Question:
It is mentioned in our books that the basic needs of a human being are three: food, clothing, and shelter. Is it permissible for us to say that medical treatment is also a basic need of a human being, taking into account the following:
There are some dangerous diseases that, if not treated, will cause great harm to the body, and this is not permissible according to the rule of harm (La darara wa la dirara)...
The question is, is it permissible for us to say that illness is of two types: severe and mild? Mild illnesses like the common cold, headaches, runny nose, etc., are treated as Mandub (recommended). Whereas severe illnesses like heart and brain surgery, influenza, a broken leg, etc., make seeking treatment an obligation (Fard)?
Answer:
- Basic needs are of two types: basic needs for individuals, which are "food, clothing, and shelter," and basic needs for the Ummah, which are "medicine, security, and education." This is detailed in The Introduction - Part Two - Explanation of Article 125. It seems that the adopted edition of The Introduction - Part Two has not been translated into your language yet; otherwise, you would have found the answer...
In any case, I will quote for you what was stated verbatim:
(...As for the evidence that food, clothing, and shelter are the basic needs for individuals, and anything else is an extra, Ahmad narrated with a chain of transmission authenticated by Ahmad Shakir from Uthman bin Affan (ra), that the Messenger of Allah (saw) said:
كُلُّ شَيْءٍ سِوَى ظِلِّ بَيْتٍ، وَجِلْفِ الْخُبْزِ، وَثَوْبٍ يُوَارِي عَوْرَتَهُ، وَالْمَاءِ، فَمَا فَضَلَ عَنْ هَذَا فَلَيْسَ لابْنِ آدَمَ فِيهِ حَقٌّ
"Everything besides the shade of a house, a piece of bread, a garment that covers his nakedness, and water; whatever exceeds this, the son of Adam has no right to it." (Musnad Ahmad)
The hadith has been reported with another wording:
لَيْسَ لابْنِ آدَمَ حَقٌّ فِي سِوَى هَذِهِ الْخِصَالِ: بَيْتٌ يَسْكُنُهُ، وَثَوْبٌ يُوَارِي عَوْرَتَهُ، وَجِلْفُ الْخُبْزِ وَالْمَاءِ
"There is no right for the son of Adam in other than these qualities: a house in which he dwells, a garment which covers his nakedness, and a piece of bread and water." (Sunan al-Tirmidhi, who said it is Hasan Sahih)
It indicates that what was mentioned in both wordings of the hadith—namely food, clothing, and shelter: "shade of a house," "a house in which he dwells," "a garment which covers his nakedness," "a piece of bread and water"—is sufficient, and in it there is adequacy. His saying in the hadith: "whatever exceeds this, the son of Adam has no right to it" is extremely explicit that these three needs are the basic needs. The two hadiths are a text stating that the basic needs are food, clothing, and shelter, and whatever is more than that is not basic. By satisfying them, the basic needs of the individuals have been satisfied...
Furthermore, the Shari'i evidences did not only obligate the fulfillment of the basic needs of individuals one by one, but also obligated the fulfillment of the basic needs of the Ummah by providing security, medicine, and education for the subjects:
As for security, it is one of the primary duties of the State. It must provide security and safety for the subjects, to the extent that the State loses its entity if it cannot maintain its security. Therefore, it is a condition for the Dar al-Islam (Abode of Islam) that the Islamic State be able to maintain its security with its own forces. For this reason, when the Messenger of Allah (saw) informed the Muslims of their place of migration, he mentioned security first. He (saw) said to his companions in Makkah, as narrated by Ibn Ishaq in his Sirah:
إِنَّ اللَّهَ عَزَّ وَجَلَّ جَعَلَ لَكُمْ إِخْوَاناً وَدَاراً تَأْمَنُونَ بِهَا
"Indeed, Allah (azwj) has made for you brothers and an abode in which you will be secure."
Also, when the Ansar received the Messenger of Allah (saw) and his companion Abu Bakr, the first thing they said to them, as narrated by Ahmad with a sahih chain from Anas: "About five hundred of the Ansar received them until they reached them. The Ansar said:
انْطَلِقَا آمِنَيْنِ مُطَاعَيْنِ
"Proceed, both of you, in security and as obeyed ones."
Thus, the State's provision of security for the subjects is one of its primary duties.
As for health and medical treatment, they are among the obligations upon the State to provide for the subjects, as clinics and hospitals are public utilities that Muslims utilize for healing and treatment. Thus, medicine, in its essence, became one of the interests (masalih) and public utilities (marafıq). The State must manage the interests and public utilities because they are part of what it must care for, acting upon the saying of the Messenger (saw):
الإِمَامُ رَاعٍ وَهُوَ وَمَسْؤُولٌ عَنْ رَعِيَّتِهِ
"The Imam is a shepherd and he is responsible for his subjects." (Sahih al-Bukhari from Abdullah bin Umar)
This is a general text regarding the responsibility of the State for health and medical treatment because they fall under the care (ri'ayah) obligated upon the State.
