24.2.1 ENDOCRINE DISORDERS
In diabetes mellitus, blindness exempts from salat al jama’at.
Diabetics with leg ulcers make yatammum instead of wudhu and adopt the most confortable salat position. Insulin-dependent
diabetics and pregnant diabetics are exempted from saum. Diabetics controlled on oral medication and diet can fast under physician
supervision. Patients anterior hypoparathyroidism and hypothyroidism offer salat and saum depending on clinical severity.
They are treated sexual failure before marital dissolution is considered. They perform tayammum instead of wudhu for cold
intolerance. The default age of 15 is used to define adulthood if puberty is delayed. They can use growth hormones can be
used for growth retardation. Wet nurses, milk banks, or artificial formula are used for lactation failure. In cases of amenorrhoea,
the presumptive period of 4 months + 10 days is used as the ‘iddat. Patients with diabetes insipidus are exempted from
saum until electrolyte and fluid imbalances are corrected. Patients with hyperthyroidism with restlessness preventing concentration
offer brief salat with short recitation. Patients with Addison’s disease offer salat sitting down to avoid postural
hypotension and delay saum and hajj until correction of fluid and electrolyte imbalances. Patients with primary hyperaldosteronism
exempted from saum until correction of electrolyte imbalances. In adreno-cortical excesss standing and posture of salat are
altered (because of myopathy and possibility of fractures due to osteoporosis), saum is delayed during the treatment, hajj
is delayed, and legal competence in impaired if psychotic symptoms are severe. Hormonal treatment of testicular and ovarian
disorders, pseudohermaphroditism, gynecomastia, and hirsuitis is allowed if benefits outweigh risks. Legal liability is decreased
if criminal behavior is due to hormonal status.
Infectious persons may be excluded from hajj and congregational salat. Under the principle of public
interest superseding private interest, the following are allowed in an epidemic: restriction of movement, quarantines, involuntary
measures (mass immunization, treatment, and prophylaxis), destruction of property (eg infected animals). Premarital screening
is obligatory in places with endemic infectious diseases. Conjugal sexual rights can be denied for fear of infection. Conviction
for zina cannot be based on incidental finding of STD in an unmarried person. Seeking divorce or khulu’u can be based on discovery of STD in a spouse. A spouse is legally liable for transmitting STD.
Islam gave detailed teachings on personal hygiene, food hygiene, excreta disposal, and waste disposal in order to keep the
environment clean and healthy.
Intervention against cancer risk factors is based on the principle that harm should be relieved, al dharar yuzaal. Laws on sexual, body, and environmental hygiene decrease risk
exposure. The tobacco-cancer link is considered yaqeen by physicians making tobacco haram. It is considered ghalabat al dhann
by jurists making tobacco makruuh. The diet-cancer link does not reach the
level of yaqeen or ghalabat al
dhann. The Law can regulate institutional but not home diets. Parents are liable for child malnutrition due to negligence.
Early disease screening is is obligatory if scientific evidence shows benefit. Treatment of advanced disease is based on the
bakance of harm and benefit, both immediate and long term.
24.2.4 GENETIC CONDITIONS
Jurists are not unanimous on the obligation of pre-nuptial genetic testing and advice. Results of genetic
testing could be used as a basis for refusing marriage or refusing to get pregnant. Pre-natal genetic screening in the form
of amniocentesis for sex selection may encourage illegal abortion. Amniocentesis for disease detection may be of benefit to
the parents to make preparations to take care of sick newborns. Marriage of close relatives has to be considered in the light
of the balance of disease risk due to consanguinity and social advantages of marrying within the family. Treatment by genetic
engineering is allowed under the rubric of permissibility of change of fitra as long as it is not done with the purpose of
defying Allah’s creation. Widespread genetic testing may introduce systematic social discrimination based on gene profile
for diseases and provide a false scientific basis for racial discrimination
24.2.5 TRAUMATIC INJURY
It is allowed to wash a patient in ablution. Tayammum is preferred for cases of profuse or active bleeding
at sites of wudhu. In cases of wounds, a wet hand is rubbed on the bandage. Tayammum is carried out instead of ghusl in cases
of burns or other conditions preventing use of water. Patients with physical disabilities pray in the most comfortable position.
The disabled are exempted from physical participation in jihad; they can however make monetary and other contributions. Impotence
in paraplegia and physical disability preventing working to support the family are grounds for marriage nullification if the
wife requests. The Law provides for financial compensation in cases of accidental injuries.