20th March 2017
السلام عليكم و رحمة الله و بركاته
Question: I was born with a condition called cystic fibrosis. I suffer with thick mucus around my lungs, my digestive system and other organs around my body. At the minute I’m having lot of problems with my pancreas. It’s stopping and blocking enzymes entering my stomach. I eat a lot but still end up losing weight. I suffer with really bad constipation and my bladder has gone really weak. I take over 45 different tablets a day of nebulisers and inhalers. My situation is not good and I’m deteriorating day by day. My situation is such that I need a lung transplant. I put my life in Allāh’s hands and if my time is up then it’s up. Is it sinful me to refuse a transplant which has the possibility of saving my life as well as killing me? Please guide me in this matter.
الجواب حامداً و مصلياً
In the name of Allāh, the Most Gracious, the Most Merciful
Answer
Seeking medical treatment has been encouraged in Islām and should not be refused especially if the means are available. The Messenger of Allāh sallallahu alayhi wasallam instructed the believers to seek medical treatment during times of urgency. Sayyidunā Usama Ibn Shareek radhiyallahu anhu reports that the Companions once asked, ‘O Messenger of Allāh! Should we seek medication?’ He replied, “Yes. O servants of Allāh seek medical treatment because Allāh has not placed any illness except has also placed its cure except for one illness; death.”[1] The Hadeeth scholars explain that the prophet’s command was of Istihbāb – preferable command, and not an obligatory one. The context of the Hadeeth suggests that the prophet’s instruction was to indicate that seeking medical treatment is not against reliance upon Allāh Almighty, as was previously assumed by some Companions which led them to this enquiry.[2]
From a juristic point of view, inevitable cure from any medical treatment falls under the remit of dhanni (speculative) knowledge. This means that doctors prescribing medication and carrying out surgical operation to permanently cure the patient is not something that is based on knowledge of certainty (yaqeeni) in spite of the advancement in the field of medicine and surgery. Even organ transplantation does not guarantee permanent restoration of health albeit it contains many benefits. This however does not dismiss the importance of seeking medication since the Prophet sallallahu alayhi wasallam himself encouraged it. It is due to this reason why the Hanafi jurists ruled seeking medical treatment is mustahab – desirable only. Therefore, you should opt for a lung transplant when you have the chance if the doctors have assured you recovery in this otherwise refusing shall not make you sinful.[3]
A point to remember is that as Muslims we believe that cure ultimately lies in the hands of Allāh Almighty. The classical jurists never deemed medication as compulsory because they understood that medication does not reach the level of certainty like food and water in respect to sustaining of one’s life and health. However, continuous advancements of the medical industry leads to discovering new ahkāms – rulings. It is possible that exceptions can be made from the general rule depending on the specific medication and the individual’s circumstances. What is important is that saving one’s own life is necessary. Should in the future a particular medicine or surgical operation guarantee to be lifesaving and unanimously agreed by all doctors then accepting it would be necessary and refusing would be a sin.
