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What Are the Islamic Rulings Related to Someone Suffering From Dementia?

Answered by Ustadh Salman Younas

Question: Assalam aleykum

My grandma has totally lost her mind. She doesn’t know what she is saying, can’t eat, or relieve herself, so the family need to do everything for her.

a. Is she exempt from prayers?

b. Does she still have to cover herself in the presence of non-mehram man?

c. When taking her up the stairs to the bathroom, at times, I have to help lift her. There are occasions when we make body contact. Is it sinful?

Answer: assalamu alaykum

We ask God to grant your family health and ease.

Regarding your questions:

a. Based on the description you have given, it does not seem like the prayer would be obligatory on your grandmother as she is no longer considered morally-responsible (mukallaf) due to a deficiency in intellect (aql).

b. The basis is that a woman must cover her entire body in front of a non-mahram man except the face, hands, and feet.

However, in the case of an elderly woman who is no longer sexually desirable, a number of scholars stated that it is permissible to look at those parts of the body that are “generally” uncovered in front of her mahrams. This would include her face, hands, head/hair, feet, arms, neck, and shin. [Ibn Qudama, al-Mughni (9:491) & Sharh al-kabir (7:342); al-Buhuti, al-Kashshaf (5:31); al-Mardawi, al-Insaf (8:26)]

c. The general rule is that it is permissible to touch those areas of a woman that are not considered part of her nakedness (awra). The exception to this is (a) if one fears desire in doing so and (b) a non-mahram. In your cases, as your grandmother is your mahram, it would be permissible for you to touch the areas mentioned above. This is especially the case if there is no one else able to properly assist her as it would be a genuine case of need.

[Ustadh] Salman Younas

Checked and approved by Shaykh Faraz Rabbani

Ustadh Salman Younas graduated from Stony Brook University with a degree in Political Science and Religious Studies. After studying the Islamic sciences online and with local scholars in New York, Ustadh Salman moved to Amman. There he studies Islamic law, legal methodology, belief, hadith methodology, logic, Arabic, and tafsir.

My Mother Is in a Coma. Is It Permissible to Stop Hydration?

Answered by Ustadha Raidah Shah Idil

Question: Assalam aleykum,

My mother has been diagnosed with Creutzfeldt-Jakob disease (CJD). There is no known cure. Two weeks ago she was put on an IV in order to receive hydration. For 10 days she has been in a coma. Her doctor has recommended that we stop hydration to let her go. Is it permissible to stop hydration?

Answer: Assalamualaykum wa rahmatullahi wa barakatuh,

I pray this finds you well. Please forgive me for the delay.

Istikhara

As you have correctly described, the decision to stop hydration for your mother is up to you and your family. Because CJD does not have a cure, then it is permissible for you to stop hydration, as it is akin to medication.

To help ease your heart, I encourage you to perform the Prayer of Guidance up til 7 times in regards to stopping hydration for your mother.

I pray that Allah grants your mother the highest rank in Jannah, and that He grant you and the rest of your family strength, patience, and acceptance of His Decree. May you all be reunited in Jannahtul Firdous.

Please see:

Extending Life Support When No Recovery is Expected

Wassalam,
[Ustadha] Raidah Shah Idil

Checked & Approved by Shaykh Faraz Rabbani

Ustadha Raidah Shah Idil has spent almost two years in Amman, Jordan, where she learned Shafi’i’ fiqh, Arabic, Seerah, Aqeedah, Tasawwuf, Tafsir and Tajweed. She continues to study with her Teachers in Malaysia and online through SeekersHub Global. She graduated with a Psychology and English degree from University of New South Wales, was a volunteer hospital chaplain for 5 years and has completed a Diploma of Counselling from the Australian Institute of Professional Counsellors. She lives in Kuala Lumpur, Malaysia, with her husband, daughter, and mother-in-law.

Extending Life Support When No Recovery is Expected

Answered by Shaykh Faraz Rabbani

Question: What would be the Islamic position on terminating life support when someone enters into a ‘”vegetative state?” Can Muslims state, in their will, their desire not to be kept alive by machines?

