Question:
Assalamualaikum w.b.t,
I am a patient of HIV and AIDS. My condition makes it impossible for me to fast because I have to consume medications around 8.00 am to 10.00am for medicinal purpose. It is known that HIV and AIDS have no effective vaccine. How should I replace my fasts? I once heard my fasts can be replaced by my warith (heirs), but I do not have any warith. Even to pay for fidyah is out of my capability because I have no income and depend solely on hospital funding. Hope for an explanation.
Answer:
Waalaikumussalam w.b.t,
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 family, companions and all those that follow his teachings to the day of judgement.
Before we give a further answer, here we first state the definition of HIV and AIDS:
HIV is the acronym for Human Immunodeficiency Virus, which refers to a virus which causes AIDS. [1] The virus causes compromised immune system of the human body. [2] In other words, HIV is a retrovirus that attacks the immune system which would ultimately destroy the immune system after a certain period of time. This virus only infects humans and may be detected through HIV antibody test. The HIV is mainly found in semen, blood and vaginal discharge and it is detected in small amount in a person’s tears and saliva. [3]
While the phrase ‘AIDS’ is an acronym for acquired immune deficiency syndrome which is a disease or spectrum of conditions caused by a virus that prevents the white blood cell in one’s body from defending him from any infection. [4] The phrase ‘acquired’ shows that this disease is not inherited. AIDS is an opportunistic infection which is an infection that takes the chance to infect someone with a compromised immune system. [5]
On the onset of the HIV infection, patients would only experience less serious illnesses and this would be followed by more serious diseases such as cancer and pneumonia (inflammation of air sacs in the lungs) and when this happens, one will be diagnosed as having AIDS. Currently, HIV and AIDS is an incurable disease while treatment and medicine are given to curb opportunistic infection and to prevent HIV from disseminates and deteriorates the immune system. [6]
Pertaining to the above question, the issues are as the following:
- Is it wajib for AIDS patient to fast or not?
- If not, is he obligated to pay fidyah or not?
- If it is wajib, what is the case for people who are poor and incapable to pay fidyah?
Hence, further discussion will be by going through these issues one by one.
First Issue
Based on the definition and above facts on HIV/AIDS, the patient can be categorised as patients with no possibility to recover if when he fasts on the day it will increase the risk of infection and decrease his immune system.
However, if his fasting may not cause the disease to worsen because medicine consumption time may be scheduled to suhoor and breaking fast, then HIV/AIDS patients are still obligated to fast. A person who fits the wajib conditions to fast as the following
- Islam
- Baligh (reach puberty)
- Able to reason
- Pure from haid and nifas
- Able to fast
are obligated to perform Ramadan fasting. If a person starts it normally, then he gets permissible excuses like sickness and if he fasts, it is feared that his sickness will worsen or burden him more, then it is permissible for him to break his fast and it is wajib for him to replace it on other days.
If he passes away before he had the chance to replace his fast, he is neither obligated to replace his fast nor pay fidyah from his inheritance. He is also not considered as sinful. The same is when he delays in replacing his fast due to any permissible excuse until he passes away, like continuous sickness, travelling, being unconscious (including being in coma and etc.), haid, nifas, pregnant, breastfeeding. For HIV/AIDS patient, he is unable to replace his fast because his sickness will become more serious.
However, if he passes away, but there are gaps of which it is possible for him to replace his fast, but he fails to do so. So, this person according to the qaul qadim in madhhab al-Shafi’e and which is tashih (confirmed) by the muhaqqiq in the madhhab;
- It is Sunnah for his warith to replace his fast.
- If the fasts are not replaced, then fidyah is taken from his inheritance for each missed day because it is a debt with Allah.
