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I am a female doctor, and I would like to request you to tell me in practical terms – with examples if possible – about remedies and medicines that it is haram to prescribe to patients. I know that it is not permissible to prescribe intoxicants, but in my daily work I may not notice that some medicines contain intoxicants. I hope that you can advise me.
Praise be to Allah.
One of the blessings that Allah, may He be Glorified and Exalted, has bestowed upon His slaves is that He has ordained a remedy for every disease, and has encouraged us to seek medical treatment .
Abu Hurayrah (may Allah be pleased with him) narrated that the Prophet (blessings and peace of Allah be upon him) said: “Allah has not sent down any disease but He has sent down a remedy for it.” (Narrated by Al-Bukhari, 5678)
It was narrated from Jabir (may Allah be pleased with him), from the Messenger of Allah (blessings and peace of Allah be upon him) that he said: “For every disease there is a remedy, and when the remedy is applied to the disease, it is healed by Allah’s leave.” (Narrated by Muslim, 2204)
Ibn Al-Qayyim (may Allah have mercy on him) said:
“The words of the Prophet (blessings and peace of Allah be upon him), “For every disease there is a remedy,” give hope to the sick person and motivate the doctor, and they encourage us to seek that remedy and look for it." (Zad Al-Ma`ad 4/15)
Even though permission has been given to seek medical treatment and it is allowed to use it and look for it, it is prohibited to seek to treat sickness by using prohibited substances.
Wa’il Al-Hadrami narrated that Tariq ibn Suwayd Al-Ju‘fi (may Allah be pleased with him) asked the Prophet (blessings and peace of Allah be upon him) about Khamr, and he forbade it to him, or disapproved of him making it.
He said: I only make it for medicinal purposes.
The Prophet (blessings and peace of Allah be upon him) said: “It is not a remedy; rather it is a disease.” (Narrated by Muslim, 1948)
Abu Hurayrah (may Allah be pleased with him) said: The Messenger of Allah (blessings and peace of Allah be upon him) forbade using evil (Khabith) remedies. (Narrated by At-Tirmidhi, 2045; classed as authentic by Al-Albani)
Abu Ad-Darda’ (may Allah be pleased with him) said: The Messenger of Allah (blessings and peace of Allah be upon him) said: “Allah has sent down the disease and the remedy, and He has created for every disease a remedy, so treat disease but do not treat it with anything that is prohibited.” (Narrated by Abu Dawud, 3874; Al-Albani (may Allah have mercy on him) said: “This Hadith is authentic – in terms of its meaning – because of corroborating reports.” (At-Ta‘liqat Ar-Radiyyah ‘ala Ar-Rawdah An-Nadiyyah, 3/154)
It is not the matter of merely saying that if a medicine contains something prohibited, such as Khamr, or something impure, such as ingredients of porcine origin, that it is automatically prohibited. Rather the matter is subject to further discussion among the scholars, which we may sum up as follows:
1. Treating sickness with things that are completely prohibited or impure such as treating sickness with Khamr or, as some people do in some countries, where a person may treat himself with his own urine. This is prohibited, because there are Hadiths which forbid treating sickness with Khamr and filthy things .
Ibn Taymiyah (may Allah have mercy on him) said:
“Treating sickness with impure, prohibited things is prohibited, because the evidence which indicates that that is prohibited – such as the verse { Prohibited to you are dead animals …} [Al-Ma’idah 5:3 - interpretation of the meaning], the Hadith, “Every predator that has fangs is prohibited”, and the verse {indeed, intoxicants, gambling, [sacrificing on] stone altars [to other than Allah], and divining arrows are but defilement } [Al-Ma’idah 5:90 - interpretation of the meaning] – is general in meaning, and includes both medical treatment and other matters. Therefore the one who differentiates between them has separated two things that Allah mentioned together, and has understood in exclusive terms what is mentioned in general terms, and that is not permissible." (Majmu‘ Al-Fatawa, 21/562)
Ibn Al-Qayyim (may Allah have mercy on him) said:
“Treating sickness with prohibited things is abhorrent both according to Islamic teachings and according to reason.
As for Islamic teachings, it is what we have mentioned above of these hHadiths and others.
As for reason, it is the fact that Allah, may He be Glorified, has only forbidden it because it is filthy, for He has not forbidden anything that is good and pure to this Ummah by way of punishing it as He forbade such things to the Children of Israel, as He said (interpretation of the meaning):
{For wrongdoing on the part of the Jews, We made unlawful for them [certain] good foods which had been lawful to them} [An-Nisa’ 4:160].
Rather He has only forbidden to this Ummah what He has forbidden because of its filthy nature, and His prohibition of it is a protection for them, so that they will not consume it. Therefore it is not appropriate to seek healing from sickness and health problems through such things. Even if it had the impact of removing the sickness, the consequence will be sickness that is even greater than it in spiritual terms, because of the strength of its filthy nature. Thus the one who is treated with it may try to remove a physical problem, but find it replaced with a spiritual problem." (Zad Al-Ma‘ad, 4/134)
2. Medicine that is mixed with intoxicants
When intoxicants are found in medicine , there are two scenarios:
· The first scenario: when the amount of intoxicant is small, in such a way that if we assume that someone were to drink a large amount of this medicine, he would not become intoxicated.