Answer: In the Name of Allah, Most Merciful.

Walaikum assalam wa rahmatullah,

It is permitted to stop medication, because it is established from the Sunna of the Messenger of Allah (peace and blessings be upon him) that it is a recommended sunna, but not obligatory, to undertake medical treatment. This is the position of the overwhelming majority of Islamic scholarship.

The issue remains whether it is permitted to stop feeding, because it is not generally permitted to stop eating and drinking, whether directly or through a guardian or caretaker’s decision.

In cases where a patient is in a ‘vegetative’ state, such that no human function is likely to return to them even in the future according to expert medical opinion, this feeding is considered akin to medication and the decision to continue it or cease it returns to the individual or their guardian or caretaker.

Some of the Fiqh of This Case

In general, the ruling of medical treatment itself is that it is a sunna, for the Messenger of Allah (peace and blessings be upon him) told us, “Allah has created a cure for every disease He has created.” [Related by Bukhari and Muslim] It is not obligatory, however, because of the many narrations from the first generations in which they chose to forgo available medical treatment that was likely to benefit. This is related from some of the leading Companions (Allah be pleased with them all), including Ibn Mas`ud and Abu al-Darda’, and the righteous Caliph Umar Ibn Abd al-Aziz [Ibn al-Hajj, al-Madkhal, 4.115-116].

This is the position of the Hanafi school, and also of the majority of Islamic scholarship [Ibn Abidin, Radd al-Muhtar; Nawawi, al-Majmu`; Ibn Qudama, al-Mughni]. Iraqi said in Tarh al-Tathrib that it is the position of the vast majority of the early Muslims (salaf) and the generality of the later Muslims (khalaf) [Iraqi, Tarh al-Tathrib, 8.181].

Some scholars, however, considered leaving medical treatment better because they deemed it closer to reliance on Allah–this is a strong position in the Hanbali school, though some notable Hanbali ulema such as Abu Ya`la and Ibn al-Jawzi disagreed [Buhuti, Kashshaf al-Qina`, 2.76]. Other scholars held that when the treatment is of reasonably sure healing or cure, then it is either a very strong sunna or even obligatory to pursue such treatment.

Living Will To Leave Treatment

It is permitted to make a living will in which one expresses the desire not to be kept alive by machines or through medication. However, it would not be permitted to request that one not be given food or drink in situations when there is medical hope of recovery.

Euthanasia

Active euthanasia, in which means are taken to end the life of the patient, is prohibited and a major sin, because of the words of Allah Most High,

“Say: Come, I will recite unto you that which your Lord has made a sacred duty for you: That you ascribe no thing as partner unto Him and that you do good to parents, and that you slay not your children because of penury – We provide for you and for them – and that you draw not nigh to lewd things whether open or concealed. And that you slay not the life which Allah has made sacred, save in the course of justice. This He has command you, in order that you may discern.” [Qur’an, 6.151]

Suicide Is Not An Option

Likewise, suicide is also prohibited and a major sin, even in situations of grave physical or emotional hardship, because of numerous texts of the Qur’an (like the above verse) and the Sunna.

Imam Ibn Hajar al-Haytami (909-974 AH) wrote in his al-Zawajir `an Iqtiraf al-Kaba’ir, which lists and explains the major sins (kaba’ir),

“The 314th Major Sin: Killing oneself. Allah Most High said, ‘Do not kill yourselves. Verily, Allah is ever Merciful unto you. Whoever does that through aggression and wrongdoing, We shall cast them into Fire, and that is ever easy for Allah’ [Qur’an, 4: 29-30].” [Haytami, al-Zawajir `an Iqtiraf al-Kaba’ir]

May Allah give life to our hearts, minds, and souls, through true love for Him and His Beloved Messenger, our master Muhammad (Allah bless him & give him peace).

Wassalam,
Faraz Rabbani