Second Issue
If a HIV/AIDS patient is unable to fast he is obligated to pay fidyah for each missed day of his Ramadan fasting. It is impermissible for others to fast on his behalf. His condition is the same as an elderly who is incapable to fast. This is a facilitation given to them in accordance with the saying of Allah SWT:
وَمَا جَعَلَ عَلَيْكُمْ فِي الدِّينِ مِنْ حَرَجٍ
And [He] has not placed upon you in the religion any difficulty
Surah al-Hajj (78)
وَعَلَى الَّذِينَ يُطِيقُونَهُ فِدْيَةٌ طَعَامُ مِسْكِينٍ
And upon those who are able [to fast, but with hardship] - a ransom [as substitute] of feeding a poor person [each day]
Surah al-Baqarah (184)
Abdullah bin Abbas RA explained the verse stating:
هُوَ الشَّيْخُ الْكَبِيرُ وَالْمَرْأَةُ الْكَبِيرَةُ لاَ يَسْتَطِيعَانِ أَنْ يَصُومَا، فَلْيُطْعِمَانِ مَكَانَ كُلِّ يَوْمٍ مِسْكِينًا
it is meant for old men and old women who have no strength to fast, so they should feed one poor person for each day of fasting (instead of fasting)
Sahih al-Bukhari (4505)
Abu Hurairah RA said:
مَنْ أَدْرَكَهُ الْكِبَرُ فَلَمْ يَسْتَطِعْ صِيَامَ شَهْرِ رَمَضَانَ فَعَلَيْهِ لِكُلِّ يَوْمٍ مُدٌّ مِنْ قَمْحٍ
“Whoever reaches an old age that he becomes incapable to fast in Ramadan, then upon him is one mudd from wheat (as fidyah payment).”
Narrated by al-Baihaqi (8319) in Sunan al-Kubra
Narrated by Qatadah RA:
أَنَّ أَنَسًا رَضِيَ اللهُ عَنْهُ ضَعُفَ عَامًا قَبْلَ مَوْتِهِ فَأَفْطَرَ وَأَمَرَ أَهْلَهُ أَنْ يُطْعِمُوا مَكَانَ كُلِّ يَوْمٍ مِسْكِينًا
“Anas RA becomes weak one year before his death. So, he did not fast and he asked his family to feed the poor for each missed day.”
Hisham (one of the narrators in the above narration) said: He fed 30 poor people.
Narrated by al-Baihaqi (8320) in Sunan al-Kubra.
Imam al-Nawawi Rahimahullah said: “Al-Shafi’e and the ashab of the madhhab said that a very old man who fasts will burden him, in which will cause an extreme burden upon him, and old people who have no chance to recover, then there is no obligation to fast upon them without khilaf. There is a statement from Ibn Munzir who cited the ijma’ on this matter. However, fidyah is wajib according to a qawl which is the most sahih.”
Refer al-Majmu’ (6/258)
Third Issue
If the patient fails to pay fidyah because having the status of mu’sir (people in straitened circumstance) who has no property, so he is not obligated to pay fidyah according to the most sahih opinion in madhhab al-Shafi’e. This is because it is analogically deduced with the obligation to pay zakat fitrah. So, others are not obligated to pay on his behalf. However, if he receives property that he becomes a musir (a well-off person) like when he is given a big amount of money. So, it is wajib for him to pay fidyah for Ramadan fasting that he left for the current year and it is forgiven for the past years which is also analogically deduced with zakat fitrah.
Refer al-Mu’tamad fi al-Fiqh al-Syafie (2/197-203)
Conclusion
Based on the above explanation, fasting for HIV/AIDS patient is in accordance with the statement from trusted medical experts. If the doctor confirms that fasting is safe for them, and the schedule for the consumption of medicine which invalidates fasting may be rescheduled to the time of suhoor and breaking fast, then the patient is obligated to fast. If not, then the patient is not obligated to fast and it is wajib for him to pay fidyah. However, if the patient is among the needy and he is unable to pay fidyah, then he is not obligated to pay fidyah.
May this explanation brings goodness and good deeds. Wallahua’lam.
End notes:
[1] 4th Edition Kamus Dewan. Refer: http://prpm.dbp.gov.my/Cari1?keyword=hiv&d=112592&#LIHATSINI
[2] MABBIM Terminology. Refer: http://prpm.dbp.gov.my/Cari1?keyword=hiv&d=228972&#LIHATSINI
[3] Manual Islam & HIV/AIDS. 2009. Jabatan Kemajuan Islam Malaysia (JAKIM). pg. 21.
[4] 4th EditionKamus Dewan. Refer: http://prpm.dbp.gov.my/Cari1?keyword=aids
[5] Manual Islam & HIV/AIDS. Ibid.
[6] Manual Islam & HIV/AIDS. Ibid. pg. 30.