Assalamualaikum wbt. I have a mother who is very old and suffering from kidney disease. However, she refuses to go to the hospital to get any treatment because she is afraid of the doctor. What is the ruling of her actions?
Waalaikumussalam wrm wbt,
Alhamdulillah, praise and thanks to Allah for the countless blessings He has blessed us all with. Blessings and salutations to the Prophet Muhammad PBUH, his wives, his family, companions and all those that follow his teachings to the day of judgement.
The Prophet PBUH said:
عن ابي هريرة رضى الله عنه عن النبي صلى الله عليه وسلم قال: مَا أَنْزَلَ اللَّهُ دَاءً إِلَّا أَنْزَلَ لَهُ شِفَاءً
From Abu Hurairah RA, the Prophet (ﷺ) said, "There is no disease that Allah has created, except that He also has created its treatment."
Sahih al-Bukhari (5678)
Imam al-Khattabi when commenting on the above hadith said that it shows knowledge on medicine is affirmed and the permissibility of seeking treatment for diseases, and it is also a sign that sickness and cure are all from Allah SWT. (Refer A’lam al-Hadis Syarh Sahih al-Bukhari, 3/1204)
Syeikh Musa Shaheen said what is meant by the phrase ‘He has also created its treatment,’ is that Allah SWT has revealed the knowledge related to medicine and treatment for people on earth. (Refer Fath al-Mun'im, 8/582)
Coming back to the above question, first, we must analyse the ruling of seeking treatment according to syarak.
The Ruling of Seeking Treatment According to Syarak
Scholars have differing opinions as to the ruling of seeking treatment and their opinions are divided to the following:
First opinion: Sunnah. This is the opinion in madhhab al-Syafie and one of the narrations of madhhab Hanbali. (Refer Al-Majmu' Syarh al-Muhadzzab, 5/96; Mughni al-Muhtaj, 1/357)
This is in accordance with the hadith of the Prophet PBUH stated previously. And madhhab al-Syafie ruled it (seeking treatment) as sunnah for the commandment to seek treatment is not qat’ie (irrevocable). While if the commandment is qat’ie, then it would be wajib. (Refer Mausu’ah al-Fiqhiyah al-Kuwaitiyah, 11/115)
Second opinions: Permissible. This is the opinion of madhhab Hanafi, Maliki and one narration in madhhab Hanbali.
Jurists from madhhab Hanafi said: It is permissible to seek treatment as long as a person has the I’tiqad (belief) that the One who cures is Allah SWT.
Madhhab Maliki jurists said: It is permissible to seek treatment when a person is sick. (Refer Al-Kifayah ‘ala al-Hidayah, 8/500; Syarh al-Zarqani ala al-Muwattha', 4/329; Kasysyaf al-Qina', 2/76)
Third opinion: Wajib. This is the opinion of madhhab al-Zahiri, a narration in madhhab Hanafi and a narration in madhhab al-Syafie.
Scholars of madhhab Hanafi stated: Seeking treatment is wajib if a person is certain that by getting the treatment it will cure him.
Imam Ibnu Hajar al-Haitami said: In our opinion, we ruled it wajib (to seek treatment) if he is suffering from a disease that can lead to him suffering in great harm.
Imam Ibn Hazim said: Indeed, the Prophet PBUH instructed us to seek treatment and restrict us from leaving it. Thus, it shows that seeking treatment is wajib. (Refer Al-Fatawa al-Hindiyah, 5/355; Mughni al-Muhtaj, 1/357; Al-Muhalla, 7/418)
Fourth opinion: Permissible, but leaving it (the treatment) is better for it is closer to taqwa. This is the opinion of Imam al-Nawawi and majority of jurists of madhhab Hanbali. (Refer Al-Majmu' Syarh al-Muhadzzab, 5/95; Kasysyaf al-Qina', 2/76)
The difference of opinions is due to different hadiths used by scholars to support each of their opinions which shows a different ruling. Among the hadiths which explains the ruling of seeking treatment are:
First: Hadith narrated by Abu Hurairah RA:
مَا أَنْزَلَ اللَّهُ دَاءً إِلَّا أَنْزَلَ لَهُ شِفَاءً
"There is no disease that Allah has created, except that He also has created its treatment."
Sahih al-Bukhari (5678)
Second: The hadith narrated by Ibnu ‘Abbas RA:
إِنْ شِئْتِ صَبَرْتِ وَلَكِ الْجَنَّةُ، وَإِنْ شِئْتِ دَعَوْتُ اللَّهَ أَنْ يُعَافِيَكِ، فَقَالَتْ: أَصْبِرُ
“Show endurance as you can do and there would be Paradise for you and, if you desire, I supplicate Allah that He may cure you. She said: I am prepared to show endurance,”
Sahih al-Bukhari (5652) and Sahih Muslim (2576)
Third: Hadith narrated by al-Mughirah Ibn Syu’bah RA:
مَنِ اكْتَوَى أَوِ اسْتَرْقَى فَقَدْ بَرِئَ مِنَ التَّوَكُّلِ
“Whoever seeks treatment by cauterization, or with Ruqyah, then he had absolved himself of reliance upon Allah.”
