In previous articles in this series we documented the view that medicinal treatment is permissible (mubaah) and the view that it is desirable (mustahabb), as well as clarifying that it is not obligatory (waajib).
In this article we will look at some good clarifications on the issue that provide more insight into the subject.
Shaykh ul-Islaam Ibn Taymiyyah said (Majmoo ul-Fataawaa 18/12):
For the people have disputed regarding medicinal treatment, is it permissible (mubaah), recommended (mustahabb) or obligatory (waajib)?
What is correct: That from it is that which is unlawful (muharram), and from it is that which is disliked (makrooh), and from it is that which is permissible (mubaah), and from it is that which is recommended (mustahabb).
And sometimes there can be from it that which is obligatory (waajib) and that is when it is known about something that [its use] will preserve [someone's] life, and [this will not occur] by anything else.
[This is] similar to when it is obligatory to eat the [meat of the] dead animal out of compelling necessity, for that is obligatory with the four Imaams and the majority of the scholars. And Masrooq has said, "Whoever is compelled by necessity to [eat the flesh of] the dead animal, does not eat and thus dies, will enter the Fire". For sometimes when an illness flares up, a person will die if he does not get treatment for it. Life can be preserved by regular treatment such as nourishment for the weak person, and such as the extraction of blood sometimes.
In the above quotation we find that Shaykh ul-Islaam Ibn Taymiyyah explains that depending on different circumstances the ruling on medicinal treatment can vary, and can span across four different rulings (unlawful, disliked, permissible, desirable). And in some instances it can be obligatory when the situation involves preservation of a life.
In such a situation it would become obligatory - when a person's life would expire by not taking an available, lawful type of medicinal treatment, about which it is established and known that the person's life will be saved by it, and not by anything else. In such a case a person would become sinful by not making use of it, in a similar manner to to the sinfulness of a person who refuses to eat from the unlawful meat when faced with starvation, and as a result dies.
Aside from this situation, the ruling on medicinal treatment is that it is either permissible (mubaah), desirable (mustahabb), disliked (makrooh) or unlawful (muharram).
Next a statement from Shaykh Ibn Uthaymeen (rahimahullaah) from Sharh ul-Mumti', in the chapter on funerals (Janaa'iz). The Shaykh documents the different views on the subject, addressing first the view that it is better to abandon it:
The second: Is the ill person ordered with medicinal treatment? Or is he ordered not to take medicinal treatment? Or is there detail in [the matter]?
The answer: Some of the scholars have said: Abandoning medicinal treatment is better, and it is not desirable for a person to take medicinal treatment. As evidence for this [view], they used the following:
- That the Prophet (sallallaahu alayhi wasallam), "When he was ill and they adminstered treatment to him, he ordered that everyone present also be adminstered treatment, except for al-Abbaas bin 'Abdul-Muttalib". They said: And this is a prof that he disliked their action. And al-ladood, is that by which the ill person is treated, and it is a type of medicinal treatment.
- That Abu Bakr (radiallaahu anhu), when he was ill, it was said to him, "Shall we not call a doctor for you?" He said, "The doctor has already seen me, and said, 'Indeed, I am the Doer of whatever I will'." And Abu Bakr is the best of the ummah after its Prophet, and he is an [exemplary] model and leader (imaam).
Then the Shaykh documents the view that use of medicinal treatment is something that is sanctioned (in the Sharee'ah):
And some of the scholars said: Rather medicinal treatment is sanctioned by tradition (the Sunnah) due to the following:
- The Prophet (sallalaahu alaihi wasallam) ordered with that.
- That it is from the beneficial ways and means (asbaab).
- That a person benefits (by way of it) in terms of his time, and especially the believer who derives [great] benefit from [his] time, he benefits from every hour that passes by.
- That the ill person is constrained (in his soul), he does not perform what is desirable for him to perform of the acts of obedience. And when Allaah heals him, his chest expands and his soul becomes lively, he will perform what is desirable for him to perform of the acts of obedience, and thus the treatment is desired for another objective [separate from itself]. Thus it is sanctioned (by the Sunnah).
Then he explains that depending on circumstances and what can be known in each case, the ruling may vary:
And some of the Scholars have said: When it is known (for sure) or it is believed to be very likely according to experience that the medicinal treatment will benefit, then it is better, and if it entails risk, then it is better to leave it. Because if it is something that entails risk then [further] harm can arise within him, and thus the person will be one who caused harm to himself. This is especially so regarding current medicinal treatments - the drug medications which act very rapidly and powerfully upon a person, when a doctor prescribes them incorrectly.
And some scholars have said: medicinal treatment is obligatory when its benefit is believed to be very likely.
Then the Shaykh makes a summary of the affair and explains what he holds to be correct, which is along similar lines of what Shaykh ul-Islaam Ibn Taymiyyah has stated. The Shaykh then concludes:
And as for what is correct:
That it is obligatory when leaving it entails death (perishing), such as localised cancer for example. Localised cancer, by Allaah's permission, when the cancer-affected area is [surgically] removed, then he will survive from it. But if he was to leave it, it may spread to the rest of the body, and the result would be death (destruction). So here the treatment is known to benefit, because the (cancer) is localised, it is cut off, and thus it ends.
And al-Khidr destroyed the ship, in order to save the rest of them [from being expropriated by the king]. Likewise, the body, when a part of it is cut off so that the rest of it can survive, then that is obligatory.
And based upon [all of] this, that which is nearest (to what is correct) is that the following is said [regarding medicinal treatment]:
1. That what is known or believed to be very likely to be of benefit, alongside the likelihood that [a person] will perish without [making use of] it, then it is obligatory (waajib).
2. That what is believed to be very likely of benefit, but there is no established likelihood of [a person] perishing by abandoning it, then it is better (afdal) [to be taken].
3. That when the two affairs are equal (i.e. the benefit and the risk), then it is better to abandon it, so that a person does not throw himself to destruction (i.e. bring more harm upon himself) without perceiving it.
- A clarification that the taking of medicinal treatment (except in one particular situation involving preservation of life) is not obligatory (waajib) and anyone who claims as such is disputed with by the Sunnah, and by the state of the Prophets and by the state of the Salaf.
- A clarification that medicinal treatment through that which is unlawful (haraam) is prohibited, and that necessity (dhuroorah) does not make it permissible, and that this situation is unlike that where unlawful meat becomes permissible when there is fear of death by starvation.
- Thus, medicinal treatment through that which is unlawful is prohibited without there being any exceptions, in the view of the scholars. This would include medicinal treatment by way of foods and drinks that are unlawful (such as flesh of swine, intoxicants, such as wine etc.) and things which are impure (najas).
- A clarification that though medicinal treatment in general is not obligatory, there is a particular situation in which it can become obligatory. This is when a life will expire if an available, lawful treatment is present but not used, and there is nothing besides this that can achieve the goal of saving the life - as explained by Shaykh ul-Islaam Ibn Taymiyyah. So here using this medicinal treatment would be obligatory.
- medicinal treatment is better abandoned in a situation where the benefit and risks are equal or weighted more towards the risks, and thus taking it in this situation would enter it into the realm of being disliked (makrooh).
- In the absence of a situation that involves the matter of life and death, or where medicinal treatment has more risks (side-effects and other damaging effects) than the actual benefit, or where the benefit and risks are equal, the ruling on medicinal treatment falls back to being either desirable (mustahabb) or permissible (mubaah).