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The following is an excerpt from The MacArthur New Testament Commentary on James 5.
Is anyone among you sick? Then he must call for the elders of the church and they are to pray over him, anointing him with oil in the name of the Lord; and the prayer offered in faith will restore the one who is sick, and the Lord will raise him up. (James 5:14–15)
This passage has been a battleground for interpreters over the centuries as various groups have used it as a proof text for their particular beliefs. At first glance it appears to be teaching that sick believers can expect physical healing through the prayers of the elders. But such an interpretation is out of harmony with the context. The suffering James has in view is evil treatment, not physical illness.
It is true that, apart from the present verse, astheneo is translated sick eighteen times in the New Testament (e.g., Matt. 10:8; 25:36, 39; Mark 6:56; Luke 4:40; John 4:46; Acts 9:37). But it is also used fourteen times to refer to emotional or spiritual weakness (Acts 20:35; Rom. 4:19; 8:3; 14:1–2; 1 Cor. 8:11–12; 2 Cor. 11:21, 29; 12:10; 13:3–4, 9). Significantly, in all but three (Phil. 2:26–27; 2 Tim. 4:20) of astheneo’s appearances in the epistles it does not refer to physical sickness. Paul’s use of astheneo in 2 Corinthians 12:10 is especially noteworthy, since it there describes weakness produced by the sufferings of life—in a similar context as its usage in the present verse.
Translating astheneo “weak” here in keeping with its predominant usage in the epistles allows us to view this verse in a different light. James moves beyond the suffering believers of the previous point to address specifically those who have become weak by that suffering. The weak are those who have been defeated in the spiritual battle, who have lost the ability to endure their suffering. They are the fallen spiritual warriors, the exhausted, weary, depressed, defeated Christians. They have tried to draw on God’s power through prayer, but have lost motivation, even falling into sinful attitudes. Having hit bottom, they are not able to pray effectively on their own. In that condition, the spiritually weak need the help of the spiritually strong (cf. 1 Thess. 5:14).
That help, James says, is to be found in the elders of the church. They are the spiritually strong, the spiritually mature, the spiritually victorious. Weak, defeated believers are to go to them and draw on their strength. They are to call (from proskaleo, “to call alongside”) the elders to come and lift them up. It is the same thought that the apostle Paul expressed in Galatians 6:1: “Brethren, even if anyone is caught in any trespass, you who are spiritual, restore such a one in a spirit of gentleness.” The wounded, exhausted, broken sheep are to go to their shepherds, who will intercede for them and ask God for renewed spiritual strength on their behalf.
This is an important—and largely neglected—ministry of the church’s pastors and elders. The apostles acknowledged its priority when they said, “We will devote ourselves to prayer and to the ministry of the word” (Acts 6:4). But in today’s church, weak, struggling believers are often handed over to so-called expert professional counselors—who often have little power in prayer. Those who have been defeated in the spiritual battle do not need to hear opinions of human wisdom; they need to be strengthened by the power of God through their leaders’ prayers.
The anointing with oil in the name of the Lord done by the elders is not a reference to some symbolic ceremony. Aleipho (the root form of the verb translated anointing) is not used in the New Testament to refer to a ceremonial anointing. Aleipho in the New Testament describes anointing one’s head with oil (Matt. 6:17; cf. Luke 7:46), the women’s anointing of Jesus’ body (Mark 16:1), Mary’s anointing of the Lord’s feet (John 11:2; 12:3), and anointing the sick with oil (Mark 6:13). Perhaps the best way to translate the phrase would be “rubbing him with oil in the name of the Lord”; it literally reads “after having oiled him.”
It may well have been that the elders literally rubbed oil on believers who had suffered physical injuries to their bodies from the persecution (cf. Luke 10:34). Medical science was certainly in a primitive state and there were few trustworthy doctors. It would have been a gracious, kind act on the part of the elders to rub oil on the wounds of those who had been beaten, or into the sore muscles of those made to work long hours under harsh treatment.
Metaphorically, the elders’ anointing of weak, defeated believers with oil conveys the responsibility for elders to stimulate, encourage, strengthen, and refresh (cf. Luke 7:46) these people.
The elders’ ministry of intercession and restoration is to be done in the name of the Lord. Any truly biblical encouragement must be consistent with who God is (which is what His name represents). To do something in the name of Christ is to do what He would have done in the situation; to pray in the name of Christ is to ask what He would want; to minister in the name of Christ is to serve others on His behalf (cf. John 14:13–14).
The blessed result of the elders’ comfort and ministry of intercession is that their prayer offered in faith will restore the one who is sick. Again, sick is misleading and not the best translation of kamno, which in its only other New Testament usage (Heb. 12:3) clearly does not refer to physical illness. James speaks here of a spiritual restoration of weak, defeated believers. Nor does sozo (restore) necessarily refer to physical healing; it is most commonly translated “save” in the New Testament. The idea here is that the elders’ prayers will deliver weak, defeated believers from their spiritual weakness and restore them to spiritual wholeness. Those prayers, of course, are but a channel for God’s power; it is the Lord who will raise up the weak. Egeiro (raise up) can also mean “to awaken” or “to arouse.” Through the righteous prayers of godly men, God will restore His battered sheep’s enthusiasm.