Sunan al-Tirmizi (2055) and Sunan Ibn Majah (3489)
CONTEMPORARY FATWAS REGARDING THE RULING OF SEEKING TREATMENT
It is stated in decision of Majma’ al-Fiqh al-Islamiy:
The ruling of seeking treatment is wajib if when a person leaves it (the treatment), it could lead to death or loss of body function or weakened of body and if he is suffering from a disease that could infect others. (Refer Qarar Majma’ al-Fiqh al-Islami, No. 2148, 3/563)
It is stated in Fiqh al-Nawazil, the ruling of seeking treatment from diseases is as the following:
It is sunnah for a sick person to seek treatment, for Allah SWT created a disease together with its cure, thus, by seeking treatment, it would make a person healthy to perform worship, learn religious knowledge and do dakwah for Allah SWT, improving his daily life as well as benefitting others. However, if he is certain that if he refuses to seek treatment, it would lead to a great harm, then it is wajib for him to seek treatment. As for if he is unsure about both (about seeking or not seeking treatment), then it is prioritized for him to not seek treatment to avoid an unknown harm. (Refer Fiqh al-Nawazil, 1/491)
In Fiqh al-Muyassar, the ruling for seeking treatment is stated as the following:
If a person is certain that if he refuses to seek treatment then he will face a greater harm and that he will benefit from the treatment, then it is wajib for him to seek the treatment, for example, treatment for cancer. The same for when a part of his limb need to be cut to save his life, then it is wajib for him to undergo the surgery.
If a person is certain that he will benefit from a treatment and there is no risk to his life if he refuses the treatment, then it is prioritized for him to get the treatment.
In a second situation, if he is certain that the treatment will benefit him but at the same time there are risks to his life, then it is prioritized for him to refuse the treatment to prevent any harm on himself. (Refer Fiqh al-Muyassar, 1/455-456)
In al-Fiqh al-Islami wa Adillatuhu, it is stated:
The ruling of undergoing or seeking treatment is different according to the situation of each individual:
It is wajib if when the person refuses the treatment then it will lead to harm on himself (death) or loss of body parts or function, or if it is a contagious disease.
The ruling is sunnah if when he refuses the treatment then it will weaken his body (not like the first situation).
It is permissible if when he refuses treatment then it will not affect him as explained in the first and second situation.
It is makruh if when he refuses it then it will result in a greater risk compared to the disease that he is trying to treat. (Refer Al-Fiqh al-Islami wa Adillatuhu, 7/5204)
Is Seeking or Undergoing Treatment Contradict the Concept of Tawakkal?
Imam Hajar al-Asqalani said: “And in the hadith narrated by Ibnu Mas’ud, it can be understood that for certain diseases of which the cure is unknown, while for seeking treatment it is a form of effort of which does not reject the concept of tawakkal to Allah SWT for believers who believe that no treatment can cure any disease except by the will and authority of Allah SWT.”
“And in the hadith narrated by Jabir RA, it can be understood that everything that happens (which means a cure or healing) is by the will of Allah SWT, as for seeking treatment, it does not deny tawakkal just as when a person is hungry or thirsty then he would eat or drink. The same applies (does not deny tawakkal) when a person avoid a harm by supplicating for good health and protected from harm.” (Refer Fath al-Bari, 10/135)
Imam Ibnu Qayyim said: “It can be understood from the hadith of the Prophet PBUH that the commandment to seek treatment does not deny the concept of tawakkal, just as it is not a denial of tawakkal by quenching one’s thirst or satisfying one’s hunger, or avoiding heat or cold by matters that could do so.” (Refer Zad al-Ma'ad, 4/15)
Imam Ibnu Kathir said: “And Allah SWT is the One who permits the healing of certain diseases, while we should make an effort and take preventive measures that could lead to the healing or cure such as getting treated from ahlu al-ikhtisas (people with expertise), they are experts in the field of medicine. Thus, neglecting reason and effort is a curded matter in religion while tawakkal or supporting a decision solely on reason is something that is cursed in tawhid.” (Refer Tafsir al-Quran al-Karim, 5/131)
Thus, seeking treatment for a certain disease is an effort to get better and does not reject the concept of tawakkal to Allah SWT. Furthermore, considering permissible reasons or ways according to syarak is commanded in Islam. However, a person must believe that Allah SWT is the only One who permits the alleviation of disease.
The original ruling of seeking treatment is celebrated by syarak, for there are numerous Quranic and prophetic evidences whether from the words or actions of the Prophet PBUH which proved this matters. It is also included in maqasid al-kuliyyah which is protecting life. (Refer Al-Fiqh al-Islami wa Adillatuhu, 7/5204)
The role of the field of medicine is stated to be similar to shariah, where it brings maslahah to the people and prevent harm to the health and well-being of people and treating them from diseases. (Refer Qawa’id al-Ahkam, 1/40). Shariah explained the importance of the knowledge of medicine and the original ruling of seeking treatment is permissible. It is also in line with one of the maqasid shariah which is to protect the lives of people, however the ruling changes according to the situation of each individual. (Refer Tuhfah al-Muhtaj, 3/182)
The concept of al-tadawi (getting treated) is to fulfil the following purposes of syarak:
- Maintaining the health of a person.
