FRIDAY FOCUS: When Medicine Meets Fiqh
Can Fatwas Be Issued Without Medical Expertise?
Dr Fiaz Maqbool Fazili
Modern medicine is evolving at an unprecedented pace. From diagnostic imaging and minimally invasive procedures to assisted reproductive technologies such as In Vitro Fertilisation (IVF), new medical developments are continuously presenting questions that intersect with Islamic jurisprudence (Fiqh). The challenge before the Muslim community is not whether religious guidance is necessary, but whether such guidance is sufficiently informed by contemporary medical knowledge.
Two incidents from my professional experience illustrate why this issue deserves serious attention.
Years ago, during Ramadan, patients frequently approached me with questions about whether eye and ear drops invalidate their fast. Recognising the confusion, I prepared a comprehensive FAQ addressing these concerns from both medical and Fiqh perspectives. Greater Kashmir, the Valley’s widely circulated newspaper, published the material as a full-page feature on two consecutive days. It subsequently became a useful reference for patients seeking clarity.
The central issue was straightforward: eye and ear drops do not invalidate fasting according to the majority of contemporary Islamic scholars and Fiqh bodies. Anatomically, the eye is not an alimentary passage, while the external ear canal has no direct communication with the digestive tract in an intact ear. Although eye drops may occasionally drain through the nasolacrimal duct, this does not automatically establish that fasting is invalidated. This example demonstrated how combining anatomical knowledge with jurisprudential principles can resolve everyday religious anxieties and prevent patients from unnecessarily discontinuing essential treatment.
A second incident, however, exposed the potential consequences of issuing medical Fatwas without adequate clinical understanding.
A few years ago, a Mufti circulated a Fatwa stating that abdominal or pelvic ultrasonography invalidates a woman’s fast. Interestingly, the same opinion appeared to permit transvaginal sonography (TVS), despite the latter involving an internal vaginal probe. I questioned the anatomical and jurisprudential basis of this distinction. Did the ruling account for the actual procedure, its anatomical route and the relevant principles of Fiqh?
When I explained the differences between abdominal ultrasound and TVS, supported by anatomical details and relevant jurisprudential references, the scholar acknowledged that his understanding was incomplete. He apologised and expressed his intention not to issue medical opinions without consulting a doctor adequately versed in Fiqh. He also agreed that such guidance should emerge through joint Mashwara (consultation).
These experiences reinforce an important principle: a Fatwa concerning a medical procedure must begin with an accurate understanding of the procedure itself. Religious scholarship deserves respect, but medical facts cannot be established through assumptions. Equally, doctors cannot independently determine religious rulings. Each discipline has its own expertise, and both must inform the final guidance.
Today, IVF presents an even more compelling challenge. Does every religious authority issuing opinions on assisted reproduction fully understand ovarian stimulation, egg retrieval, fertilisation, embryo culture, embryo transfer, cryopreservation, donor gametes and the different clinical protocols involved? Have the relevant procedures been explained by specialists, including the ethical and practical distinctions between them?
Some opinions have already emerged, including contributions from scholars with medical or Islamic academic backgrounds. Nevertheless, the complexity and rapid evolution of reproductive medicine demand more comprehensive, transparent and multidisciplinary deliberation.
It is high time that senior Muftis, Islamic scholars, representatives of the local, National or International Clergy , orv Muslim Personal Law Board and credible medical professionals with sound grounding in Islamic sciences establish a permanent consultative mechanism. Such a body should engage IVF specialists, visit fertility centres, understand actual clinical procedures and develop evidence-informed guidelines through collective Mashwara.
The objective is not to challenge the authority of the Ulama, but to strengthen the credibility of religious guidance. A medically uninformed Fatwa can create unnecessary anxiety, compromise treatment or mislead vulnerable patients.
As technology advances, jurisprudential guidance must remain informed, contextual and responsive. The faithful deserve neither medicine without ethics nor Fatwas without medical facts. The way forward is not clergy versus doctors, but Ulama and doctors working together—for informed faith, ethical medicine and the welfare of patients.
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