James 5:13–16 ranks among Scripture’s most difficult passages to interpret. Charismatics use this passage to promise healing to the sick when a Christian believes as he ought when he prays. Catholics use this passage to teach “extreme unction” whereby they anoint someone with oil and say prayers for someone who is at the point of death. Even among sound interpreters, the healing in this passage is said to be either physical or spiritual, resulting in very different interpretations. Should the elders be called to pray for the spiritually sick who suffers from sin? Or should the elders be called to pray for the physically sick whose sickness may or may not be from underlying sin? The last of these options seems best for the reasons given below.1
First, the word for sick in James 5:14 (astheneō) is used to refer to both physical (e.g., Matthew 10:8) and spiritual (e.g., Romans 4:19) matters in the NT, so being “sick” could refer physical suffering. Some tie the sickness in James 5:14a to the spiritual suffering of James 5:13 (cf. James 5:10 with 2 Timothy 2:9; 4:5). But, just as James shifts from suffering to cheerfulness in James 5:13, so also he could shift topics again from cheerfulness to physical suffering in James 5:13b–14a. This is not to say that physical sickness is always unrelated to spiritual matters (cf. 1 Samuel 5:6–12; 1 Corinthians 11:30), but this is to say that, whether sin is involved or not (cf. James 5:15b), the sickness in James 5:14 could be physical.
Second, just as anointing someone with actual oil and his healing is physical in Mark 6:13, so also it is likely the same here in James 5:14. Granted, the elders who pray in James 5:14–15 are not apostles, but in both situations, it is the ultimately the Lord Jesus who heals the one anointed with oil (cf. Mark 6:7; James 5:15b). Some hold that oil is a metaphor for the uplifting ministry of the elders whose ministry mitigates spiritual sickness (cf. Psalm 23:6; Isaiah 1:6), but oil is otherwise always physical in the NT and indeed so in a very similar context in Mark 6:13. It could be used medicinally (cf. Luke 10:34) and could have thus symbolized the greater healing that only the Lord could do in a dire situation.
Third, “the prayer of faith” seems to refer to something miraculous. James gives certainty that this prayer indeed “will save” the one who is sick. The faith that accompanies this prayer is thus the faith beyond saving faith that is necessary for miracles, and the healing is then the miraculous healing that comes with this kind of faith. This kind of faith and its accompanying healing are listed as spiritual gifts in 1 Corinthians 12:9. They are apparently not granted in every occasion, even to apostles (e.g., Philippians 2:27; 2 Timothy 4:20).
Fourth, though used only one other time in the NT to refer to spiritual weakness (Hebrews 12:3), the verb behind “the one who is sick” (kamnō) was used in Bible times to refer to physical weakness and even death. This word, too, could refer to physical sickness.
Fifth, like the words for sickness above, “save” (sōzō) can also refer to physical salvation. It is commonly used to refer to both spiritual and physical salvation in the NT (e.g., Matthew 1:21; 8:25). Admittedly, this use of “save” would be James’s one use of the word for something physical (cf. James 1:21; 2:14; 4:12; 5:20), but it is possible to understand this use to be salvation from physical illness.
Sixth, it is only possible that this sickness is related to sin. In addition to physical salvation, James adds, “if he has committed sins, he will be forgiven” (James 5:15). But that is only “if” sin is involved and causing his physical sickness. Sin might not be involved in the matter at all.
Seventh, “heal” (James 5:16, iaomai) can refer to physical healing. It can refer to either spiritual or physical healing (e.g., Matthew 8:8; 15:13), and, as it does most of the time in the NT, it seems to refer here to physical healing. In James 5:16, this healing comes immediately after James mentions the confession of sin, again indicating that physical sickness may result from sin.
Putting together everything above, the elders in James’s day (the era of the apostles) could be called to anoint the physically sick person with actual oil, pray a prayer with extraordinary faith that knew the person would be healed, and then the Lord would certainly heal this person. What does this passage with all of its particularities mean for us today?
First, if the exercise of miraculous faith and gifts ceased with the apostles (cf. Acts 1:21–26; 2 Corinthians 12:12), so also did this healing and its extraordinary faith. However, the sick may summon his elders for prayer and a symbolic anointing with oil if desired, and it may be that the Lord grants healing in response to their prayers. The healing may even be miraculous, but without special revelation, neither the elders nor the sick would ever know.
Second, we are both physical and spiritual beings, and physical sickness may be due to unconfessed sin. David gives testimony to this phenomenon in Psalm 32:1–4. Scripture also indicates that the Lord at times strikes the sinner with sickness as judgment for his sin (cf. 1 Samuel 5:6–12; 1 Corinthians 11:30). It may be that, as the elders minister to the sick person, he confesses sin and finds physical healing as well.
Third, as this passage could involve elders ministering through prayer to someone with unconfessed sin, certainly the elders should rally with prayer around the spiritually discouraged. In fact, James addresses all of the brothers in the next two verses (James 5:19–20) and encourages them to bring spiritual wanderers back to the truth. All Christians are responsible to restore transgressors to a righteous way of living (Galatians 6:1) and to help the spiritually weak (1 Thessalonians 5:13–14).
Fourth, this context is a private setting in which the sick summons the presence of his elders. It is not an assembly of the church. Healing by faith in the apostolic era never drew inordinate attention to itself as do the so-called faith healers today.
Fifth, this context involves serious sickness which may include but is not limited to death. Extreme unction or last rites misunderstands and limits this passage to a very specific situation that James would not endorse.
- For contrasting viewpoints among sound interpreters, see D. Edmond. Hiebert, James (Winona Lake, IN: BMH, 1997) and John F. MacArthur, James (MacArthur New Testament Commentary; Chicago: Moody, 1998). My view is close to what is found in John Calvin’s commentary on James. See https://www.ccel.org/ccel/calvin/calcom45.vi.vi.v.html.