- Recovery of a person’s health according to efforts that he is capable of.
- Relieve of alleviate the pain with efforts that a person is capable of.
- Choosing a lesser harm to prevent a greater harm.
- Leaving a lesser benefit to protect a greater benefit.
(Refer Zad al-Ma'ad, 3/111; Al-Tib al-Nawawi, pg. 114)
As for the hadith narrated by Ibnu Abbas (إٍن شِئْتِ صَبَرْتِ وَلَكِ الْجَنَّة), scholars commented the meaning of the hadith as the following:
This hadith shows the permissibility to leave or refuse treatment to choose a harder choice of being patient in enduring the disease without seeking treatment for those who are capable to do so. And it is only permissible if it fulfils two conditions which are a true intention and a strong dependence to Allah SWT. However, seeking treatment is still encouraged according to other hadiths of the Prophet PBUH, but this hadith explains that there is an advantage for those who choose to be patient. (Refer Fath al-Bari, 10/115)
Imam al-Syanqiti said: “There are several choices in the shariah, it is whether for something good or better. And the words of prophet in the hadith (إن شئت دعوت لك) means that the prophet gave her a choice of whether to get treated and be cured from the sickness which is a good choice or a better choice of tawakkal and surrender her affairs to Allah SWT if she is certain of herself (that she will be able to be patient with her disease). However, this does not mean that the encouragement of seeking treatment is abrogated, but tawakkal is a better choice recommended by the Prophet PBUH for her.” (Refer Syarh Zaad al-Mustaqni', 243/20)
This hadith does not contradict hadiths which encourage a person to seek treatment, thus, anyone who is able to be patient, then he can choose to do so, while for those who are incapable to be patient in his sickness, then it is prioritized for him to seek treatment for the advantages of tawakkal is no longer applicable for he do not have the capability to be patient. (Refer Al-Raudhah al-Nadiyyah, 2/228)
Whereas for the hadith from al-Mughirah bin Syub’bah (مَن اكْتَوَى أَوِ اسْتَرْقَى فَقَدْ بَرِئَ مِنَ التَّوَكُّل), Scholars detailed the hadith as the following:
It is stated in al-Adab al-Syari’yyah: “This hadith does not mean that it is encouraged to not seek treatment for ruqyah is not considered as treatment, for it is related to their belief, for during the time of ignorance, most ruqyah are related to deviant teachings and superstitions.” (Refer Al-Adab al-Syar'iyyah, 2/333)
Imam al-Nawawi said: “This hadith does not contradict the hadith that encourage seeking treatment, for ruqyah meant here are ruqyah which includes words of disbelief or of which the meanings are unknown, for it may mean disbelief or hated speech. As for ruqyah from the verses of the Quran and famous dhikr (supported by scholars), then they are not restricted but they are even sunnah.” (Refer Nail al-Authar, 8/230)
Thus, after analysing the above discussion, we are inclined to state that the ruling of seeking treatment is greatly encouraged in Islam. However, the rulings are different according to the situation and condition of the individual. If by refusing treatment then it would lead to disability or harm for himself or others such as in contagious diseases cases, then the ruling becomes wajib. The ruling of seeking treatment is sunnah when refusing treatment would weaken a person’s body, but it will not reach the level where it would harm the patient. The ruling will remain as permissible if the treatment will not have the effects as explained in the first and second situations explained earlier. While the ruling will become makruh if there are other risks involved if he gets the treatment and it will lead to a greater side effect compared to the disease that he is trying to treat.
To conclude, seeking treatment is greatly encouraged in Islam for it is in line with one of the maqasid shariah which is to protect life. It also does not reject the concept of tawakkal itself for it is one of the efforts to find a cure through permissible ways according to syarak. However, a person must believe that medication and treatment is his efforts while the One who cures every illness is Allah SWT.
However, the ruling of seeking treatment is different according to the condition and situation of each individual as the following:
First: Wajib – If when he refuses the treatment it will lead to disability to his body or harm to himself or others such as in contagious disease cases.
Second: Sunah – If when he refuses treatment, then it will weaken his body but it does not harm him. It is also sunnah if when a person refuses treatment then it will lead to the neglect of the rights of others such as when a father where he will no longer be able to provide sustenance for his wife and children and it will lead to the neglect of the rights of Allah SWT such as weary in performing g worship like prayer and fast. (Refer Silsilah al-Tafasir, 8/80)
Third: Permissible – if when a person refuses to get treatment, then it will not affect him as explained in the first and second situations.
Fourth: Makruh – If there is a risk that the treatment will have other worse side-effects from the disease that is treated.
Thus, a suitable and appropriate treatment should be chosen for a patient who is suffering from a disease that can harm him, especially if threatens his life. However, all risks and treatments must first be referred and confirmed by medical experts. Wallahua’lam.
May Allah SWT give us the correct understanding in religion. Amin.