Question
Salam,
I am a male doctor hoping to specialise in dermatology, a speciality I really enjoy.
The work involves NHS work and also extra private work, the latter one does to attain additional income and which is, in a way, non essential.
There are some issues I am grappling with regarding the private work, for which I would like a fatwa.
Work as a dermatologist involves having consultatations, for medical purposes albeit, with women, and therefore being alone with them and examining parts of their awrah (sometimes without a chaperone) for generally non urgent things such as a slow growing skin cancers, eczema, psoriasis, fungal infection or various types of scar.
My understanding is that, although interaction without the opposite gender and examining of the awrah, especially in seclusion is prohibited islamically, it is permissible as an NHS doctor, because:
-it is occurring for a medical reason (even if non urgent)
-that in the NHS you can’t discriminate by gender (eg as a male doctor, request you only see male patients)
-that the resources aren’t always there for a chaperone.
With private work, I would still be seeing female patients, inevitably having to at times examine their awrah, and that also being without a chaperone occasionally. Would such work, that is not essential, that I am only doing for extra income, although for a medical purpose be mubaah/makruh/haram?
I have thought occasionally that I could set my own private practice, only seeing male patients somehow, or perhaps working in partnership with a female dermatologist who sees female patients and I see male patients. And trying to employ a female nurse at all times who can chaperone the consultations. However, for a number of reasons I don’t think I’ll be doing this. And the most realistic mode of my private work will be working by myself seeing male and female patients, and often examining the awrah.
So in summary: would it be mubah/makruh/haram for me as a male dermatologist to see female patients, occasionally examining their awrah and in khalwah, outside the NHS (ie as private practice), in order to earn extra income, but for medical purposes?
Answer
The work described is not intrinsically unlawful but entails some problematic aspects that one must mitigate.
First, it would be better for such work to be forwarded to a female practitioner in the circumstances described. If this is not possible, it would be permitted to conduct check-ups on female patients, viewing only what is absolutely necessary and keeping the other parts of the body covered.[1] It is essential to guard one’s gaze, looking only at what is required. It is also advised that seek the path of spiritual enlightenment through tassawuf to ensure that discipline and god-consciousness.
You have submitted that the check-ups are conducted for medical reasons, though not always urgent care. This would not have a shar‘i impact. In a fatwa advising a male with testicular pain, Maulana Ashraf Ali Thanawi writes that the level of need required to uncover the awra is not “need” from a shar’ia perspective, i.e., fear of life or limb. Instead, the level of need required for uncovering the awra in a medical setting is a natural or customary need (tab‘i o-‘aadi).[2] The reasons submitted above meet this criterion.
You have also submitted concerns about being in seclusion (khalwa) with non-mahram female patients. Total seclusion wherein another individual cannot enter upon the non-mahram male and female is not permitted. Therefore, keeping the door open can mitigate this if a chaperone or third party is unavailable. If the door must be closed for patient confidentiality, the door should not be locked, and the windows must not have curtains drawn, which would disallow onlookers from viewing what is taking place therein. In sum, one must make sure that there is a possibility of others looking or entering upon the two secluded non-mahrams to mitigate this prohibition.[3]
[1] الفتاوى العالمكيرية = الفتاوى الهندية» (5/ 330): امرأة أصابتها قرحة في موضع لا يحل للرجل أن ينظر إليه لا يحل أن ينظر إليها لكن تعلم امرأة تداويها، فإن لم يجدوا امرأة تداويها، ولا امرأة تتعلم ذلك إذا علمت وخيف عليها البلاء أو الوجع أو الهلاك، فإنه يستر منها كل شيء إلا موضع تلك القرحة، ثم يداويها الرجل ويغض بصره ما استطاع إلا عن ذلك الموضع، ولا فرق في هذا بين ذوات المحارم وغيرهن؛ لأن النظر إلى العورة لا يحل بسبب المحرمية، كذا في فتاوى قاضي خان»
حاشية ابن عابدين = رد المحتار ط الحلبي» (6/ 370): (وَشِرَائِهَا وَمُدَاوَاتِهَا يَنْظُرُ) الطَّبِيبُ (إلَى مَوْضِعِ مَرَضِهَا بِقَدْرِ الضَّرُورَةِ) إذْ الضَّرُورَاتُ تَتَقَدَّرُ بِقَدْرِهَا وَكَذَا نَظَرُ قَابِلَةٍ وَخَتَّانٍ وَيَنْبَغِي أَنْ يُعَلِّمَ امْرَأَةً تُدَاوِيهَا لِأَنَّ نَظَرَ الْجِنْسِ إلَى الْجِنْسِ أَخَفُّ … «(قَوْلُهُ وَيَنْبَغِي إلَخْ) كَذَا أَطْلَقَهُ فِي الْهِدَايَةِ وَالْخَانِيَّةِ. وَقَالَ فِي الْجَوْهَرَةِ: إذَا كَانَ الْمَرَضُ فِي سَائِرِ بَدَنِهَا غَيْرَ الْفَرْجِ يَجُوزُ النَّظَرُ إلَيْهِ عِنْدَ الدَّوَاءِ، لِأَنَّهُ مَوْضِعُ ضَرُورَةٍ، وَإِنْ كَانَ فِي مَوْضِعِ الْفَرْجِ، فَيَنْبَغِي أَنْ يُعَلِّمَ امْرَأَةً تُدَاوِيهَا فَإِنْ لَمْ تُوجَدْ وَخَافُوا عَلَيْهَا أَنْ تَهْلِكَ أَوْ يُصِيبَهَا وَجَعٌ لَا تَحْتَمِلُهُ يَسْتُرُوا مِنْهَا كُلَّ شَيْءٍ إلَّا مَوْضِعَ الْعِلَّةِ ثُمَّ يُدَاوِيهَا الرَّجُلُ وَيَغُضُّ بَصَرَهُ مَا اسْتَطَاعَ إلَّا عَنْ مَوْضِعِ الْجُرْحِ اهـ فَتَأَمَّلْ وَالظَّاهِرُ أَنَّ ” يَنْبَغِيَ ” هُنَا لِلْوُجُوبِ»
[2] Maulana Ashraf Ali Thanawi, Imadadul Fatawa, 4:211.
