What is the ruling on a person who is mentally ill breaking their fast due to severe thirst from medication prescribed by a doctor, then breaking their fast again without a medical permit, and then intentionally breaking their fast by engaging in sexual intercourse in the third year?

A sick person is permitted to break their fast if fasting causes them hardship, increases their illness, or delays their recovery, based on the words of Allah Almighty: "But whoever among you is sick or on a journey, then [he is to fast] a number of other days." The illness that permits breaking the fast is one where there is a fear of the illness increasing or recovery being delayed, whether this is known through the patient's experience or the word of a trustworthy doctor. There is no blame on someone who breaks their fast due to a legitimate religious excuse for doing all things that invalidate the fast during the daytime in Ramadan, including conjugal relations with one's wife if she also has an excuse that permits her to break the fast.