Can a person who suffers from illness fast during the holy month of Ramadan?
Although the obligation of fasting in the holy month of Ramadan is incumbent upon every Muslim, there are certain categories of people who cannot fast because it would be harmful for their health and wellbeing.
Muslim scholars generally agree that a person who merely is afraid (or has ‘fear’) of developing a health condition as a result of fasting, or afraid that their health condition would worsen by fasting, or afraid that their recovery and cure from a health condition would be hampered by fasting, is not required to fast. Instead, this person is required to keep qaḍāʾ (lapsed) fasts within a year prior to the commencement of the next holy month of Ramadan. In the event where a person’s health condition does not change and extends to the next holy month of Ramadan, they do not need to keep lapsed fasts, but instead are required to pay a penalty known as fidya.
The general position propounded by Muslims scholars is rather relative, insofar as it is solely at an individual’s discretion whether they deem themselves healthy enough to fast or not. However, this potentially raises two concerns:
- A person who is diagnosed with minor health problems may choose to fast without knowing that their health condition may be aggravated or prolonged due to fasting.
- A person may forgo the substantial benefits of fasting due to harbouring an unfounded fear that fasting may aggravate or prolong their health condition.
It is prohibited for a person who is afraid of developing a health condition, or is diagnosed with a long-term health condition, and/or is on regular medication prescribed by a doctor, to fast without seeking medical advice prior to fasting. Medical consultation will enable an individual to assess whether:
- Their fear of developing a health condition is justified or not.
- Fasting would aggravate and prolong a long-term health condition or not.
- Any reasonable adjustments could be made in altering medication or the timings of when medication is taken.
If after the medical consultation, the individual chooses not to fast then they are required to keep their lapsed fasts within a year prior to the commencement of the next holy month of Ramadan. If an individual’s health condition does not change and extends to the next month of Ramadan, they do not need to keep lapsed fasts, but instead are required to pay a penalty known as fidya.
1. The Quran stipulates, “O you who believe, fasting is prescribed for you, as it was prescribed for those before you, so that you may be God-conscious. Fast for a specific number of days, but if you are ill, or on a journey, on other days later. For those who can fast only with extreme difficulty, there is a way to compensate – feed a needy person. But if anyone does good of his own accord, it is better for him, and fasting is better for you, if only you knew.”
This verse of the Quran clearly excuses any person who suffers from a health condition from observing obligatory fasts during the holy month of Ramadan and instead prescribes that they can fast on another day (outside of the holy month of Ramadan), or feed the needy as compensation for not fasting.
However, the general verse of the Quran does not clarify what exactly is meant by “illness” and therefore, it can be interpreted in an unrestricted manner and indicate any kind of physical or mental health condition, which would include the mere fear of developing a health condition due to fasting.
2. There are numerous juristic maxims (qawāʿid al-fiqhiyya) that are derived from the Quran and the traditions of the Prophet and his family that act as meta-legal principles, which support the unrestricted reading of the aforementioned verse of the Quran. Amongst these juristic maxims is the maxim of ‘eliminating harm’ (nafī al-ḍarar). According to this maxim, causing any harm to oneself or to others is prohibited, and therefore if enacting a Sharia obligation of fasting would harm an individual, then it is prohibited for that individual to fast.
3. The verse of the Quran, however, does claim that “fasting is better for you, if only you knew.” This gives rise to doubt in the mind of a person who has a pre-existing health condition, or has a fear of developing a health condition, about whether they are obligated or prohibited from fasting.
In light of the verse of the Quran that states, “ask those who know”, it becomes clear that the most qualified group of people who can assess and advise on the level of bearable or unbearable harm an individual may experience due to fasting are medical practitioners. Accordingly, it is necessary for those who have pre-existing health conditions, or who have a fear of developing a health condition, that they consult their medical practitioner prior to the commencement of the holy month of Ramadan.
 Quran 2:183-4
 Quran 2:184
 Quran 21:7, 16:43