In this case, a number of the scholars have ruled that it is permissible to take this type of medicine, because the reason why it is prohibited to drink a large or small amount of Khamr is intoxication. But in the case of this medicine, the reason for the prohibition, which is intoxication, is no longer there, for a large or small amount of it will not cause intoxication; therefore they regard it is permissible to take it.
· The second scenario: if the amount of the intoxicating substance in the medicine is large, in such a way that if someone were to drink a large amount of it he would become intoxicated. In this case, it is not permissible to dispense the medicine to the patient, because the reason for the prohibition, which is intoxication, is present, so it comes under the same ruling as Khamr.
`Aishah (may Allah be pleased with her) said: The Messenger of Allah (blessings and peace of Allah be upon him) was asked about mead. He said: “Every drink that intoxicates is prohibited.” (Narrated by Muslim, 2001)
Jabir ibn ‘Abdullah (may Allah be pleased with him) said: The Messenger of Allah (blessings and peace of Allah be upon him) said: “Whatever intoxicates in large amounts, a small amount of it is prohibited.” (Narrated by Abu Dawud, 3681); classed as authentic by Al-Albani in Sahih Abu Dawud, 3681)
3. Medicine that is mixed with impure , prohibited substances such as some medicines that contain some pork fat, or parts of animals that were not slaughtered in accordance with Islamic teachings, and the like. There are two scenarios:
· The first scenario is transformation of these prohibited, impure substances when they are mixed with the medicine.
Transformation (Istihalah) refers to when something is transformed and changes from its original characteristics. (Al-Mawsu‘ah Al-Fiqhiyyah, 3/213)
During the manufacturing process, some impure substances undergo chemical processes which cause them to lose their original characteristics, so that they turn into different substances.
Many of the scholars are of the view that if an impure substance loses its original characteristics and changes, to the extent that it becomes something else, then in this case the reason for regarding it as impure is no longer there, so it may be deemed pure.
Al-Qarafi (may Allah have mercy on him) said:
“That is because Allah has not decreed that certain things are impure or are contaminated with impurity merely because of what they are, according to scholarly consensus. Rather it is because of specific characteristics that are found in these substances and entities, such as a specific colour or some specific quality that is usually known in that substance. If that quality is eliminated and those characteristics are no longer there, then the ruling [that it is impure] no longer applies, because the reason for it is no longer there." (Al-Furuq, 2/207)
Ibn Al-Qayyim (may Allah have mercy on him) said:
“Thus Khamr may be deemed pure if it has undergone a process of transformation (Istihalah), for Khamr is impure because of some filthy or evil characteristic in it; therefore, if that evil characteristic is no longer there, then the ruling no longer applies. This is the basis of Islamic teachings and is the basis for reward and punishment.
Based on that, the sound analogy is to apply the ruling mentioned above to all other impure substances if they are subjected to a process of transformation. The Prophet (blessings and peace of Allah be upon him) exhumed the graves of the polytheists which were on the site where he wanted to build his mosque, but he did not remove the soil. Allah, may He be Glorified, has told us that milk comes out from between dung and blood. And the Muslims unanimously agreed that if an animal has been fed on impure things, then it was detained and fed on pure things, then its milk and meat become permissible, and if crops and fruit trees were irrigated with impure water, then they are irrigated with pure water, they become permissible, because the evil characteristics have been transformed and have become good.
The opposite of that is that if something good is transformed into something filthy and evil, it becomes impure, such as water and food when they are transformed into urine and stools. Thus we see how transformation has an impact of turning something good into something filthy, so how could it not have the impact of turning something filthy into something good? Allah, may He be Exalted, brings forth what is good from what is filthy, and brings forth what is filthy from what is good. It does not matter what its origin is; rather what matters is the description of the thing itself…" (I`lam Al-Muwaqqi`in, 3/183)
This is the view of the majority, as Shaykh Al-Islam Ibn Taymiyah (may Allah have mercy on him) said: The majority are of the view that impure things that have been transformed become pure, as is well known among the Hanafis and Thahiris (literalists). This is one of the two views in the Madhhabs of Malik and Ahmad, and it is one view in the Madhhab of Ash-Shafa‘i." (Majmu` Al-Fatawa, 21/510)
· The second scenario is when the impure substance remains in its original form in the medicine, and has not changed into some other substance. For example, some medicines contain pork fat, which remains as it was and is not changed during the production of the medicine. In that case, taking the medicine is haram, because it is consuming something that is impure.
For more information, please see the book: Ahkam Al-Adwiyah fi’sh-Shari‘ah Al-Islamiyyah by Hasan ibn Ahmad Al-Fakki. This is a book which will be very useful for you in your specialty, and it is written in an easy style. You can find it on the Internet.
In conclusion, if something that is prohibited – because it causes intoxication or because it is impure but does not cause intoxication – has lost the characteristics because of which it was prohibited, so that no trace of the characteristics of impurity remain, or the intoxicating substance that is mixed with the medicine no longer has an intoxicating effect, it is permissible to take that medicine and it is permissible to prescribe it for patients, because what was prohibited or impure has been absorbed into it, and no trace of it is left.
But if the trace of the prohibited substance is still there, it is not permissible to prescribe it or use it to treat sickness.
Whether that trace remains or not is something that is known to experts through observation and experience. Finding out the percentage of what is mixed with the medicine may help to determine that.
With regard to the names of medicines that contain prohibited ingredients, this is something that you have to ask specialists about, such as pharmacists who specialize in the manufacture of medicines, who can be trusted because of their religious commitment.
And Allah knows best.