What are the decrees of our religion about treatment? Are there any places where it is permissible to be treated with haram things?

Details of the Question
What are the decrees of our religion about treatment? Are there any places where it is permissible to be treated with haram things?
The Answer

Dear Brother / Sister,

It is fard for a person to protect his life and to stay away from things that will harm him.

When a person becomes sick, he has the right and even the duty to be treated. For, the body is something entrusted to him. It is necessary for the body to be healthy so that a person will worship and fulfill certain Islamic orders and avoid prohibitions. If a disease hits a believer despite the measures, he needs to be treated. For, the Prophet (pbuh) said,

"O slaves of Allah! Be treated." (see Tirmidhi, Tibb, 2; Abu Dawud, Tibb, 1, II; Ibn Majah, Tibb, 1; Ahmad b. Hanbal, III/156, IV/278)

Treatment includes all methods of treatment like use of medicines, cleaning the wound with surgery, blood transfusion when necessary, amputation of a limb, or removal of a limb that has to be separated from the body. During such an operation, the doctor can look at the private parts of the patient as much as it is necessary. However, it is essential for women to be treated and operated by female doctors and nurses as much as possible. For, the Prophet (pbuh) expressed various warnings regarding the issue.

The Companions asked Hz. Prophet (pbuh),

"O Messenger of Allah! Does a person have to be careful about covering his body even when he is alone?"He answered as follows:

"It is definite that Allah is worthy of being ashamed of more."(Bukhari, Ghasl, 20; Tirmidhi, Adab, 22, 39; Ibn Majah, Nikah, 28)

Once, the Messenger of Allah (pbuh) went to the place where camels given as zakah were kept. When he saw that the shepherd had taken off his clothes under the sun, he dismissed the shepherd and said,

"A person who has no shame should not work for us." (as-Sarakhsi, al-Mabsut, X, 156)

However, it is permissible to look at the private parts of a man or a woman when there is a necessity. For example, it is permissible for the doctor to look at a man's private part for circumcision or for treatment. Similarly, the midwife looks at the private parts of the woman during birth; when there is no female doctor, a male doctor can treat a woman if it is necessary. For, the Prophet allowed midwives to be present during birth and witness the birth when necessary. This state includes looking, too. (as-Sarakhsi, ibid, X, 156)

As- Sarakhsi (6. 490/1097) states the following about the treatment of a woman by a man:

"If it is not possible to find a woman (doctor) who will cure a boil on the body of a woman, if it is not possible to teach another woman how to treat it, and if the sick woman might die or become exhausted or suffer a pain that she cannot stand, it is permissible for a man to treat it by covering the body of the woman except the place where the boil is. This man avoids looking at the other parts of her body. For, it is worse for a person to look at the opposite gender. Here, it is necessary to decide whether there is a necessity or not. The necessity is the risk of death. When such a risk occurs, it is not permissible to look at her more than what is necessary." (as-Sarakhsi, ibid, X /157)

Treatment with haram things.

There is a disagreement whether it is permissible to use things that are haram to eat and drink, whether they are dirty or not, in treatment.

According to Hanafis, it is permissible to be treated by something haram if it is definitely known that it will cure. Al-Qasani (d. 587/1191), a great Hanafi scholar, states the following:

"It is permissible to eat carrion for a person when he is about to starve, to drink wine when one is too thirsty and to remove the morsel in the throat; similarly, it is permissible to be treated by haram food and drinks if it is definitely known that they will cure. However, if it is not definite that it will cure, treatment with it is not possible. On the other hand, Abu Yusuf regarded drinking urine of camel with the purpose of treatment permissible.  For, the Prophet (pbuh) ordered Uranis, who got sick due to climate difference, to drink the urine of camels of zakah. (al-Qasani, ibid, I, 61)  According to Abu Hanifa, it is not permissible because it is not definitely known that it will cure. According to him, it is possible to understand the hadith about Uranis as follows: "Hz. Prophet (pbuh) stated that this urine will cure only them. (al-Qasani, ibid, I, 61-62)

According to Hanbalis, it is not permissible to be treated with the food and drinks rendered haram in Islam. Ibn Taymiyya gave the following answer to the question whether it was permissible to be treated by wine, pork and similar things:

"Treatment with them is not permissible." (Ibn Taymiyya, Fatawa, Egypt, 1329, I, 270)

Ibnul-Qayyim gave the same answer. (Ibnul-Qayyim, Zadul-Maad, II, 114) After quoting, Sahnun's statement, "Wine and pork cannot be used in treatment", Ibnul-Arabi adopted the same view. (Ibnul-Arabi, Ahkamul-Quran, I, 59)

The evidence they base their view on is the Sunnah. According to what is reported from Tariq b. Suwayy al-Jufi, he asked the Messenger of Allah (pbuh) about wine and the Messenger of Allah prohibited it. Tariq said, "I produce it as medicine." Thereupon, he said, "It is no medicine, but an ailment." (Darimi, Ashriba, 6; Muslim, Ashriba, 12; Abu Dawud, Tibb, II; Tirmidhi, Tibb, 8)

Abud-Darda states that the Messenger of Allah (pbuh) said,

"Allah sent both illness and cure; He created a cure for each illness; be treated but do not use haram things in treatment." (see Malik, Muwatta', Ayn, 12; Ahmad b. Hanbal, Musnad I,13, 446, III, 156)

