you to make up for, and if it is easy to take it at night without any difficulty upon you; then it is worthier.” (Fataawa Al-Lajnah Ad-Daa-imah 10/252)

 

The ruling of the one who suffers from heart problems

 

Q:  Is it permissible for the one who has heart problems to eat (i.e. not fast)?

Shaikh Ahmad An-Najmee said: “I say: heart problems are not (all) equal, so if the heart problem is mild and comes on occasions; then it is obligatory upon him to fast and it is necessary upon him to keep away from the things which would increase his ailment.

As for if the heart problem is severe; and he cannot fast with it, or that it increases with the fast; then in this case he should eat and instead feed a needy person for each day. Yet if his recovery is expected after that; then if he recovers – he should make up (for them) after that, and if his recovery is not expected; then there is nothing upon him after that.” (Fataawa As-Siyaam p.25)

 

Taking inhalers for those who suffer from asthma

 

Q: What is the ruling on using the inhaler in the mouth for the fasting person during the day – for the one who suffers from asthma and its like?

Shaikh bin Baaz said: “Its ruling is that it is allowed – if one is compelled to that, due to the saying of Allaah, The Mighty and Majestic:

وَقَدْ فَصَّلَ لَكُم مَّا حَرَّمَ عَلَيْكُمْ إِلَّا مَا اضْطُرِرْتُمْ إِلَيْهِ

((Whilst He has indeed explained in detail to you what He has forbidden upon you, except that which you are compelled thereto.)) (Al-An’aam: 119)

 

Likewise because it does not resemble eating and drinking, so it resembles the extraction of blood for examination and injections which are not for nutrition.” (Al-Mawsoo’ah Al-Baaziyyah fil Masaa-il An-Nisaa-iyyah 2/878)

 

Shaikh ‘Uthaimeen said concerning the two types of medication: “There is a medicine known as capsules which one can use; this breaks the fast because it is a medicine that possesses volume (mass) and enters the stomach. The fasting person should not use it during Ramadhaan except in an essential circumstance. So if he uses it in an essential circumstance, then he would have eaten, he can eat and drink for the rest of his day – and he should make up a day in place of it. If it is assumed that this illness is always ongoing with him then he is like the elderly aged person, upon him is to feed a needy person for each day – and fasting is not obligatory upon him.

The second type; from the medications for asthma is a gas which has nothing in it except air, it opens the arteries so that one can breathe easily. This does not break the fast nor does it invalidate the fast, and it is for the fasting person to use it – and his fast is correct.” (Majmu’ Fataawa 19/210)

 

Shaikh ‘Uthaimeen said likewise: “This inhaler vaporizes and does not reach the stomach. Therefore we say there is no harm that you use this inhaler and you are fasting, and you do not break your fast with that.” (Fataawa Arkaan Al-Islaam p.475)

 

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[1] Reported by Aboo Dawood (no.2367) and Ibn Maajah (no.1681) and At-Tirmidhee (no.774) and others, it was declared Saheeh (authentic) by Shaikh Al-Albaanee in his Saheeh Sunan Abee Dawood (no.2367).

[2] The Shaikh clarified this elsewhere when he said: “What is correct is that drops and kohl do not break the fast, and the issue has in it some difference between the people of knowledge as to if the taste of the kohl and drops reach the throat. Some of the people of knowledge said: that it breaks it, and what is correct is that it does not break it; because the eye is not an opening. However; whoever makes that up out of caution as well as to exit from any difference then there is no harm, except that what is correct is that it does not break it. Drops in the ear and the eye and kohl in the eye – all of this – then what is correct is that the fasting person does not break his fast because the eye is not an opening.” (See: Fataawa Noorun ‘alad-Darb 3/1241)

[3] Shaikh ‘Uthaimeen explains: “exerting in Istinshaaq: is sniffing and taking it (the water) in with a strong breath…And exertion is disliked for the fasting person, because it can lead to swallowing the water and its descent from the nose to the stomach.” (See: Sharh Al-Mumti’ 1/172-173)

[4] Reported by Aboo Dawood (no.142) and At-Tirmidhee (no.788) and others and was declared Saheeh (authentic) by Shaikh Al-Albaanee in his Saheeh Sunan Abee Dawood (no.142).

[5] A measure of volume which equates to four handfuls consisting of two hands together.

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