Jesus never promised His people a pain-free life. In a fallen world, we all experience physical breakdown and decay as we await “the redemption of our bodies” (Rom. 8:23). Sometimes, though, as James 5:13–18 describes, that future redemption breaks into the present, and God graciously heals what ails us.
Glorious as the promises of this passage are, it’s not easy to interpret. It must be studied carefully by any who hope to reap its rewards today.
The Plain Point and a Caveat
The obvious challenge and encouragement contained in James 5:13–18 is simple: pray! All six verses are about prayer. It’s possible for us to become so distracted by the passage’s unresolved questions that we leave aside what James is plainly saying, which is that in all the circumstances of our lives—in sickness and in health, in joy and in sorrow—our great recourse is going to our heavenly, faithful Father in dependent prayer. In trouble, we go to God in prayer. In blessing, we go to God in prayer.
If we’re going to pray properly, however, we need to pray with a God-centered perspective and a God-centered trust. We recognize that God has not placed any of us at the center of His plans, and we believe that our heavenly Father knows best—always and in every circumstance.
We recognize that God has not placed any of us at the center of His plans, and we believe that our heavenly Father knows best—always and in every circumstance.
The exhortation to pray is obvious; the details, however, do not come as easily. Roman Catholics take these verses as warrant for extreme unction, which is an anointing typically offered to those on their deathbeds. Others, including John Calvin, say the healing mentioned here was a special witness reserved for the apostolic age.1 Still others say that what the text prescribes has been superseded by modern medicine. And some take James’s words to mean that physical healing is always God’s desire and that He will grant it if we have “enough faith.”
There are no clear parallel passages to shed light on James 5:13–18, and so any honest interpreter must proceed with caution. At some point, we must become okay with not having everything cut and dried and systematized. Scripture itself acknowledges that some of its passages are particularly “hard to understand” (2 Peter 3:16). As long as we can guard against bending the Bible to fit our own predetermined notions, then we are in good company with the apostle Peter himself.
With all this in mind, we can examine the content of James’s call to prayer.
The Community of the Healed
Let’s first look at who is involved. We can identify three parties in verse 14: the church, the elders, and the ailing person.
The Church
James takes it for granted that his readers will be involved in a local community of faith. He assumes that Christian believers will be in such close relationship with one another that they will face both blessing and trouble together. God never intended His people to face life alone. He redeems individuals to live not in isolation but in community, where we find encouragement and support.
The Elders
James also assumes the presence of leadership within the church: men of Christian maturity and discernment who shepherd under Jesus, the Chief Shepherd. Each member of a local church is responsible to others under Christ, but God sets some apart—namely, elders—to be responsible for others under Christ. An elder’s responsibilities for tending the flock of God extend to this area of prayerful involvement with the needs of those who are ailing.
The Sick
Finally, we have the one whose present condition requires prayer. The Greek word rendered “sick” in verse 14 (asthenei) means to be without strength. It is commonly, but not exclusively, used of bodily weakness. It can also refer to other kinds of weaknesses—mental, moral, spiritual, and otherwise.
Not only those who are physically ill but also those who come to the gathering of God’s people depressed and defeated, buffeted and blasted, have every legitimate right to go to the leaders of the church and say, “Pray for me! Please pray for me. I am weak to the point of failure. I find myself burdened by a weight from which I cannot free myself.” And it ought to be the glad and happy privilege of those leaders to take seriously the privilege of prayer in response.
God’s Healing Power
Next, let’s look at what’s involved in this interchange between the ailing individual and the church elders.
Bedside Manner
In verse 14, it is the sick party who calls upon the elders—or if that person is unable, perhaps a close brother or sister alerts the elders on the ailing person’s behalf. Whatever the case, the picture is not that the elders are constantly performing physical wellness checks but that members of the congregation will sometimes take the initiative to alert the church’s leadership to issues requiring their attention.
When the elders arrive at the sick person’s side, they are to “to pray over him, anointing him with oil in the name of the Lord” (v. 14). What can we say about this anointing with oil? We can certainly dispel the notion that this is some sort of magic, as if it were the oil itself that effected healing. Verse 15 informs us that prayer is the primary instrument and that ultimately, it is the Lord who heals.