The following was reported from Ibn Mas'ud: "Allah did not create cure in the things that He rendered haram." (ash-Shawkani, Naylul-Awtar, VIII, 203). In another hadith, the Messenger of Allah prohibited dirty medicine and said,

"Allah did not create cure of my ummah in the things that He rendered haram to them." (see Abu Dawud, Tibb, II; Tirmidhi, Tibb, 7; Ibn Majah, Tibb, II, Ahmad b. Hanbal, II, 305, 446, 478; ash-Shawkani, ibid, VIII, 203; Ibn Taymiyya, I, 270)

According to those who hold this view, when there is nothing else but haram things to overcome hunger and thirst for a person who is in great difficulty, the only remedy is to eat or drink haram due to necessity. As for the treatment of diseases, medication is not only this haram thing. There are usually alternative medication or methods of treatment. Therefore, hunger and disease are not the same. For, it is certain that hunger can be removed with the haram food but it is not known beforehand in the same certainty that this disease will be treated with this medication. On the other hand, it is fard for a person who understands that he will die of starvation to eat haram food; it is controversial whether it is fard to be treated with haram in case of illness. For, many Companions and Tabiun did not undergo treatment and no scholar blamed them. (Ibn Taymiyya, Fatawa, I, 259-260, 268-270)

According to Zahiris, it is permissible to be treated with haram things. Ibn Hazm, a Zahiri scholar, says,

"Wine becomes permissible for a person who is in great difficulty. A person who drinks wine in order to overcome his thirst, to be treated or to prevent being choked is not punished." (Mu'jamul-Fiqhi Ibn Hazm, Ta'lif, comittee, Damascus University)

The evidence Ibn Hazm bases his view on is as follows:

"To eat and drink urine is haram at normal times but it is not haram in cases of treatment and similar necessities. As a matter of fact, the Messenger of Allah (pbuh) rendered urine of camel permissible to Uranis for the treatment of their illnesses." (Mu'jamul-Fiqhi Ibn Hazm, I, 353; al-Qasani, ibid, I, 61)

Ibn Hazm analyzed the hadiths that those who did not regard treatment with haram things permissible based their views on and stated that some of them were weak; he interpreted the others as follows:  

"It is permissible to drink haram things when there is a necessity for treatment. When they are permissible, they should not be included among “dirty medicines”, which are forbidden to use in treatment; therefore, they cannot be called “dirty”.(see Abu Dawud, Tibb, II; Tirmidhi, Tibb, 7; Ibn Majah, Tibb, II; Ahmad b. Hanbal, II, 305, 446, 478; Mu'jamul-Fiqh, I, 353)

In conclusion, the moderate way about treatment with haram things is the view of Hanafis. If it is possible to treat the illness with legitimate food, drinks and medicine, they are used. If it is known through experience that the illness can be treated by haram food, drinks or medicine, it is permissible to use them in treatment. In this case, the rule "Necessities make impermissible things permissible" is applied. For, an illness is included in the scope of the concept of necessity when it is grave.

Adding intoxicants into medicine

Alcohol and other intoxicants are added to some medicine and they are advised to patients by doctors. First of all, if there is an alternative medicine without alcohol, it should be preferred. If there is no alternative and if it is certain that it will cure or relieve the patient, it is permissible for the patient to use that medicine. Today, most of the drugs used in depressive and neurological cases include tranquilizers. The nervous system of the patient is tranquilized; he is prevented from feeling pain; his sleeplessness is eliminated and the state of panic and anxiety in operations is reduced to a minimum. 

If the tranquilizer used in drugs undergo some changes through metamorphosis, the quality of “dirtiness” of it can change. Al-Qasani (d. 587/1191), the great Hanafi fiqh scholar, states the following while explaining the view of Muhammad b. Hasan ash-Shaybani (d. 189/805):

"According to Imam Muhammad, if something dirty undergoes a change in the course of time and if its properties change, it becomes something else and clean. When something dirty undergoes a change, its properties and meaning change, it ceases to be dirty. For, the word dirty is used for it due to a certain property. When that property changes, its name changes too, like wine transformed into vinegar." (al-Qasani, al-Badayi, 85)

Ibnul-Arabi, a Maliki fiqh scholar, states the following:

"If somebody has to be treated by a dirty animal, he can use it as it is or after burning it. If it undergoes a change when it is burnt, it is permissible to use it in treatment and to perform prayers when it is on him." (Ibnl-Arabi, Ahkamul-Qur'an, I, 59)

Ibn Taymiyya, a Hanbali scholar, states the following:

"If a dirty animal, blood, pork, and similar substances rendered haram by Allah fall into water or another liquid, break up in it and lose their property and traces, no dirty animal, blood or pork exists in it any longer. When wine falls into a flowing substance, disappears in it and loses all of its properties that can be perceived by sense organs, if a person drinks that substance, he is not regarded to have drunk wine." (Ibn Taymiyya, Fatawa, I, 20)

In conclusion, if a small amount of something that is haram to eat and drink is mixed with a medicine in a way that it will melt and disappear and its color, taste or trace will disappear or its properties that are haram will disappear, compared to a dirty substance that is transformed into something else by melting or boiling, it becomes permissible to be used as medicine. (For detailed information, see Abdülkerim Zeydan, İslâm Hukukunda Zaruret Hali, Translated by H. Karaman, İslâm'ın Işığında Günün Meseleleri, İstanbul 1982, I, 312 ff)

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