What is the ruling on fasting concerning a patient who suffers from chronic diseases such as diabetes and heart troubles? Is the fasting valid despite his extreme suffering? Is it obligatory for him to fast, or is he allowed to abandon fasting?

All perfect praise be to Allah, The Lord of the Worlds. I testify that none is worthy of worship except Allah and that Muhammad, sallallaahu ‘alayhi wa sallam, is His slave and messenger.

There is no doubt that diseases are of different degrees in terms of severity. Moreover, some diseases may affect fasting, while others may not. Thus, patients are of various states with regards to fasting:

First: Patients who suffer from diseases that do not affect fasting, such as common cold, easy headache and toothache, and so on. A patient is not allowed to abandon fasting in this case, instead, it is obligatory for him to do.

Second: Patients who face hardship in observing fasting but are not harmed by it. Fasting is disliked in this case and it is permissible for one to abandon fasting.

Third: Patients for whom fasting involves hardship and harm, as when one suffers kidney disease, diabetes, and so on. Fasting is forbidden in this case. The scholars have two different opinions on whether fasting in this case absolves one of liability or not. It does according to some opinions but does not do so according to others. Ibn Hazm adopted the second opinion, arguing that the patient declines to accept the concession prescribed by Allah for him to abandon fasting.

Consequently, a patient who suffers a chronic disease has to abandon fasting and is even forbidden to do, provided that fasting is seriously harmful to him.

We ask Allah to heal all Muslim patients and make them healthy.

As for making up for the missed days, there are some details in this case. If the patient is likely to recover, then he has to make up for the missed days after recovery. Allah Almighty Says (what means): {So whoever among you is sick or on a journey [during them]—then an equal number of days [are to be made up].}[Quran 2: 184]

If recovery is not expected, however, then one is required to give an expiation by feeding a poor person for each day he missed. The amount of the expiation is one Mudd [volumetric measure (handful)], equaling 750 grams].