Islamic Teaching and Cancer Care

This page is for Muslim patients and families, and the clinicians who care for them. It covers what Islamic rulings say about starting and stopping cancer treatment, resuscitation, pain relief, fasting, and medicines.

There is no single Islamic view on most of what follows. A page that pretended otherwise would do patients a disservice. Fatwa bodies, the councils that issue formal religious rulings, differ. Schools of law differ. Sunni and Shia authorities differ on some questions. Where the sources agree, this page says so. Where they do not, it says that too. The right next step is then your own scholar, together with your oncology team.

The Fiqh Council of North America states that mercy killing (euthanasia) is forbidden in Islam. It treats withholding or withdrawing treatment as a different matter.

Most people assume it is. The classical answer is more open than that.

The basis is a well-known hadith, a saying of the Prophet: "there is no disease that Allah has created, except that He also has created its treatment." It shows that seeking treatment is legitimate. It does not conflict with trust in God. It does not set up an obligation.

The International Islamic Fiqh Academy's 1992 resolution sets out four levels rather than one rule. (Fiqh means Islamic law.) Treatment is obligatory where going without it risks self-destruction. The same holds where it risks loss of an organ, disability, or spread of disease to others. It is recommended where it prevents bodily weakness without severe consequences. It is permitted in other circumstances. It is discouraged where the treatment is risky. This means serious complications "worse than the disease."

A published narrative review of Islamic juridical rulings on life support records that "the majority of jurists hold the opinion that seeking treatment is simply permissible, with no sin on a person that chooses not to seek treatment."

That matters if you are weighing more chemotherapy against the time and side effects it would bring. The Fiqh Academy's framework makes obligation depend on the clinical facts. Your own scholar can help you apply it.

The same resolution is clear that hopelessness does not end the duty of care. Staff should "continue to look after him, and alleviate his psychological and physical sufferings" whatever the prognosis.

The Fiqh Council of North America speaks to a terminally ill patient who depends on artificial means. It says treatment that only prolongs dying is not required. It applies this to respirators and feeding tubes. It says withholding or withdrawing treatment that does not improve the patient's condition is permissible. This is different from euthanasia. It adds that actively starving a patient who can eat normally is killing. It says the decision should involve medical experts, the family and local law.

The narrative review looked at 15 fatwas. Nearly all, except one, permit stopping life support when conditions are met. Examples are medical futility, brain death or terminal illness. Most separate life support, such as a ventilator, from basic care such as nutrition and hydration. They say basic care should generally continue. The review also notes that the fatwas give few examples of when treatment counts as futile.

So there is real difference of view, especially on artificial nutrition and brain death. A family facing these questions needs their own scholar, not a general rule. It also helps to discuss limits of treatment before it starts. Then choices are clearer later.

Whether to attempt resuscitation is a question for your scholar and your care team together. The review above found that the fatwas rely on doctors to judge when treatment is futile. In the United States, your hospital also follows its own consent rules. You can state your own wishes. See goals-of-care conversations.

Pain and symptom control is a normal part of cancer care. Some people worry about being too drowsy to pray or to say the Shahada. If that is true for you, tell your care team. Doses and timing can often be adjusted. You can ask for this early.

Do not stop a prescribed medicine on your own. Ask your scholar about any religious questions on a specific medicine, and ask your care team about options.

Whether fasting applies to you with cancer is a question for your own scholar, together with your oncology team.

The Islamic Fiqh Academy's 1997 resolution (No. 93) is useful on the details. It says these do not break the fast:

• Eye and ear drops, and nasal drops or spray, if nothing reaches the throat
• Tablets under the tongue
• Dental treatment and mouthwash
• Oxygen, skin creams and medicinal patches
• Biopsies, and gastroscopy (a camera test of the stomach) without added liquids
• "Subcutaneous, intramuscular, or intravenous injections," excluding nutritious fluids

The Academy postponed its ruling on several things. These include blood sampling, blood transfusion and dialysis. It advised Muslim doctors to suggest putting off non-urgent treatment until after the fast. This applies when that is medically safe.

NCI says chemotherapy is most often given through an IV. Whether a particular infusion counts as an injection or as fluid is a question for your scholar. Bring details from your oncology team.

Fasting can be risky when you are unwell. Dehydration is one reason. MedlinePlus says dehydration can come from vomiting, diarrhea or too little fluid. It says severe cases are life threatening. Ask your oncology team whether fasting is safe with your treatment.

If you are worried that a medicine contains gelatin or alcohol, ask the pharmacist whether another form exists. Ask your scholar about the religious question. Do not stop a prescribed medicine while you work this out.

Ask for a same-gender clinician for examinations where that matters to you. Ask about space and timing for prayer. Ask about praying seated or lying down if you cannot stand. Ask whether the hospital has an imam, or an arrangement with a local mosque. A general chaplain may be able to arrange one. They may do this even if they cannot fill the role themselves.

Families should also raise expectations after death early. Washing, shrouding and rapid burial are the norm. Autopsy and cremation are generally objected to. Paperwork delays are the usual obstacle. Telling the hospital in advance is far easier. Negotiating in the same hour as a death is hard.

Most of this page is about rulings. This part is not. If you decide to fast while on treatment, the risk is physical. It can build quietly over a long day.

• Call 911 or go to an emergency department right away if the person fasting becomes confused, cannot be woken properly, loses consciousness, has a seizure, or has chest pain or trouble breathing. MedlinePlus lists confusion and loss of consciousness as emergency signs. They point to severe dehydration.
• Break the fast and call your oncology team right away if you are passing very little urine or it is very dark, you feel dizzy or your heart is racing, or you have muscle cramps with very little urine. Also call if vomiting and diarrhea mean nothing is staying down.
• Call your oncology team before you fast to check it against your treatment. This matters most if you take drugs that affect the kidneys. It also matters if your drugs commonly cause vomiting.

Breaking a fast to protect your health is not a failure. Ask your scholar how to make up the days.

• MedlinePlus — Dehydration
• National Cancer Institute — Faith and Spirituality in Cancer Care
• National Cancer Institute — Chemotherapy to Treat Cancer
• International Islamic Fiqh Academy — Resolution No. 67 (5/7), Medical Treatments (1992)
• International Islamic Fiqh Academy — Resolution No. 93 (1/10), Invalidators of Fasting in Medical Treatments (1997)
• Chamsi-Pasha & Albar et al., "When can Muslims withdraw or withhold life support? A narrative review of Islamic juridical rulings" (PMC7144300)
• Fiqh Council of North America — Withdrawal of Life Sustaining Care