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Islam and Spiritualism ( 5 Apr 2023, NewAgeIslam.Com)

Thirty Lessons of Ramadan: The Fourteenth Lesson on the Updated Guidelines for the Treatment in the State of Fasting – Part 14

By Mufti Abdul Malik Misbahi, New Age Islam

Translated into English by Ghulam Ghaus Siddiqi, New Age Islam

5 April 2023

Question: Is It Permissible Or Impermissible To Take Glucose Or Insulin During A Fast?

Answer: The books of jurisprudence have made such matters very clear that If there are any indications that a patient cannot fast, or if fasting will harm him, or if the disease will worsen, or if recovery will take longer than expected, or if these things are demonstrated by experience or by an expert Muslim physician who is not a Faasiq, it is permissible for him to not fast for as many days as he is in these conditions. Even though Kaffarah is not required under such circumstances, he must observe the Qazaa of the missed fasts once his health has returned to normal.

Allah Almighty says in the Quran,

“... So those of you who witness the month must fast in it. But the one who is sick, or is on a journey (should fast) as much from other days (as he missed). Allah intends (to provide) ease for you and does not intend (to create) hardship for you.” (2:185)

As a result, if there is an instance where it is lawful to refrain from keeping fast, it is still permissible to take any required medications, such as glucose or insulin, while fasting, provided that they are supplied through a Ghair Manfaz, i.e. an unnatural orifice of the body, as opposed to the mouth, nose, etc. The jurists agree with this point of view.

Question: Does Taking Glucose Or Insulin During A Fast Invalidate It Or Not?

Answer: The fast will be invalidated and its Qazaa will be mandatory if glucose is consumed by way of eating and drinking like regular medications. This is true whether the glucose is in the form of glucose powder that is dissolved in water and swallowed, glucose tablets that are placed in the mouth and chewed, or glucose syrup that is taken in one or two spoonfuls as prescribed by the doctor.

But certainly, taking insulin or glucose via injection will not break the fast since the fast is broken by medication or food that enters the brain or stomach through the natural orifices [Manaafiz-e-Asaliyyah] of the body [such as the mouth, nose, etc.]. And since the Arabic word Masaam is derived from "Samm al-Ibrah," which means "the pore or hole of a needle," the pore created inside the body through the injection is obviously not a natural orifice [Manfaz] but an artificial pore [Masaam], so the injection will not invalidate the fast whether it is inserted into the flesh or into a vein. The vast majority of Sunni jurists hold this position.

The Grand Mufti of India Mustafa Raza Khan (may Allah be pleased with him) says about injection: "In fact, an injection does not invalidate the fast because the medicine does not enter the stomach through an injection," (Fatawa Mufti-e-Azam, Vol. 3, p. 203, Imam Ahmad Raza Academy, Bareilly Sharif)

Question: Does Undergoing Dialysis While Fasting Invalidate The Fast Or Not?

Answer: There are two procedures for dialysis (blood purification):

One method of dialysis is Hemodialysis which involves the mechanical removal of impurities, excessive salt, and excessive water from the blood, the administration of medications, chemicals, and nutrients, and finally the return of the blood to the body—all via the veins. Using this method won't invalidate the fast because nothing enters the body through the natural orifice [Manfaz], and nothing enters the stomach or brain either. Instead, blood from veins is removed by machine, filtered, and then returned to the body through veins. Hence, the fast is not broken if blood is drawn from or injected into a vein.

Another method of dialysis is Peritoneal Dialysis. In this procedure, a hole is formed in the abdomen of a patient up to the thick layer, after which a tube is inserted into the outer membrane adjacent to the stomach, and then a special type of liquid known as “peritoneal fluid” is injected into the stomach membrane and then ejected. This process of surgery and delivering medicine is similar to the method of delivering medicine to an abdominal wound—the method which invalidates the fast according to the jurisprudential opinion of Imam-e-Aazam Abu Hanifa (may Allah be pleased with him). The peritoneal dialysis procedure will cause the fast to be broken; hence keeping the Qazaa fast will be required.

When medication is given to a wound that extends to the stomach or brain membrane of a person, the fast will be invalid if the medication reaches the brain or stomach. Whether the medication is dry or liquid, this rule still applies. Even if the medication is passing through but its destination—the stomach or the brain—is unknown, the fast will still be invalid. But, if the medication in this case was dry (powder, etc.), the fast would not be broken. [Alamgiri vol.5, p.789, cited in Bahar-e-Shariat]

Given these jurisprudential statements, it is required that the kidney patient observe the Qazaa of the fast as a precautionary measure if he undergoes peritoneal dialysis.

Allah knows the best.

(Continued)

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Mufti Abdul Malik Misbahi is the author of multiple books. He has also lectured and held positions such as Mufti, Shaykhul Hadith, president, founder, and director at a number of institutions, including Darul Uloom Ghousia in Hubli, Karnataka, and Darul Uoom Solemaniya Rahmaniya in Bikaner Darul Uloom Reza-e-Mustafa, Bihar, Madrasa Shah Khalid, Vanwa Libo Muslim League, Fiji (near Australia), Madina Educational Society, Rajasthan. He currently holds the positions of Mufti in the Sunni Darul Ifta in the Madina Masjid, General Secretary of the Raza Foundation, Director of the Darain Academy, Founder of the Afkar-e- Raza Institution, and Chief Editor of the Do-Maahi Raza-e-Madina (Urdu, Hindi) in Azadnagar, Jamshedpur, Jharkhand.