Should the Sick Be Anointed with Oil? (James 5)

This article is part of the Tough Passages series.

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14Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. 15And the prayer of faith will save the one who is sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. 16Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working.

Elders Should Pray

James says a sick person should call the elders of the church to come pray over him. The fact that the elders must be summoned to the house of a sick person indicates he is likely too sick to leave his home easily. Note also that the elders are to pray “over” him (v. 14)—possibly implying that the sick person is bedridden. It is noteworthy that James assumes there will be a plurality of elders in the local congregation. The modern model of a “lone ranger” pastor is a departure from the biblical model of plural eldership.

James instructs the church elders to “anoint” the sick person with oil “in the name of the Lord” (v. 14). Throughout the centuries, Christians have struggled to understand and apply this verse. The Roman church developed the practice of “extreme unction,” in which it was believed that a dying person’s remaining sins were wiped away through a priest-administered sacrament. Partly in reaction to this error, other Christians insist that the oil here was merely a form of ancient medicine. While it is true that oil was used to cleanse wounds in the first century (cf. Luke 10:34), oil did not have medical application to all of the diseases known at that time.

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The closest biblical parallel we find to James’s instructions is the disciples’ ministry in Mark 6. There Jesus sends out the disciples in groups of two to preach and perform miracles throughout Israel. In Mark 6:13 we read, “They . . . anointed with oil many who were sick and healed them.” The oil, both there and in James 5:14, seems to have been a visible, symbolic means of setting the sick person apart for God’s miraculous intervention—similar to the way that many modern Christians will place a hand on the shoulder of the person for whom they are praying. James does not emphasize anointing as an imperative act in and of itself but specifies it as something done “in the name of the Lord” (v. 14), that is, as an action performed while calling upon the Lord in faith to heal.

In verse 15 James assures his readers, “The prayer of faith will save the one who is sick, and the Lord will raise him up.” This verse has caused consternation for many interpreters. Some understand the verse eschatologically. That is, regardless of how any sickness ends, the Lord has assured his people that he will save them ultimately and resurrect them on the last day. While theologically true, this interpretation does not adequately respect the immediate context, which favors understanding James as referring to temporal healing.

Other interpreters have seen this promise as referring to a special dispensation of faith given only occasionally. In other words, there are times of praying for the sick in which one will be given a “prayer of faith” that will prove supernaturally effective. Again, this interpretation stumbles over a more natural reading of “prayer of faith,” which understands the phrase as referring to a “prayer offered in faith,” or “believing prayer.”

Should All Sickness Be Healed?

One distorted form of Christianity argues that Christians should always expect to be healed from sickness in this life. If one is not healed, then that person lacks faith, it is argued. Read in isolation, James 5:15 could seem to support this interpretation, but other passages of Scripture make clear that the sick and suffering are not always healed — even when the request is made in pure (even apostolic!) faith (cf. 2 Cor. 12:8–9). The 100 percent mortality rate of humanity testifies to the fact that all of us will eventually succumb to sickness, injury, or old age.

The statement that “the prayer of faith will save the one who is sick” is best understood as a typical promissory statement that does not necessarily list exceptions. We find many parallels in Jesus’ ministry (e.g., “Ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you. For everyone who asks receives, and the one who seeks finds, and to the one who knocks it will be opened”; Matt. 7:7–8). Such invitations are made memorable by focusing attention on God’s gracious invitation and our rightful expectation of response.

Of course, submission to God’s will should underlie every Christian petition, and sometimes the authors of Scripture make such an understanding explicit (e.g., “If we ask anything according to his will”; 1 John 5:14). All in all, it is the sovereign God, and no one else, who will determine the answers to our prayers.

As James concludes his discussion of praying for the sick, he asserts, “And if [the sick person] has committed sins, he will be forgiven” (James 5:15b). Here we are reminded that Scripture testifies that some sickness, even death, comes upon believers as a result of God’s fatherly discipline (Acts 5:1–11; 1 Cor. 11:30). Pastors should be wary, however, of always drawing a one-to-one correspondence between sickness and sin, as the Pharisaical opponents of Jesus did (John 9:34). Most human sickness, while not outside of God’s divine will, is simply the result of living in a broken world.

Confess Your Sins

After implying that unconfessed sin could result in physical sickness (v. 15b), James draws the conclusion (“Therefore”; v. 16) that all believers should regularly confess their sins (and, implicitly, turn from their sins in repentance). Although confession to God is the most necessary form of confession (Ps. 51:4), any genuine Godward repentance will be mirrored in relationships within the Christian community. Believers should not only confess their sins to those whom they have wronged (Luke 19:8); they should also confess their “secret sins” of pride, lust, resentment, and greed to a trusted fellow believer or believers. Such confession, James tells us, will result in spiritual, if not physical, healing (James 5:16a).

All in all, it is the sovereign God, and no one else, who will determine the answers to our prayers.

In the latter part of verse 16, James transitions from the subject of praying for spiritual/physical healing to the matter of effective prayer more generally. Specifically, James points out that one can expect tremendous divine power to be unleashed through the prayer of a “righteous person.” In one sense, all Christians are “righteous” (dikaios) in that we are justified before God. But the Greek word dikaios can also refer to practical and visible godly behavior (e.g., Matt. 1:19), as it seems to be here. In other words, those who walk closely with the Lord can expect to see a powerful response to their petitions (cf. Matt. 17:19–20; 1 John 3:22).

God Is the Healer

This final section of James is the passage from which I receive the most student questions. People want to know, “What are we supposed to do about these instructions to anoint with oil?” In the church where I serve, when someone asks for the pastors to come pray over them, we seek to have two or more elders present. One of us will bring a small glass bottle of olive oil. We begin by talking with the church member and their family—asking them how they are doing and listening carefully. Then we ask permission to read Scripture, and one of us reads from James 5:13–18 and elsewhere. We then ask if anyone would like to say or share anything else. Next we explain, “I have this little bottle of olive oil. In obedience to Scripture, I am going to take a drop of this oil with my finger and place it on your forehead. This oil is not magic. We, as a church, are setting you apart symbolically before God. We are asking him to intervene and heal you.”

In this last portion of his letter, James also challenges us to embrace the practice of confessing sin to other Christians. Too often we think, “I confess my sins to God. Confessing to others? I do not need to do that!” But, as we see in 5:16, Scripture instructs us to confess our sins to each other and pray for each other (apparently in regard to those sins and struggles) with the wonderful encouragement, “that you may be healed.” It is a healing gift to have one of God’s holy people look you in the eye and say, “Christ died for that sin. Jesus forgives you. I am going to pray that God will enable you not to fall into that sin again.”

This article is written by Robert L. Plummer and adapted from the ESV Expository Commentary Series: Hebrews–Revelation (Volume 12).

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