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Is any sick among you? 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:
And the prayer of faith shall save the sick, and the Lord shall raise him up; and if he have committed sins, they shall be forgiven him.

New Defender's Study Bible Notes

5:14 sick. The promise of healing in this passage applies only to the special case of one whose sins have brought about the Lord’s chastening in the form of sickness. The word “sick” in this verse means “ill.” In James 5:13, on the other hand, the word “afflicted” means “suffering trouble” (same as in James 5:10; also, the same as “endure hardness” in II Timothy 2:3; see also II Timothy 2:9 and 4:5). In such a case of affliction in a believer’s life, assuming it is not clearly a specific chastising because of sin, the admonition is: “Let him pray.” The Lord in such cases will answer in whatever way best serves His greater purpose (note Paul’s testimony in II Corinthians 12:9). In cases of divinely imposed illness, however, when the sick person has injured the body of Christ by his sin (as in I Corinthians 11:18-34, especially verses 30-31), he must first confess his sin to God and to those injured, as represented by the elders of the church, asking them to pray for him—the initiative coming from him rather than the elders.

5:14 oil. There is nothing magical in the anointing oil, of course. It could well have been used as merely a soothing ointment to alleviate the suffering (note Isaiah 1:6; Mark 6:13; Luke 10:34). The oil was merely a spiritual symbol, representing God’s hoped-for anointing of the sick person by the Holy Spirit, in order to bring him back to active service for the Lord. This symbol recalled how priests and kings had been anointed in ancient Israel, symbolizing their divine call to service.

5:15 faith shall save. “Save” here means “deliver”—that is, from his illness.

5:15 sick. “Sick” in this verse is different from both “afflicted” in James 5:13 and “sick” in James 5:14. Used elsewhere only in Hebrews 12:3 and Revelation 2:3, it means “wearied.” In context, it must refer to the depression induced by the guilt of his sin. This can only be relieved, not by some psychiatric encouragement of his supposed self-worth, but by repentant confession of his specific sin to God (I John 1:9), then to the church and its elders. The latter can then pray for him in faith (note that the latter prayer is their prayer, not his—they must have the faith to believe God’s promise). If all conditions are met, then “the Lord shall raise him up.” Notice that nothing in the context mentions the need for someone with the gift of healing, though one or more of the elders (at least in apostolic times, before the completion of the New Testament) may well have had such a gift (to be used, however, in evangelizing, rather than in a case such as the one described here). The reason why this type of healing does not occur more often today is probably because one or more of the conditions are not met.

5:15 if. “If” here means “since.” The reason for the illness in such a case is unconfessed sin that has injured the church and its ministry. If the conditions have been met for healing, they will also have been met for forgiveness.

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