There are also specific evidences for health and medical treatment: Muslim narrated from Jabir who said:
بَعَثَ رَسُولُ اللَّهِ صلى الله عليه وسلم إِلَى أُبَيِّ بْنِ كَعْبٍ طَبِيبًا فَقَطَعَ مِنْهُ عِرْقًا ثُمَّ كَوَاهُ عَلَيْهِ
"The Messenger of Allah (saw) sent a doctor to Ubayy bin Ka'b; he cut a vein from him and then cauterized it." (Sahih Muslim)
Al-Hakim narrated in al-Mustadrak from Zaid bin Aslam, from his father, who said: "I became severely ill during the time of Umar bin al-Khattab, so Umar called a doctor for me, who put me on a strict diet until I would suck on a date stone due to the severity of the diet."
The Messenger (saw), in his capacity as a ruler, sent a doctor to Ubayy, and Umar (ra), the second Rightly Guided Caliph, called a doctor for Aslam to treat him. These are two evidences that health and medical treatment are among the basic needs of the subjects that the State must provide free of charge to those who need them among the subjects.
As for education, it is because the Messenger (saw) made the ransom of the captive from the disbelievers the teaching of ten Muslim children, instead of his ransom from the spoils, which belong to all Muslims... and due to the consensus (Ijma') of the Sahaba on giving teachers a specific amount from the Bayt al-Mal (Public Treasury) as their wages.
Accordingly, the State must provide security, medicine, and education for all the subjects, and the Bayt al-Mal must guarantee them, without any difference between a Muslim and a Dhimmi, nor between a rich person and a poor person...
Due to the importance of the basic needs for the individual and the Ummah, the Messenger of Allah (saw) explained that the provision of these needs is like possessing the entire world, as a metaphor for the importance of these needs. Tirmidhi narrated from Salama bin Ubaydullah bin Mihsan al-Ansari from his father, who was a companion, who said: The Messenger of Allah (saw) said:
مَنْ أَصْبَحَ مِنْكُمْ آمِنًا فِي سِرْبِهِ، مُعَافًى فِي جَسَدِهِ، عِنْدَهُ قُوتُ يَوْمِهِ، فَكَأَنَّمَا حِيزَتْ لَهُ الدُّنْيَا
"Whoever among you wakes up secure in his property, healthy in his body, and has his food for the day, it is as if the whole world were brought to him." (Sunan al-Tirmidhi, who said this is a Hasan Gharib hadith). It was also narrated by Ibn Majah with a hasan chain, and in Abu Nu’aym’s al-Hilya via Abu al-Darda’ with a similar wording but with the addition "in its entirety", meaning "the world in its entirety was brought to him.") End quote.
The summary is that basic needs are of two types:
Basic needs for the individual, which are food, clothing, and shelter. These are provided by the State for every individual according to the Shari'i rulings: from his own work, and if he is unable, then from his provider, and if there is none, then from the State.
Basic needs for the Ummah, which are security, medical treatment, and education. These are provided by the State for the Ummah as a whole. Thus, public hospitals, government doctors, and sufficient public pharmacies exist to provide health for everyone, as well as security and education.
- As for what you mentioned regarding the Shari'i ruling on medical treatment being Mandub (recommended) in the case of mild illness and Fard (obligatory) in the case of severe illness... this is not the case. Rather, the Shari'i ruling on seeking treatment is recommendation (al-nadb), whether the illness is mild or severe, as long as the illness has befallen the human being by the Decree (Qada) of Allah (swt). Among the evidences for this:
جَاءَ أَعْرَابِيٌّ فَقَالَ: يَا رَسُولَ اللَّهِ، أَنَتَدَاوَى؟ قَالَ: نَعَمْ، فَإِنَّ اللَّهَ لَمْ يُنْزِلْ دَاءً إِلاَّ أَنْزَلَ لَهُ شِفَاءً، عَلِمَهُ مَنْ عَلِمَهُ وَجَهِلَهُ مَنْ جَهِلَهُ
"A Bedouin came and said: O Messenger of Allah, shall we seek treatment? He said: Yes, for indeed Allah did not send down a disease except that He sent down a cure for it; those who know it know it, and those who are ignorant of it are ignorant of it." (Musnad Ahmad from Usama bin Sharik)
In the narration of al-Tabarani in al-Mu'jam al-Kabir, also from Usama bin Sharik, he said: "We were with the Messenger of Allah (saw), and some Bedouins came to him and asked him, saying: O Messenger of Allah, shall we seek treatment? He said: Yes, for indeed Allah (azwj) did not send down a disease except that He sent down a cure for it."
