Sick? Call the Elders, Pt. 1

September 22nd, 2026
by Lance Waldie

James 5:14-15 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; 15 and the prayer offered in faith will restore the one who is sick, and the Lord will raise him up…

James says that when Christians suffer, they must pray; when cheerful, they must praise (5:13). In v. 14 he asks, “Is anyone among you sick?” These must “call for the elders” so that they can “pray over… anointing him with oil in the name of the Lord.” This oft misinterpreted passage led the Roman Catholic Church in AD 852 to justify extreme unction—praying over the dead. Likewise, it has led others to believe that prayer and oil will heal all diseases. A cursory look at the text might lead to such conclusions, but a more accurate view is much-needed.

At the heart of the issue is the term translated “sick” (Gr. astheneō) in v. 14. This term in its verbal form, as here, is used 33 times in the NT, 19 of which refer to some kind of physical illness (Matt. 10:8; 25:36, 39; Mark 6:56; Luke 4:40; John 4:46; 5:3, 7; 6:2; 11:1-3, 6; Acts 19:12; Phil. 2:26-27; 2 Tim. 4:20). But 14 times in the NT, in its verbal form, astheneō refers to 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); being “weak.” As a noun or adjective in the NT, the Greek term is asthenēs, used 25 times. Paul uses the term for spiritual inability (Rom. 5:6), moral depravity (Rom. 6:19), the conscience (1 Cor. 8:7, 9; cf. Rom 14:1, 2), and his own physical form (2 Cor. 10:10). James almost certainly uses the term in the context of being “spiritually weak,” not bodily ill. Why? Simply because it is not true that when elders pray over the sick, they are guaranteed wellness.

In v. 15, James uses another Greek term (kamnonta), also translated “sick” in the English text, referring to the same one who was sick (astheneō) in v. 14 who needs prayer—two different words in Greek to refer to the same problem and issue. In v. 15 the term is kamnonta, used only twice in the NT, here and in Hebrews 12:3 where it is translated “grow weary” in reference to Christians under intense trial and persecution.

Since James is not talking about physical illness but spiritual weakness, those who find themselves in a spiritually weak condition have a cure for their sickness: call the church elders to pray over them. Church elders (aka, overseers and pastors) are spiritually mature men (cf. 1 Tim. 3:1-7; Titus 1:5-9) in charge of protecting and feeding Christians in the local church (cf. 1 Pet. 5:1-4). They “shepherd,” or “pastor,” Christ’s followers (Acts 20:28)—His Church. Since elders are leaders recognized for their spiritual maturity, it is natural that they, with their firm devotion to Christ, should be called on to pray for Christians who are “sick”—who are spiritually weak. It is notable that though some in the early Church indeed had the apostolic gift of healing (1 Cor. 12:9), since James was not referring to physical illnesses, he did not call for them to heal the sick; rather, he specified the elders of the Church since the issue was spiritual, not physical.

So, when referring to the “sick,” James is not talking about one who has the flu or cancer; in keeping with the context of his entire epistle, he was encouraging those who had grown weary in their sufferings, who had become weak both morally and spiritually, to confess, repent, and to assertively call for the elders of the church for prayer—those with the God-given task of helping the weak. The guarantee in v. 15 is that “the Lord will raise him up” as a result of such prayer.

Food For Thought
Since prayer for the physically ill will not always raise them up, James’ teaching can only be true for spiritual weakness. So although it is perfectly permissible for Christians to call their church leaders to pray over their physical ailments, the guarantee of healing in v. 15, and in James’ broader context, is not that of physical recovery but of spiritual revival.