Setting the Balance: Fiqh of
Health
Dr Muhammad Haytham Al Khayat
Setting the balance
This is a discourse in the fiqh of health.
Fiqh, as we all know, is knowledge of
practical Islamic rulings as deduced from detailed statements and
religious text.
Health, as we define it today, is a state
of complete physical, psychological, social and spiritual well-being.
We have in our great reference books on
Islamic jurisprudence gems of knowledge in the fiqh of worship (ibadat),
fiqh of commercial transactions (muamalat), fiqh of marriage (nikah) and
fiqh of prosecution (aqidah); but we have no chapter on the fiqh of
health. Its absence is not because it does not exist or is too difficult
to find. In fact, it is available everywhere in these reference works.
Perhaps it has come to be overlooked because of its immediate
availability. It is sometimes said that very close proximity hides an
object like a screen.
This book is a modest attempt to bring out
this fiqh and to find its threads. I am helped in this by the great change
that has occurred in the general concept of health throughout the world.
This has led to a general consensus among people responsible for health
the whole world over to work together for a single aim, namely, Health for
All by the year 2000 and to adopt the primary health care approach in
order to achieve it. Muslims, whom God has honored with the task of being
the advocates of the message of civilization to mankind, should have been
in the forefront of this blessed task. They would be simply advocating
principles that they have been reading for centuries. God has described
them as being the best community ever produced for mankind. (3:110) This
presupposes that they can find the best solutions for the problems of
humanity and define the best methods for its advancement. I hope you will
agree with me that in the attempt to formulate the fiqh of health, we will
find the best way to safeguard and enhance human health.
When we speak of health, we do not restrict
ourselves to medicine, as it is commonly understood nowadays, meaning
curative medicine. Doctors of former and present times agree that there
are two types of medicine: preservation of the health of those who are
healthy, and restoration of health to the sick through medication and
rehabilitation. A number of hadith have come down to us from the Prophet
prescribing certain medicines for certain diseases. Scholars have given
these statements due importance, treating them as part of the divine
revelations and consequently as part of the religion of Islam. But we find
that some of them reflect only what the Arabs at the time had, by
experience, found useful. An example of these is the authentic hadith1:
"If there is any good [or he might have said ‘cure’] in any of
your medication then it will be that in an incision to bleed, or in a
drink of honey, or in cauterization, matching the illness [of which one
complains]. As for me, I do not like cauterization". Some of these
are suitable in a particular environment, considering its climate,
temperature and other factors, such as the desert environment of Arabia.
They cannot be applied universally, as explained by Imam Ibn Al-Qayyim in
Zaad al-ma’ad: "God’s messenger has been sent as a guide to
mankind, calling on them to believe in God and follow the way which
ensures their admittance to heaven. He has explained to people about God,
and clearly pointed out what pleases Him, enjoining people to do it. He
has also pointed out to them what incurs God’s displeasure emphasizing
that they must refrain from it… … As for medication for physical
illnesses, this is complementary to his message. It is meant to serve a
different purpose".
What is important in this aspect of
medicine, which is the curative aspect, is that the Prophet approved the
principle of medical treatment and encouraged us to seek it. In an
authentic hadith, he is quoted2 as saying: "Seek medical
treatment". In another version of this hadith, he says3: "Yes,
servants of God! Seek medical treatment". He raised the hopes of
patients, making clear that all diseases may be cured. In an authentic
hadith, he says4: "God has not created a disease without creating a
cure for it". He also urged doctors to try to identify cures,
pursuing the necessary scientific research for this purpose. A hadith5
quotes the Prophet as saying: "Every disease has a cure. If treatment
is administered with the right cure, the patient will recover by God’s
grace". In a different version6: "God has not created a disease
without creating a cure for it, which may be known to some and unknown to
others".
Also important in relation to curative
medicine is the fact that the Prophet placed the whole issue of the
treatment of illnesses in its proper perspective. He was once asked7:
"Do our supplication, medication and methods of prevention prevent
anything that God has willed?" He replied: "These are also part
of God’s will". Thus he has made it clear that one aspect of
God’s will may be prevented by another. It is evident that Islam leaves
no room for fatalism, even though it may be mistaken for reliance on God.
Although disease occurs by God’s will, every Muslim is commanded to try
to protect himself against it utilizing methods of prevention which also
work by God’s will. In that, as always, they should place their trust in
God.
A similarly important point in relation to
curative medicine is that the Prophet opposed so-called faith healing. He
approved medicine that relies on study and experimentation, seeking to
relate causes to effects. He spoke against the practices of the pagan
Arabs who discarded evident causes and laws of nature in preference for
mysterious causes and powers, such as charms, talismans, incomprehensible
jabbering and tricks practised by sorcerers and quacks. In a hadith8, he
is quoted as saying: "Whoever wears a charm is guilty of associating
partners with God". In another version9, he says: "Whoever wears
a charm, may God never fulfill his purpose, and whoever wears a talisman,
may God never let him enjoy peace of mind".