In Tirmidhi, from Usama bin Sharik, with the wording: "The Bedouins said: O Messenger of Allah, shall we not seek treatment? He said:
نَعَمْ، يَا عِبَادَ اللَّهِ تَدَاوَوْا، فَإِنَّ اللَّهَ لَمْ يَضَعْ دَاءً إِلا وَضَعَ لَهُ شِفَاءً، أَوْ قَالَ دَوَاءً إِلا دَاءً وَاحِدًا، قَالُوا: يَا رَسُولَ اللَّهِ، وَمَا هُوَ؟ قَالَ: الْهَرَمُ
"Yes, O servants of Allah, seek treatment, for Allah did not appoint a disease except that He appointed a cure for it—or he said a medicine—except for one disease. They said: O Messenger of Allah, what is it? He said: الْهَرَمُ." (Sunan al-Tirmidhi, who said this is a Hasan Sahih hadith). And الْهَرَمُ is the weakness of old age followed by death and destruction; meaning there is no cure for death.
Likewise, Ahmad narrated from Anas that the Messenger of Allah (saw) said:
إِنَّ اللَّهَ حَيْثُ خَلَقَ الدَّاءَ، خَلَقَ الدَّوَاءَ، فَتَدَاوَوْا
"Indeed, Allah, when He created the disease, He created the cure, so seek treatment." (Musnad Ahmad)
In these hadiths, there is a command from the Messenger (saw) to seek treatment, sometimes with an explicit command "seek treatment," and sometimes by answering a question, "Shall we seek treatment? He said: Yes."
The command indicates a request in general, and it does not indicate obligation (wujub) unless it is a decisive command. Decisiveness requires a context (qarinah) that points to it, and there is no context in the hadiths pointing to obligation.
Additionally, there are hadiths indicating the permissibility of leaving medical treatment, which negates the indication of obligation from these hadiths. Muslim narrated from Imran bin Husayn that the Prophet (saw) said:
يَدْخُلُ الْجَنَّةَ مِنْ أُمَّتِي سَبْعُونَ أَلْفًا بِغَيْرِ حِسَابٍ
"Seventy thousand of my Ummah will enter Paradise without reckoning." They said: Who are they, O Messenger of Allah? He said:
هُمُ الَّذِينَ لَا يَسْتَرْقُونَ، وَلَا يَتَطَيَّرُونَ، وَلَا يَكْتَوُونَ، وَعَلَى رَبِّهِمْ يَتَوَكَّلُونَ
"They are those who do not ask for ruqyah (incantations), do not believe in omens, do not use cauterization, and they rely upon their Lord." (Sahih Muslim)
Bukhari narrated from Ibn Abbas who said: "This black woman came to the Prophet (saw) and said: I have fits (epilepsy) and I become uncovered, so supplicate to Allah for me. He (saw) said:
إِنْ شِئْتِ صَبَرْتِ وَلَكِ الجَنَّةُ، وَإِنْ شِئْتِ دَعَوْتُ اللَّهَ أَنْ يُعَافِيَكِ
"If you wish, you can be patient and you will have Paradise, and if you wish, I will supplicate to Allah to heal you." She said: I will be patient. Then she said: I become uncovered, so supplicate to Allah that I do not become uncovered. So he supplicated for her."
These two hadiths indicate the permissibility of leaving treatment. In the first hadith, those who enter Paradise without reckoning are described as not asking for ruqyah and not using cauterization, meaning they do not seek treatment, but rather leave the matter to their Lord and rely upon Him in all their affairs. Ruqyah and cauterization are forms of treatment. The Messenger (saw) had encouraged treatment with ruqyah, and Jibril (as) performed ruqyah on him. He also said:
الشِّفَاءُ فِي ثَلاَثَةٍ: فِي شَرْطَةِ مِحْجَمٍ، أَوْ شَرْبَةِ عَسَلٍ، أَوْ كَيَّةٍ بِنَارٍ، وَأَنَا أَنْهَى أُمَّتِي عَنِ الكَيِّ
"Healing is in three things: the incision of a cupper, a drink of honey, or cauterization with fire, but I forbid my Ummah from cauterization." (Sahih al-Bukhari from Ibn Abbas). In the second hadith, the Messenger (saw) gave the woman a choice between being patient with the epilepsy she had—and having Paradise—and between him supplicating to Allah for her to be healed, which indicates the permissibility of leaving treatment. Thus, these two hadiths divert the command to seek treatment mentioned in those other hadiths from being an obligation. Due to the strength of the Messenger's (saw) encouragement to seek treatment, the command to seek treatment mentioned in the hadiths is for recommendation (al-nadb).
As for the hadith:
لا ضَرَرَ وَلَا ضِرَارَ
"There should be neither harming nor reciprocating harm." (Sunan Ibn Majah)
It relates to a person causing harm to others or to himself, and its ruling is explained in the rule of harm. It does not relate to an illness that befalls a human being as a Decree (Qada) from Allah (swt).