[3] حاشية ابن عابدين = رد المحتار ط الحلبي» (6/ 368): وَالظَّاهِرُ أَنَّ عِلَّةَ الْكَرَاهَةِ الْخَلْوَةُ، وَمُفَادُهُ أَنَّهَا تَنْتَفِي بِوُجُودِ رَجُلٍ آخَرَ، لَكِنَّهُ يُفِيدُ أَيْضًا أَنَّهَا لَا تَنْتَفِي بِوُجُودِ امْرَأَةٍ أُخْرَى فَيُخَالِفُ مَا مَرَّ مِنْ الِاكْتِفَاءِ بِامْرَأَةٍ ثِقَةٍ ثُمَّ رَأَيْت فِي مُنْيَةِ الْمُفْتِي مَا نَصُّهُ: الْخَلْوَةُ بِالْأَجْنَبِيَّةِ مَكْرُوهَةٌ وَإِنْ كَانَتْ مَعَهَا أُخْرَى كَرَاهَةَ تَحْرِيمٍ اهـ وَيَظْهَرُ لِي أَنَّ مُرَادَهُمْ بِالْمَرْأَةِ الثِّقَةِ أَنْ تَكُونَ عَجُوزًا لَا يُجَامَعُ مِثْلُهَا مَعَ كَوْنِهَا قَادِرَةً عَلَى الدَّفْعِ عَنْهَا وَعَنْ الْمُطَلَّقَةِ فَلْيُتَأَمَّلْ
«المبسوط للسرخسي» (5/ 150): تَصِحُّ الْخَلْوَةُ لِقِيَامِ الْمَانِعِ إلَّا أَنْ يَكُونَ الثَّالِثُ مِمَّنْ لَا يَشْعُرُ بِذَلِكَ كَصَغِيرٍ لَا يَعْقِلُ أَوْ مُغْمًى عَلَيْهِ أَوْ نَحْوِ ذَلِكَ، وَإِنْ خَلَا بِزَوْجَتِهِ وَهُنَاكَ أَمَتُهُ وَكَانَ مُحَمَّدٌ – رَحِمَهُ اللَّهُ تَعَالَى – يَقُولُ: لَا تَصِحُّ الْخَلْوَةُ، بِخِلَافِ مَا إذَا كَانَ هُنَاكَ أَمَتَهَا؛ لِأَنَّهُ يَحِلُّ لَهُ وَطْءُ أَمَتِهِ دُونَ أَمَتِهَا ثُمَّ رَجَعَ، وَقَالَ لَا تَصِحُّ الْخَلْوَةُ، وَهُوَ قَوْلُ أَبِي حَنِيفَةَ وَأَبِي يُوسُفَ رَحِمَهَا اللَّهُ تَعَالَى -؛ لِأَنَّهُ يَمْتَنِعُ مِنْ غَشَيَانِهَا بَيْنَ يَدَيْ أَمَتِهِ طَبْعًا، وَعَلَى هَذَا لَوْ خَلَا بِزَوْجَتَيْهِ لَمْ تَصِحَّ الْخَلْوَةُ لِمَا قُلْنَا، وَالْمَكَانُ الَّذِي لَا تَصِحُّ الْخَلْوَةُ فِيهِ أَنْ يَأْمَنَا فِيهِ اطِّلَاعَ غَيْرِهِمَا عَلَيْهِمَا بِغَيْرِ إذْنٍ كَالدَّارِ وَالْبَيْتِ وَمَا أَشْبَهَ ذَلِكَ، وَلِهَذَا لَا تَصِحُّ الْخَلْوَةُ فِي الْمَسْجِدِ وَالطَّرِيقِ الْأَعْظَمِ وَالسَّطْحِ الَّذِي لَيْسَ عَلَى جَوَانِبِهِ سُتْرَةٌ
Answered by:
Maulana Ikramul Hoque Miah
Checked & Approved by:
Mufti Abdul Rahman Mangera
Mufti Zubair Patel