(25) In the event of any sickness that makes people feel unwell, a person is allowed not to fast. The basis for this is the aayah (interpretation of the meaning): “… and whoever is ill or on a journey, the same number [of days on which one did not observe sawm must be made up] from other days…” [al-Baqarah 2:185]. But if the ailment is minor, such as a cough or headache, then it is not a reason to break one's fast.

If there is medical proof, or a person knows from his usual experience, or he is certain, that fasting will make his illness worse or delay his recovery, he is permitted to break his fast; indeed, it is disliked (makrooh) for him to fast in such cases. If a person is seriously ill, he does not have to have the intention during the night to fast the following day, even if there is a possibility that he may be well in the morning, because what counts is the present moment.

(26) If fasting will cause unconsciousness, he should break his fast and make the fast up later on. (al-Fataawa, 25/217). If a person falls unconscious during the day and recovers before Maghrib or after, his fast is still valid, so long as he was fasting in the morning; if he is unconscious from Fajr until Maghrib, then according to the majority of scholars his fast is not valid. According to the majority of scholars, it is obligatory for a person who falls unconscious to make up his fasts later on, no matter how long he was unconscious. (Al-Mughni ma’a al-Sharh al-Kabeer, 1/412, 3/32; al-Mawsoo’ah al-Fiqhiyyah al-Kuwaytiyyah, 5/268).

Some scholars issued fatwaas to the effect that a person who falls unconscious or takes sleeping pills or receives a general anaesthetic for a genuine reason, and becomes unconscious for three days or less, must make up the fasts later on, because he is regarded as being like one who sleeps; if he is unconscious for more than three days, he does not have to make up the fasts, because he is regarded as being like one who is insane. (From the fataawa of Shaykh ‘Abd al-‘Azeez ibn Baaz, issued verbally).

(27) If a person feels extreme hunger or thirst, and fears that he may die or that some of his faculties may be irreparably damaged, and has rational grounds for believing this to be so, he may break his fast and make up for it later on, because saving one’s life is obligatory. But it is not permissible to break one's fast because of bearable hardship or because one feels tired or is afraid of some imagined illness. People who work in physically demanding jobs are not permitted to break their fast, and they must have the intention at night of fasting the following day. If they cannot stop working and they are afraid that some harm may befall them during the day, or they face some extreme hardship that causes them to break their fast, then they should eat only what is enough to help them bear the hardship, then they should refrain from eating until sunset, and they have to make the fast up later. Workers in physically demanding jobs, such as working with furnaces and smelting metals, should try to change their hours so that they work at night, or take their holidays during Ramadaan, or even take unpaid leave, but if this is not possible, then they should look for another job, where they can combine their religious and worldly duties. “And whoever fears Allaah and keeps his duty to Him, He will make a way for him to get out (from every difficulty). And He will provide him from (sources) he could never imagine.” [al-Talaaq 65:2-3 – interpretation of the meaning]. (Fataawa al-Lajnah al-Daa’imah, 10/233, 235)

Students’ exams are no excuse for breaking one’s fast during Ramadaan, and it is not permissible to obey one’s parents in breaking the fast because of having exams, because there is no obedience to any created being if it involves disobedience to the Creator.

(Fataawa al-Lajnah al-Daa’imah, 10/241).

(28) The sick person who hopes to recover should wait until he gets better, then make up for the fasts he has missed; he is not allowed just to feed the poor. The person who is suffering from a chronic illness and has no hope of recovery and elderly people who are unable to fast should feed a poor person with half a saa’ of the staple food of his country for every day that he has missed. (Half a saa’ is roughly equivalent to one and a half kilograms of rice). It is permissible for him to do this all at once, on one day at the end of the month, or to feed one poor person every day. He has to do this by giving actual food, because of the wording of the aayah – he cannot do it by giving money to the poor (Fataawa al-Lajnah al-Daa’imah, 10/198). But he can give money to a trustworthy person or charitable organization to buy food and distribute it to the poor on his behalf. If a sick person does not fast in Ramadaan, waiting to recover so that he can make the days up later, then he finds out that his sickness is chronic, he has to feed a poor person for every day that he did not fast. (From the fataawa of Shaykh Ibn ‘Uthaymeen). If a person is waiting to recover from his illness and hopes to get better, but then dies, there is no “debt” owed by him or his heirs. If a person’s sickness is considered to be chronic, so he does not fast and feeds the poor instead, then advances in medical science mean that there is now a cure, which he uses and gets better, he does not have to make up the fasts he has missed, because he did what he had to do at the time. (Fataawa al-Lajnah al-Daa’imah, 10/195)

(29) If a person is sick, then recovers, and is able to make up the missed fasts but does not do so before he dies, then money should be taken from his estate to feed a poor person for every day that he missed. If any of his relatives want to fast on his behalf, then this is OK, because it was reported in al-Saheehayn that the Messenger of Allaah (peace and blessings of Allaah be upon him) said: “Whoever dies owing some fasts, let his heir fast on his behalf.” (From Fataawa al-Lajnah al-Daa’imah, volume on Da’wah, 806).