This is some of the Prophet’s guidance in
respect of seeking medical treatment. The other objective of medicine,
which is preserving the health of those who are healthy, comes out clearly
in his guidance. The rules that relate to health protection are general
rules that fit in well with the natural laws that God has put in place to
promote the well-being of His creation. God says in the Quran:
Praise the name of your Lord, the Most
High, who has created all things and proportioned them. (87:1–2)
O man! What has enticed you from your
gracious Lord who has created and well proportioned you, and given you a
perfect molding? (82:5–7)
By the soul and Him who has molded it in
perfect proportions. (91:7)
To preserve this situation of perfect
molding and right proportion is an important objective of Islamic law. The
eminent scholar Izz Eddin ibn Abdussalam says in Qawaid al-ahkam fi
masaleh al-anam: "Islamic law aims to serve the interests of people
and to prevent everything which adversely affects them". He explains
this by saying: ‘The achievement of what is beneficent is the pivot
round which Islamic law turns: it either prevents what is harmful or
enhances what is good. When you hear God say ‘O you who believe’,
reflect on what comes after His address. You are bound to find something
good which He encourages you to do, or something evil from which He
prevents you, or you may find a combination of encouragement and
prevention. He has outlined in His book some of the evils and the benefits
addressed by His legislation in order to encourage people to keep away
from evil and do what is good".
This eminent scholar is right. God says to
the Prophet in the Quran:
God knocks truth and falsehood together. As
for the scum, it vanishes without trace; what benefits mankind lingers on
in the earth. (13:17)
God, then, defines what benefits mankind,
in this present life and in the life to come, as the truth which He sent
with His messenger.
He says: Mankind, the messenger has come to
you with the truth from your Lord. (4:17)
He also says: What has been sent down to
you by your Lord is the Truth (13:1) and
Those who are endowed with knowledge
believe that what has been revealed to you by your Lord is the Truth
(34:6).
Perhaps one of the best discussions of this
subject is the one by Imam Najmuddin At-Toofi of the Hanbali school of
thought. In his commentary on the Prophet’s pronouncement: "Do not
harm yourself or others", Imam At-Toofi says: "It requires the
promotion of whatever benefits the individual and the community and the
abolition of whatever works against their benefit". He supports his
argument with a number of detailed statements from the Quran and the
Sunnah. He then presents his method that seeks to make judgments "on
the basis of clear text in the Quran and the hadith, as well as the
consensus of scholars, with regard to matters of worship, and on the basis
of utility in transactions and other matters". He goes on to explain:
"We give priority to utility in transactions and similar matters,
rather than in worship, because worship is a duty we owe to the Legislator
Himself. We are unable to determine what we owe to Him, its quantity,
quality, time and place without His direct explanation. Every one of us
then knows what he is required to do. The rights of other people are
different. They are determined through a legal policy which is established
to serve their interests, which are of paramount importance in this
regard".
"All scholars, indeed all
creeds", as Imam Shatibi says, "are unanimous that the aim of
the sharia is to safeguard the five essentials of life, namely: faith,
body, offspring, property and mind". These are indeed the essential
human rights.
It needs little reflection to conclude that
three out of these five essentials, namely, body, offspring and mind,
cannot be completely safeguarded without maintaining good health. Good
health, however, is only one of a number of important elements that are
absolutely necessary for maintaining these essentials. To maintain good
health also requires the provision of other developmental needs, such as
good food, drink, clothing, shelter, marriage, transport, security,
education and income. The Prophet, however, assigns top priority to good
health. He instructs us to: "Pray God for forgiveness and sound
well-being. No blessing other than faith is better than well-being".
The Prophet says: "Wealth is appropriate to a God-fearing person, but
good health is better for the God-fearing than wealth". He further
says: "He of you who finds himself enjoying good health, secure in
his community and has his daily sustenance, is as if he had the whole
world at his finger tips".
Therefore, it is no wonder that we find in
the Quran, and in the traditions of the Prophet, many statements that help
to protect and promote health, preserving the proper, balanced position in
which man is created. If we study these statements carefully and apply
them properly, as we are required to do, we will find at our disposal a
large volume on the fiqh of health. This is based on the fact that the
sharî’ah is embodied in clear statements, while the fiqh is the result
of careful study of such statements and implementing them.
The first of these blessed statements is a
unique one that no one other than the Prophet has ever made. This is the
highly authentic hadith in which Abdullah ibn Amr quotes the Prophet as
saying: "Your body has a [human] right". Fourteen centuries
after the establishment of human rights by Islam, the world issued the
International Declaration on Human Rights. However, mankind has not yet
declared rights for the human body. The human body may rightfully claim
from its owner to be fed when hungry, rested when tired, cleaned when it
gets dirty, protected against harm and disease, treated when suffering an
illness, and not overburdened. This is a rightful claim that imposes a
duty on every one of us. It must never be neglected or made subordinate to
other rights and claims, including those belonging to God Himself.
