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Modes of Administration of Medication and Medical Interventions which may Invalidate a Fast

بِسۡمِ اللهِ الرَّحۡمٰنِ الرَّحِيۡمِ
 

This webpage serves as a concise resource intended for healthcare professionals worldwide, as well as individuals interested in the impact of various medication administration methods and medical interventions on fasting validity. The information on this page has been compiled from various sources and based primarily on the rulings of contemporary Ḥanafī jurists. For comments, suggestions or feedback, please contact Dr. A. Hussain via email at ahussain1999@doctors.org.uk.

Information regarding non-medical factors that invalidate fasting and guidelines for the general public are provided on this page

The contents on this page is grounded in the principles of Ḥanafī fiqh, supplemented by variant rulings from other jurists, particularly recommendations from the 9th Fiqh-Medical seminar on "An Islamic View of Certain Contemporary Medical Issues" convened in Casablanca, Morocco, from June 14-17, 1997, organized by the Islamic Organization for Medical Sciences (IOMS). Additionally, rulings from the Permanent Committee for Scholarly Research and Ifta of Saudi Arabia, specifically those of Shaikh Abdul Aziz bin Abdullāh bin Baz and Abū 'Abd Allāh Muhammad ibn Sālih Al Uthaymeen رحمهما الله, are considered. To try to maintain clarity and avoid confusion, not all scholarly opinions have been exhaustively detailed.

The left-hand column presents legal rulings according to contemporary Ḥanafī jurists who incorporate current medical knowledge. The corresponding right-hand column offers supplementary information, including rulings from other jurists.

One frequently encountered inquiry, concerning the use of inhalers and whether they invalidate fasting, is discussed in detail on a separate page.

General Principle of Fasting Invalidation:
Fasting is deemed invalid if an "agent of consequence" reaches a "cavity of consequence" (jawf), remains therein independently via an "orifice of consequence," and lacks any excuse (e.g., forgetfulness). Fulfilment of all five criteria is necessary for fasting invalidation according to the Ḥanafiyyah. It is pertinent to note that the orifice of consequence must be connected to the cavity of consequence via a passage, manfadh, whether natural or artificial.

Agent of Consequence (Invalidating Substance):
An agent of consequence, capable of invalidating fasting, must possess a discernible body and remain independently within a cavity of consequence, detached from external entities, as per Ḥanafī jurists.

Cavities of Consequence (Invalidating Cavities) Jawf:
Contemporary Ḥanafī jurists primarily limit the jawf to the throat, stomach, and intestine, though classical views may vary.

Orifices of Consequences (Invalidating Entry Points):
This encompasses all natural orifices and any non-natural orifices with a direct or indirect path to a cavity of consequence. The mouth, nose, and anus are natural orifices of consequence. Notably, the lacrimal duct is not considered an orifice of consequence in Ḥanafī fiqh.

 

Reasons for Divergent Rulings:
Several factors contribute to the divergence of legal opinions on fasting, including:

1. Worship of fasting and Rational Meaning: Varied interpretations exist regarding the rationality behind fasting. Some perceive fasting as directly related to hunger and thirst, while others argue that its significance transcends mere physiological needs, resulting in the equal treatment of food and non-food substances during fasting.

2. Definition of Jawf (Cavity of Consequence): The interpretation of jawf differs among Muslim juristsGIT pic:
  i) Classical Ḥanafī scholars identified various bodily openings, such as the throat, eyes, ears, nose, anus, urinary tract, vagina, and deep wounds leading into the abdomen or head, as constituting the jawf. Disagreements arose even among Ḥanafi jurists themselves. Notable differentiations were made by Al-Firghinani regarding substances entering the ear canal and by Al-Marghinani regarding the application of dry versus wet medications to deep wounds. However, contemporary Ḥanafī jurists typically limit the jawf to the throat, stomach, and intestine. This perspective informs the content presented on this platform, although some scholars may reference classical views from ancient texts.
  ii) Classical Mālikiyyah scholars generally confined the jawf definition to natural bodily orifices, including the throat, ear canal, eyes, nose, anus, and vagina, while excluding deep wounds.
  iii) The classical Shāfi’iyyah considered additional openings, such as the urinary tract and deep wounds to the head, as part of the jawf.
  iv) The classical Hanābilah included various bodily openings, akin to those identified by Ḥanafī and Shāfi’i scholars.
  v) Ibn Ḥazm al-Tāhirī restricted the jawf to the throat and stomach, excluding the ears, eyes, nose, and urinary tract based on their lack of association with eating or drinking.

3. Shāfi’iyyah Stance on Intentional Inhalation: Unlike other schools of thought, the Shāfi’iyyah do not consider intentional inhalation of steam or smoke to invalidate fasting.

4. Limited Anatomical Understanding: Classical jurists' rulings were sometimes based on incomplete anatomical knowledge, resulting in:
  i) The ear canal, eye, and nose being viewed as pathways to the brain or throat.
  ii) The brain is considered part of the jawf due to its semantic significance or perceived role in nourishing the body or its connection to the throat.
  iii) The female urethra and vagina, and occasionally the male urethra, being considered part of or connected to the jawf.

 

Practical Considerations:
Determining the fasting implications of medical interventions necessitates an understanding of both fiqhi principles and procedural realities. For instance, while a gastroscope insertion alone does not invalidate fasting, associated procedures involving local anaesthetics or lubricants may.

Additionally, dental treatment during Ramadan should ideally occur in the morning. Delaying the intention to fast until midday is permissible for Ḥanafī fiqh, provided water ingestion during treatment is avoided. If water or other substances are swallowed, fasting for that day is nullified, necessitating makeup later.

This delay provision applies solely to Ḥanafī fiqh.

 

Dr. A. Hussain

 

Useful links (Hanafi fiqh sites)

Nur al-idah (Classical Hanafi fiqh textbook)

Principles on what invalidates the fast based on "Dabit al-Mufattirat" by Mufti Rafi Usmani 

Criterion of Breaking Fast Mufti Mohammed Zubair Butt 

Actions which break the fast A Manual of Hanafi fiqh

FAQs on fasting Fatwa Jamiatul Ulema South Africa

Can one take a steam bath while fasting or not? Darul-Ifta Jamia Binoria Aalamia

Does the use of a drip break the fast? Fataawa Mahmoodiya, V: 10, P: 149, Farooqiyyah   Also see.

Does Fasting become void if eye-drops are used in the eyes? Darul-Ifta Jamia Binoria Aalamia

Using Eyedrops while Fasting Fatwa Jamiatul Ulema South Africa

Can we use inhaler while fasting? Darul-Ifta Jamia Binoria Aalamia

Use of Asthma Inhaler Fatwa Jamiatul Ulema South Africa

Test of sperms for purpose of fertility while fasting in Ramadan (IVF)  Darul-Ifta Jamia Binoria Aalamia

Is it permissible for a woman to have a pap smear while fasting?  Darul-Ifta Jamia Binoria Aalamia

Does a cervical smear test invalidate one’s fast? Detailed fatwa by Mufti Muhammad ibn Adam (Leicester)

Is it permissible to apply a haemorrhoids ointment inside of the anus while fasting? Darul-Ifta Jamia Binoria Aalamia

Can a person make an intention to keep a Fast after Sehri time has ended? Jamiatul Ulema South Africa

 

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Modes of Administration
v 1.2 May 2018
Medical interventions
v 1.2 May 2018