Does vertigo make it permissible not to fast in Ramadan, and is the view of one doctor sufficient?

Question 507411

When I was in medical school, during my graduating year, I was on call at work in the emergency surgery department, during the day in Ramadan. A small child who had been injured was brought in, accompanied by a young man who was one of his relatives.

When I was stitching up the wound, the young man was required to hold him. After a little while, the young man could no longer bear seeing the wounds and blood, and he became dizzy and nearly vomited, so he moved away to rest.

When we talked to him, he said that he was tired because he had been driving for a long time, and he was going to drive further after that to reach another state that I think is far away; I do not remember exactly. We were worried that he would get into an accident because of the dizziness that he was suffering, and because he was also very tired, as he told us. So I advised him, after discussing the matter with a colleague, a woman doctor who had already graduated and was senior to me, to break the fast and make it up later on. The young man accepted that advice and broke his fast by drinking a carton of juice in the hospital. Then he felt better, regained his energy and left.

My question is: is what we did correct according to Islamic teachings?

Answer

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Praise be to Allah, and blessings and peace be upon the Messenger of Allah:

I.

It is permissible for one who is sick to break the fast in Ramadan, according to the text of the Quran. Allah, may He be Exalted, says: {So whoever is present during the month, let him fast it; and whoever is ill or on a journey - then an equal number of other days} [Al-Baqarah 2:185].

In the answer to question no. 12488, we explained what is meant by the level of sickness that makes it permissible to break the fast. That includes four factors:

1. The sickness will be made worse by fasting
2. Recovery will be delayed by fasting
3. Fasting will cause intense hardship, even if it does not make the sickness worse or delay recovery
4. The scholars also included those who fear that they may become sick because of fasting.

II.

As for the question of whether dizziness (vertigo) is an excuse that allows one not to fast during Ramadan, that is based on how dangerous it is and its impact. We have found – after researching the matter – that doctors mention two scenarios regarding vertigo:

The first scenario:

When it is transient and of short duration. This does not affect the individual and does not pose any danger to him, so the fasting person should not break his fast because of it.

The second scenario:

When dizziness is ongoing or happens repeatedly. In this case there is the fear that it may get worse and lead to unconsciousness. We may add to this another risk, which is if the sick person is dealing with heavy equipment or needs to drive a vehicle. The one who is affected by this should break his fast, eat some suitable food and take appropriate medications, after identifying the cause of dizziness.

Based on this, what appears to be the case is that this individual comes under the second heading, so it is permissible for him to break his fast, and he must make up that day later on.

III.

For a sick person to break his fast, it is sufficient for one trustworthy doctor to tell him that fasting will harm him, even if the doctor is a woman.

Al-Bahuti said: The sick person may pray lying on his back, even when he is able to stand, for the purpose of medical treatment, on the instructions of a trustworthy Muslim doctor. And he may break his fast if the doctor tells him: fasting will make your problem worse.

End quote from Ar-Rawd al-Murbi`, 2/373.

Ibn Qasim (may Allah have mercy on him) said in his commentary:

Even if the doctor is a woman, because it is a religious matter. End quote.

It is also sufficient for the doctor to tell him not to fast on the basis of what he thinks is most likely to be the case, and it is not stipulated that he should be certain, because usually it is impossible to be certain.

Al-Mirdawi (may Allah have mercy on him) said:

As we accept what the doctor advises, it is sufficient for his instructions to be based on what he thinks is most likely to be correct, according to the correct view of the madhhab.

And it was said: It is stipulated, in order to accept his instructions, that they should be based on certainty.

I say: This is very farfetched.

End quote from Al-Insaf, 5/19.

And Allah knows best.

Fasting