One of the most important texts from which
we may deduce the fiqh of health is the statement of God in the Quran:
And He enforced the balance. That you
exceed not the bounds; but observe the balance strictly; and fall not
short thereof. (55:7–9)
This comprehensive statement mentions the
balance that God has established in the universe, with its different
forces and influences, including man. It draws our attentions to this
balance that applies to everything, making clear that any disturbance of
the balance, whether by increase or decrease, may lead to terrible
consequences.
God says: Mankind! Your transgression will
rebound on your own selves (10:23).
The Muslim doctor fully understood this and
applied it to health, referring to this dynamic equilibrium as a
"state of equilibrium". Ali ibn al-Abbas, who lived one thousand
years ago, in his book, Kamil as-sina’ah, gave health a very brief
definition: "Health means that the body is in a state of
equilibrium" (volume 2, page 3). Ibn Sina, in A.D. 1093 in his famous
book Al-Qanoon, expresses the dynamism of this balance, saying: "The
state of equilibrium which a human being enjoys has a certain range with
an upper and a lower limit". It is, then, like a balance that moves
between two extreme limits.
To maintain this health balance in the
state of equilibrium, protect it against imbalance, and restore it to its
proper position every time it is disturbed, a human being must have a
"health potential", so to speak. This is referred to in the
hadith, quoting the Prophet as saying: "And store up enough health to
draw on during your illness". This health potential may take the form
of proper nutrition, or good immunity, or physical fitness that enables a
person to cope well with the stress that the body may face. Health
potential may also be in the form of mental and personal security and
stability that enables people to deal with the mental stress that may
beset them. Indeed, the health potential is all these aspects put
together.
* * *
What I have discussed so far concerning
the fiqh of health is something that we in the World Health Organization
consider to be among the great discoveries of the modern era, giving
health two important dimensions, namely, health balance and health
potential. We refer to the means we take to maintain the health balance as
"health protection" while the means that aim to increase health
potential are referred to as "health promotion". Within these
two dimensions the World Health Organization approved its definition of
health just fifty years ago as "a state of complete physical, mental
and social well-being and not merely the absence of disease or
infirmity". This definition reminds us of the Prophet’s statement:
"Pray God for well-being. No blessing other than faith is better than
well-being". WHO’s definition of health has had a great impact.
Previously, doctors used to define health as the absence of disease, just
as someone who defines life as the absence of death! The great Western
doctors in the first half of this century ignored what the doctors of the
Arab Islamic civilization said hundreds of years ago. The Islamic and
medical scholar Ibn Rushd defined health in his book Al-kulliyat, some 800
years ago, as: "A state in which an organ performs its normal
function or undergoes its normal reaction". In Kamil as-sina’ah,
1000 years ago, Ali ibn al-Abbas stated that health is: "A state of
the body in which functions are run in the normal course". In Al-moojaz
fi-tibb, Ibn al-Nafees, 700 years ago said: "Health is a state of the
body in which functions are normal per se, while disease is the opposite
state".
All our medical scholars, then, made health
their starting point, while illness was the opposite to it. This is a
reflection of their understanding of what God says in the Quran:
Your gracious Lord ... has created and well
proportioned you, and given you a perfect molding (82:6–7) Your Lord ...
has created all things and well proportioned them. (87:2)
We have created man in a most perfect
image. (95:4)
By the individual and Him who has molded it
in perfect proportions. (91:7)
A noteworthy feature of the WHO definition
is the fact that it speaks of complete well-being not merely well-being.
In Arabic, the term used is derived from a root that indicates plenty and
high quality. This is indeed the kind of health we would like to prevail:
human beings enjoying the best condition, physically, mentally, socially
and spiritually.
Notes:
1. Related by Al-Bukhari and Muslim on the authority of Jaber
2. By Abu Dawood following Usama ibn Shareek
3. Related by Al-Tirmizi
4. Related to Al-Bukhari following Abu Hauraira
5. Related by Muslim and Ahmad following Jaber
6. Related by Ahmad
7. According to Al-Tirmizi following Abu Khizama
8. Related by Ahamad following Oqba ibn Amer
9.
Related by Abu Dawood, Al-Nasa'i, Ibn Majah and Al-Hakim
Source:
The Right Path to Health (book)
Health Education through Religion
Health An Islamic Perspective
Dr Muhammad Haytham Al Khayat
WORLD HEALTH ORGANIZATION
Regional Office for the Eastern Mediterranean
Alexandria, Egypt
1997
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