Taharah and Salah of a patient

Fatwa no. 17798 All praise be to Allah Alone, and peace and blessings be upon the Last of the Prophets. The Permanent Committee for Scholarly Research and Ifta' has examined the Fatwa request submitted to His Eminence, the Grand Mufty, by a sincere brother, and referred to the Committee by the Secretariat General of the Council of Senior Scholars under no. 5431 dated 25/12/1414 A.H. The brother states in his message that he detected a lack of knowledge on the part of some patients in a hospital regarding how they should perform Salah (Prayer) and Wudu' (ablution), especially the patients who are unable to move. His request is to receive a detailed Fatwa on the rulings of Taharah (ritual purification) and Salah of a sick person.

After considering the Fatwa request, the Committee gave the following answer: First: Taharah observed by a sick person:1. Like a healthy person, a patient has to perform Taharah with water to remove both major and minor impurity. A patient has to perform Wudu' to remove minor Hadath (ritual impurity that necessitates ablution) and Ghusl (full ritual bath) to remove major Hadath (ritual impurity that necessitates full bath).2. It is necessary to perform Istinja' (cleansing the private parts with water after urination or defecation) or Istijmar (cleansing the private parts with a hard material after urination or defecation) before Wudu'. (Part No. 24; Page No. 406) In the case of Istijmar, it is necessary to use three pure stones. It is not permissible to perform Istijmar using animal's dung, bones, food, or anything considered inviolable. It is better to perform Istijmar with stone, toilet paper, adobe, and the like and then use water afterwards, for stones will remove the impurity itself and water will purify the area, which is more effective.It is optional for the person to perform either Istinja' with water or Istijmar with stones and similar materials. If a person wants to choose one of them, then water is better because it removes the impurity and its traces and cleanses the organs, and it is more effective in cleansing the area. If the person wants to use stones only, it is sufficient for them to use three stones, if they are enough to cleanse the area. If they are not enough, they may use a fourth and fifth until the area is cleansed. It is better for the person to use an odd number of stones.It is not permissible for the person to perform Istijmar with the right hand. However, if the left hand is cut off, broken, wounded, and so on, it will be permissible to perform Istijmar with the right hand due to necessity, and there is no blame placed.3. If the sick person cannot perform Wudu' using water due to inability, fear of complications, or delay of recovery, it will be permissible for them to perform Tayammum (dry ablution with clean earth).Tayammum is to strike pure dust with the palms of the hands one time, (Part No. 24; Page No. 407) and then rub the face with the inner surface of the fingers, and the hands with the palms.It is permissible for a person to perform Tayammum on any pure object (surface) that has dust on it, even if it is not the ground. For example, dust may cover a wall or the like, so it is permissible to perform Tayammum by striking the wall. If after the first time of Tayammum, the person stays ritually pure, they may offer another Salah, just like in the case of Wudu', even for several Salahs and they do not have to renew their Tayammum because it is a substitute for water and has the same ruling as its substitute.Whatever invalidates Wudu' invalidates Tayammum in addition to the presence of water, and when a person can use it.4. If the disease is not severe and the use of water will not incur damage, cause sickness, delay recovery, or increase pain, for example, a headache or a toothache and the like, or one can use tepid water without suffering any harm, it will not be permissible for the person to perform Tayammum. It is permissible only when the use of water will cause harm, but there is no harm in this case, and water is available. Thus, it is obligatory for the person to use water.5. If the sick person finds it hard to perform Wudu' or Tayammum by themselves, another person may help them with it and it will count as sufficient.6. If a person, who suffers wounds, ulcers, or a disease that will worsen by the use of water, gets into a state of Janabah (major ritual impurity related to sexual discharge), it will be permissible for them to perform Tayammum. If they are able to wash the sound parts (Part No. 24; Page No. 408) of their body with water, it will be obligatory for them to do so, then perform Tayammum for the rest.7. Whoever has a wound in one of the body parts required to be washed in Wudu' should wash it with water. If it is hard for them to wash it or it is harmful, they may rub a wet hand on it when they wash it in its order. If it is hard for them to rub water on it or it causes them harm to do so, they may perform Tayammum for that area and it will be sufficient for them.8. The