Ruling on giving medicine to the patient without his knowledge
Question

Is it permissible to give my mother psychiatric medicine, because she is very hot-tempered. My mother has had three strokes, so she cannot speak or walk, and her bad temper is unbearable, so we have no choice but to give her tranquilizers. They have a strong effect on her, so she sleeps all the time, and her colour has turned pale, and she has a poor appetite. Are we sinning for doing that? Please note that if we leave her without medication, no one would be able to put up with her bad temper or be able to look after her.
Praise be to Allah.Firstly:
If the patient is an adult of sound mind, it is not permissible to give him medicine without his knowledge, unless it is thought most likely that he will die without the medicine, or will be harmed greatly.
That is because, in principle, taking medicine is permissible or recommended (mustahabb), so the patient has the right to refrain and should not be forced to take it.
If it is thought most likely that he will die if he does not take the medicine, or that not taking it will result in clear harm, or damage of a limb or faculty, then taking the medicine becomes obligatory, and it is permissible to give it to him without his knowledge, because of the obligation to protect life and the prohibition on destroying it. Allah, may He be exalted, says (interpretation of the meaning):
{And do not kill yourselves [or one another]} [an-Nisa’ 4:29].
This may be understood from the statements of some of the jurists with regard to forcing the patient to take medicine if there is a fear that he may die.
It says in al-Darar al-Bahiyyah fi Sharh al-Bahjah al-Wardiyyah (2/78):
It says in ar-Rawdah: It is disliked (makruh) to force him to take the medicine. End quote.
What appears to be the case is that this applies in the case when it is not known and is not thought that not taking the medicine will lead to his death, as was said about taking medicine. End quote.
If it is permissible to force the patient to take medicine, then [giving it to him without his knowledge] may come under the same ruling, or it may be better to give it to him without his knowledge.
The Islamic Fiqh Council adopted the view that it is obligatory to administer medical treatment if not doing so will lead to loss of life or limb, or lead to incapacity, or the harm of the sickness may be transmitted to others, as in the case of contagious diseases.
End quote from Majallat Majma‘ al-Fiqh al-Islami (issue no. 7, vol. 3, p.729).
See the text of the Council’s statement in the answer to question no. 2148.
Based on that, so long as your mother is conscious and of sound mind, and this medicine only calms her down and she will not die if she does not take it, you do not have the right to give it to her except with her permission.
If it has negative side-effects that outweigh the hoped-for benefits, it is not permissible for her to take it, because the Prophet (blessings and peace of Allah be upon him) said: “There should be neither harming nor reciprocating harm.” Narrated by Ahmad (2865) and Ibn Majah (2341); classed as sahih by al-Albani in Sahih Ibn Majah.
If you find a remedy that will calm her bad temper and will not lead to any harmful side effects, then there is nothing wrong with using it, so long as it is with her permission.
Secondly:
Some specialist doctors have said that one of the best medicines for seniors, and the least likely to have negative side effects, is aripiprazole, with a dose of 5 mg once a day; and mirtazapine, with one dose of 15 mg at night. We advise you to consult the doctor who is treating your mother and ask him about these medicines, to see how suitable they may be in your mother’s case.
The specialist also advised us that strokes are usually followed by what is called post-stroke major depression, and one of the best treatments for seniors in this case is electroconvulsive therapy (ECT). It is completely safe for seniors, but it should be administered under the supervision of a neurologist who does follow-up for stroke patients. End quote.
Thirdly:
You should bear with patience what your mother does, treat her kindly, offer a lot of supplication for her, and try to convince her to see the doctor and take whatever medicine he prescribes.
We ask Allah to grant her healing and well-being, and to avert harm from her.
And Allah knows best.