[Allãh Knows Best]
Written by (Mufti) Abdul Waheed
Answer Attested by Shaykh Mufti Saiful Islam
JKN Fatawa Department
[1] Abū Dāwood
عَنْ أُسَامَةَ بْنِ شَرِيكٍ قَالَ: «قَالُوا: يَا رَسُولَ اللَّهِ أَفَنَتَدَاوَى؟ قَالَ: ” نَعَمْ، يَا عِبَادَ اللَّهِ! تَدَاوَوْا، فَإِنَّ اللَّهَ لَمْ يَضَعْ دَاءً إِلَّا وَضَعَ لَهُ شِفَاءً، غَيْرَ دَاءٍ وَاحِدٍ، الْهَرَمُ» “. رَوَاهُ أَحْمَدُ، وَالتِّرْمِذِيُّ، وَأَبُو دَاوُدَ
[2] Mirqat sharh Mishkāt No: 4532
(نَعَمْ) : وَأَمَّا قَوْلُ الطِّيبِيِّ: الْفَاءُ عَطْفٌ عَلَى مُقَدَّرٍ تَسْتَدْعِيهِ الْهَمْزَةُ يَعْنِي: أَنَعْتَبِرُ الطِّبَّ فَنَتَدَاوَى أَوْ نَتَوَكَّلُ عَلَى اللَّهِ وَنَتْرُكُ التَّدَاوِيَ؟ فَلَا خَفَاءَ أَنَّهُ لَا يُلَائِمُهُ الْجَوَابُ بِقَوْلِهِ: نَعَمْ، وَأَيْضًا جَعْلُ التَّوَكُّلِ مِنْ قِسْمِ تَرْكِ التَّدَاوِي غَيْرَ صَحِيحٍ فِي الْمَعْنَى. (يَا عِبَادَ اللَّهِ) : إِشَارَةٌ إِلَى أَنَّ التَّدَاوِيَ لَا يُنَافِي الْعُبُودِيَّةَ، وَلَا يَدَعُ التَّوَكُّلَ عَلَى صَاحِبِ الرُّبُوبِيَّةِ، وَلِذَا قَالَ فِي الْحَدِيثِ: ” اعْقِلْ وَتَوَكَّلْ “.(تَدَاوُوا) : تَأْكِيدًا لِمَا فُهِمَ مِنْ قَوْلِهِ: ” نَعَمْ “، وَالْمَعْنَى تَدَاوُوا وَلَا تَعْتَمِدُوا فِي الشِّفَاءِ عَلَى التَّدَاوِي، بَلْ كُونُوا عِبَادَ اللَّهِ مُتَوَكِّلِينَ عَلَيْهِ، وَمُفَوِّضِينَ الْأُمُورَ إِلَيْهِ،
Thathreeb fi Sharhi Taqreeb 184 vol 8
(السَّادِسَةُ) فِيهِ اسْتِحْبَابُ التَّدَاوِي وَهُوَ مَذْهَبُ أَصْحَابِنَا وَجُمْهُورِ السَّلَفِ وَعَامَّةِ الْخَلَفِ وَفِيهِ رَدٌّ عَلَى مَنْ أَنْكَرَ التَّدَاوِيَ مِنْ غُلَاةِ الصُّوفِيَّةِ، وَقَالَ كُلُّ شَيْءٍ بِقَضَاءٍ وَقَدَرٍ فَلَا حَاجَةَ إلَى التَّدَاوِي وَحُجَّةُ الْعُلَمَاءِ هَذَا الْحَدِيثُ وَمَا فِي مَعْنَاهُ وَفِي صَحِيحِ مُسْلِمٍ عَنْ جَابِرٍ عَنْ رَسُولِ اللَّهِ – صَلَّى اللَّهُ عَلَيْهِ وَسَلَّمَ – أَنَّهُ قَالَ: «لِكُلِّ دَاءٍ دَوَاءٌ فَإِذَا أُصِيبَ دَوَاءُ الدَّاءِ أَبْرَأَهُ بِإِذْنِ اللَّهِ عَزَّ وَجَلَّ» .وَرَوَى التِّرْمِذِيُّ وَغَيْرُهُ عَنْ أُسَامَةَ بْنِ شَرِيكٍ قَالَ «قَالَتْ الْأَعْرَابُ يَا رَسُولَ اللَّهِ أَلَا نَتَدَاوَى؟ قَالَ نَعَمْ يَا عِبَادَ اللَّهِ تَدَاوَوْا فَإِنَّ اللَّهَ لَمْ يَضَعْ دَاءً إلَّا وَضَعَ لَهُ شِفَاءً إلَّا دَاءً وَاحِدًا وَهُوَ الْهَرَمُ» قَالُوا وَيَجِبُ أَنْ يَعْتَقِدَ أَنَّ اللَّهَ تَعَالَى هُوَ الْفَاعِلُ، وَأَنَّ التَّدَاوِيَ أَيْضًا مِنْ قَدَرِ اللَّهِ تَعَالَى، وَهَذَا كَالْأَمْرِ بِالدُّعَاءِ
[3] Fatawa Hindiyyah Kitāb Karahiyyah, Mu’alajah p 434 vol 5
مَرِضَ أَوْ رَمِدَ فَلَمْ يُعَالِجْ حَتَّى مَاتَ لَا يَأْثَمُ كَذَا فِي الْمُلْتَقَطِ. وَالرَّجُلُ إذَا اسْتَطْلَقَ بَطْنَهُ أَوْ رَمِدَتْ عَيْنَاهُ فَلَمْ يُعَالِجْ حَتَّى أَضْعَفَهُ ذَلِكَ وَأَضْنَاهُ وَمَاتَ مِنْهُ لَا إثْمَ عَلَيْهِ فَرْقٌ بَيْنَ هَذَا وَبَيْنَمَا إذَا جَاعَ وَلَمْ يَأْكُلْ مَعَ الْقُدْرَةِ حَتَّى مَاتَ حَيْثُ يَأْثَمُ وَالْفَرْقُ أَنَّ الْأَكْلَ مِقْدَارُ قُوتِهِ مُشْبِعٌ بِيَقِينٍ فَكَانَ تَرْكُهُ إهْلَاكًا وَلَا كَذَلِكَ الْمُعَالَجَةُ وَالتَّدَاوِي كَذَا فِي الظَّهِيرِيَّةِ.