Some contend that James is prescribing a sacramental ritual; others that, given the medical practices of the time, this is actually medicinal; and others that this is symbolic—that the oil represents the healing power of God. Yet however we understand the practice, what we can say with certainty that it is the prayer, not the oil, that is the vital means of God’s healing action.
The Prayer of Faith
What, then, can we say about this prayer itself? Verse 15 says, “The prayer of faith will save the one who is sick, and the Lord will raise him up.” This is not simply a reference to prayer in general but to a particular prayer that is offered up in faith with regard to the presenting problem—namely, the sickness of the one who has called for the elders.
The prayer of faith takes those praying it beyond simple trust to the point of laying hold of the healing that they believe to be God’s will. James is not describing some on-demand gift of healing that belongs to the church elders. Rather, it seems that God sometimes grants elders the gift of faith to pray for His work of healing.
So, even though “the prayer of a righteous person has great power” (v. 16), it is ultimately the Lord who raises up ailing individuals (v. 15). It is not the process, not the oil, not the faith, not the elders, but the Lord Himself who acts and heals.
But what if physical healing does not prove to be God’s will for the individual? Douglas Moo so helpfully responds to that question:
This faith, while certainly including the notion of confidence in God’s ability to answer, also involves absolute confidence in the perfection of God’s will. A true prayer of faith, then, always includes within it a tacit acknowledgment of God’s sovereignty in all matters; that it is God’s will that must be done. And it is clear that it is by no means always God’s will to heal those who are ill …. Therefore, the “faith” that is the indispensable condition for our prayers for healing to be answered—this faith being the gift of God—can be truly present only when it is God’s will to heal.2
In other words, God does not prompt the spiritually mature and wise to lay hold upon His promise in this way unless He has already purposed to bring about healing according to His will.
Forgiveness for Sin
Another matter to consider is that of the forgiveness mentioned alongside the praying and healing in verse 15: “And if he has committed sins, he will be forgiven.”
We need to set aside the idea that illness is always and immediately to be associated with sin—that there is a one-to-one link between sickness and sin. The whole book of Job makes it perfectly clear that there is no such connection. Similarly, in John 9, when the disciples passed by a man who was blind from birth and asked Jesus, “Rabbi, who sinned, this man or his parents, that he was born blind?” He responded, “It was not that this man sinned, or his parents, but that the works of God might be displayed in him” (vv. 2–3). We err if we insist on a direct, causal relationship between personal sin and sickness.
At the same time, we need to admit that sin involving the misuse of our bodies may indeed result in illness. Paul describes sin that leads to physical illness in 1 Corinthians 11:29–31 in his discussion of the Lord’s Supper. There, poor judgment led to ailment. So what James is likely saying is that if there is indeed sin behind an individual’s need for healing, then the presence of the elders and the practice of earnest prayer provide the perfect context for repentance and forgiveness.
Grace for All Our Weakness
As we consider this challenging passage, one of the most important truths to remember is that God doesn’t guarantee healing in this age. We need only look to Paul’s own thorn in the flesh, which God determined not to relieve (2 Cor. 12:7–9). He heals according to His sovereign will, and it is God Himself who ordains the means of prayer as well as the end result of restoration to health or not.
Whether we remain flat on our back or feel the blessing of strength again, God’s grace is sufficient for us today, and complete rejuvenation is almost here.
Yet whether God grants the healing or not, sickness may actually be a means of grace to us. To be set aside for a time, to be unwell, to be in a situation where we need to call for this kind of intervention can produce a period of reflection, an opportunity to examine ourselves—especially if the sickness confronts us with our mortality and we are made aware of our own finitude. But whether we remain flat on our back or feel the blessing of strength again, God’s grace is sufficient for us today (2 Cor. 12:9), and complete rejuvenation awaits us (1 Cor. 15:51–56)!
This article is adapted from the sermons “‘If Anyone Is Sick…’ — Part One” and “‘If Anyone Is Sick…’ — Part Two” by Alistair Begg.
1 John Calvin, Commentaries on the Catholic Epistles, trans. John Owen (Edinburgh: Calvin Translation Society, 1855), 355–56.
2 Douglas Moo, The Epistle of James: An Introduction and Commentary, Tyndale New Testament Commentaries (Grand Rapids: Eerdmans, 1985), 182.