Is it permissible for a married couple to role-play certain scenarios during intercourse—such as the husband imagining he is a doctor and the wife a patient—without imagining another person, while maintaining their true appearance and form, given that this has a positive effect on their relationship?

These fantasies - such as a husband having intercourse with his wife while he or she imagines they are not married - are forbidden. This is because it resembles someone drinking water while imagining it is wine. Jurists have stipulated that when engaging in permissible acts, there should be no intention that would imply their prohibition. There are legitimate ways for spouses to arouse each other, such as foreplay and affectionate words.