patient wearing a cast: a patient with a fractured bone that is put in plaster with a bandage wrapped around it or the like, should wipe over this plastered part with a wet hand and it will be sufficient for them, even if the limb or part has been put in plaster while in a state of ritual impurity.9. The sick person has to pay much attention to the purity of their body, clothes, and place of Salah. If they are unable to do so, they may pray and there will be no blame on them.10. If the person suffers incurable enuresis, they have to perform Istinja' and Wudu' for every Salah, after the beginning of its due time, along with washing the parts of their body and clothes smeared by urine. They should assign a pure garment for Salah, if this is possible. Otherwise, they do not have to do so, but should prevent urine from soiling their body, clothes, and place of Salah by, for example, placing something protective on their private parts.Second: Salah performed by a sick person: (Part No. 24; Page No. 409) 1. The sick should offer Salah while standing as much as they can.2. Whoever cannot stand during Salah may offer Salah while sitting; and it will be better for them to assume a cross-legged position.3. If the sick person is unable to offer Salah while sitting, they may offer Salah while lying on their side with their face towards the Qiblah (Ka`bah-direction faced in Prayer), and it is Mustahab (desirable) for them to lie on their right side.4. If the sick person is unable to offer Salah while lying on their side, they may offer Salah while lying on their back with their feet towards the Qiblah.5. Whoever is able to offer Salah while standing, but unable to bow or prostrate, is not excused from the obligation to stand. They should pray while standing and lower their head to indicate Ruku` (bowing), and then sit and lower their head to indicate Sujud (prostration).6. If the person suffers a disease in their eye, then a reliable doctor tells them that they have to offer Salah while lying on their back to get cured or else they will not get cured, it will be permissible for them to offer Salah while lying on their back.7. Whoever is unable to do Ruku` or Sujud may lower their head to indicate doing them and should lower their head in Sujud more than in Ruku`.8. Whoever is unable to do only Sujud should do Ruku` and lower their head to indicate Sujud.9. Whoever cannot bow their back may bow their neck, and if they suffer curvature of the spine, they should bow the back a little more when doing Ruku` and get their face as close to the ground as they can upon Sujud. (Part No. 24; Page No. 410) 10. If the person cannot lower their head, they may pronounce Takbir (saying: "Allahu Akbar [Allah is the Greatest]") and start reciting the Qur'an, and intend by their heart to stand, do Ruku` and rise from it, do Sujud and rise from it, and sit between the two times of Sujud, sit to recite Tashahhud (a recitation in the sitting position in the second/ last unit of Prayer) and recite the authentically reported Adhkar (invocations). With regard to what some sick people do, that is, point with their fingers, it has no basis in Shari`ah (Islamic law).11. Once a patient who is offering Salah feels able to do what they have been unable to do, such as standing, sitting, Ruku`, Sujud, or gesturing, they have to complete the current Salah while doing such acts and do not have to repeat the performed parts.12. If the patient or any person was sleeping during the due time of Salah or forgot it, they must offer it as soon as they wake up or remember it. It is not permissible for them to delay it until the time of the same Salah on another day.13. It is not permissible to abandon Salah for any reason. In fact, a Mukallaf (person meeting the conditions to be held legally accountable for their actions) has to offer Salah under all circumstances, whether healthy or diseased. Salah is the Pillar of Islam and the most important obligatory act of worship after the two Shahadahs (Testimony of Faith). So it is not permissible for a Muslim to delay an obligatory Salah until its prescribed time is over, even if they are sick as long as they are sane and conscious. In fact, they have to offer it at its prescribed time, as their ability allows, as we have mentioned in detail. With regard to what some sick people do, that is, delay Salah until they recover (Part No. 24; Page No. 411) from their disease, this is not permissible and has no basis in the sanctified Shari`ah.14. If it is hard for the sick to offer every Salah at its prescribed time, they may combine Zhuhr (Noon) Prayer and `Asr (Afternoon) Prayer at the time of any of them, whether the earlier or the later, according to ability, and `Isha' (Night) Prayer and Maghrib (Sunset) Prayer at the time of any of them.With regard to Fajr (Dawn) Prayer, it cannot be combined with another Prayer, because its time is separate from the Salahs before and after it.May Allah grant us success. May peace and blessings be upon our Prophet Muhammad, his family and Companions.