Anointing the sick:

Revisiting a misunderstood service

Kim Papaioannou, PhD, pastors in Cyprus.

Paddy had been a stalwart member of his small Adventist church. When he was in his 70s and in frail health, I got a call from his daughter, who said that he had been taken to the hospital’s intensive care unit and was not expected to last the night. At the hospital, I met the family and two pastors who knew him. Only one pastor was allowed to go into the ICU, and he prayed with Paddy.

The next day, Paddy was doing so well that he came home that afternoon. His family could not believe it. Though not active believers, they openly confessed that this was a miracle.

About a year later, Paddy’s health again deteriorated. The same three pastors met again, this time in Paddy’s home. We anointed him with oil and prayed as the apostle James directs us. A day or two later, Paddy died.

What was the difference between the first prayer that “worked” and the second that apparently didn’t?

Or did it?

What is the purpose of anointing? What is the expected outcome? Contemporary Christianity is fascinated with physical healing, and James’s injunction to anoint the sick is understood within this context. Sometimes, as pastors, we might be hesitant to anoint the sick in case the person does not get better, and our credibility might be questioned. According to the Bible, though, what is the real focus of anointing?

Not the last rites (James 5:14)

First, anointing is not last rites, although the two are often conflated. This was manifested when an elderly member of my church was about to have a heart operation. It was not major surgery. She was in good health, but because of her age, a higher than usual risk was involved. As such, she requested anointing.

The atmosphere in her room was pleasant. Just before the anointing, her daughter began to cry. She did not say why, but apparently, in her church, anointing was reserved for the dying. We reassured her that, from a biblical perspective, this was not the case, and then she calmed down. We had the anointing, the operation went well, and soon the elderly member was worshiping with us again.

James describes anointing as a service for any believer who is sick: “Is 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” (James 5:14).1 While anointing should not be taken lightly, it should not be offered only in life-threatening situations. It is a service that can be offered to all suffering believers.

A service for believers (James 5:14)

James begins the anointing pericope with the words: “Is anyone among you sick?” (verse 14). The phrase “among you,” en humin, literally “in you” or “in your midst,” indicates that James is referring to believers who have made the local congregation their spiritual home.

Of course, we can pray for the well-being of unbelievers as well. Jesus offered healing not only for active followers or for Israelites but also for Gentiles, like the Syro-Phoenician woman’s daughter (Mark 7:26).

It seems, however, that anointing is more than a prayer for healing. Oil represents the Holy Spirit (e.g., 1 Sam. 16:13; Acts 10:38), suggesting that a person who requests anointing has at least a foundational faith.

The promise of salvation (James 5:15)

The Bible promises four things to the sick person who is anointed. The first is that “the prayer of faith will save the one who is sick” (James 5:15).

The verb sōzō, “to save,” appears 106 times in the New Testament (NT) and can refer to salvation from sin as well as “salvation” from disease or other predicaments. The former nuance predominates. In addition to verse 15, James uses the verb four more times, each one with spiritual salvation in view.

Why would James offer a promise of spiritual salvation to a physically sick person?

Jews believed that sickness was the result of sin (e.g., John 9:2), perhaps because God had promised Israel health if they followed His commandments (e.g., Exod. 15:26). Sickness, therefore, was seen as evidence of transgression.

Jesus negated this thinking, but not completely. While one man’s blindness was not a result of sin (John 9:3), to the paralytic, He said: “Sin no more, that nothing worse may happen to you” (John 5:14).

A sick believer could question his or her standing before God; others could question that standing as well. Or that sickness could have been, indeed, a result of sin. The anointing service would function as a reaffirmation of forgiveness, as well as of the person’s standing before God and the congregation.

The first promise, therefore, offers spiritual rather than physical salvation.

The promise of a rising (James 5:15)

The second promise follows the first: “the Lord will raise him up” (James 5:15).

The verb egeirō, “to raise up,” is used 144 times in the NT but only here in James. It often refers to the eschatological resurrection (e.g., Luke 20:37). But it can also refer to all kinds of temporal risings—from the rising of a sick person from sickness (e.g., Matt. 8:15) to the rising out of bed in the morning (e.g., Matt. 1:24), or even to things like the rising of one nation against another (Mark 13:8).

What is the meaning here? Two possibilities: it refers either to the future resurrection or to a healed person rising from the sickbed. Because the context is that of sickness, the latter option seems best. Conversely, because this phrase follows immediately on the promise of salvation, James could be talking about eschatological salvation, the first resurrection.

It does not have to be either-or. Clearly, the sick person would like to rise from the sickbed, healed. However, this does not always happen. There were times when even Jesus would not heal (e.g., Mark 6:5 or John 5:3, where He healed only one of “a multitude of invalids”).

A believer getting sick and, perhaps, dying could place a stigma on that person, especially when sickness was believed to be a result of sin. In contrast, James assures the sick that, by being prayed over and anointed, they are good before God. Whether or not they rise from their sickbed, they will rise in the resurrection of the just.

The promise of forgiveness (James 5:15)

The third promise is of forgiveness: “If he [the sick person] has committed sins, he will be forgiven” (James 5:15). Here, James indirectly acknowledges the widespread belief that sickness was caused by sin. But, like Jesus in John 9:3, he dismisses a casuistic relation between the two and puts the association in very tentative terms: “If he has committed sins.”

Whether the underlying cause is sin or whether such a perception exists, James assures that the anointing establishes forgiveness as a fact. In this sense, the spiritual status of the sick believer will be fully restored before the church family and before God, so the person can face the future unafraid.

The promise of healing—perhaps (James 5:16)

The first three promises in James 5:15 deal primarily with spiritual reassurance, salvation, resurrection, and forgiveness. All three primary verbs, “save,” “raise up,” and “forgiven,” appear in the indicative mood, the mood of certainty.2

We now come to the last promise, the only one that pertains solely to physical healing. It is preceded by an injunction to mutual confession: “Confess your sins to one another” (verse 16).

Though God has the prerogative to save anyone who requests salvation, the work of redemption entails the restoration of not only Divine-human relations but also human relationships, accomplished through mutual confession.

With mutual confession accomplished, James offers the only statement that pertains to physical healing alone: “Pray for one another, that you may be healed” (verse 16). This is also the only promise that appears in the mood of probability, the subjunctive mood,3 iathēte, “that you may be healed.” There is no guarantee that God will heal the person physically. No such thing is promised. Rather, James instructs his readers to offer such a request and leave the matter to God.

James does not want to dismiss physical healing. On the contrary, he assures his readers that “the prayer of a righteous person has great power as it is working” (verse 16).

The expression “the prayer . . . as it is working” (deēsis . . . energoumenē) is unusual. The word translated “prayer,” deēsis, signifies not just a prayer but a heartfelt entreaty.4 It reflects back on God’s promise through Jeremiah: “You will seek me and find me, when you seek me with all your heart” (Jer. 29:13).

The phrase “it is working,” energoumenē, appears in the present tense and suggests ongoing action. This could suggest two things. First, prayer should be ongoing; that is, it should continue after the anointing service. Second, we need to understand prayer in the context of the cosmic conflict, whereby everything good that God wants to do for His people is resisted by the “accuser of our brothers” (Rev. 12:10). The meaning could be that a prayer offered will be acted upon when the time is right. A prayer is never wasted, even if not answered immediately.

To boost confidence in the efficacy of prayer, James mentions Elijah, who prayed, and rain was withheld for three and a half years. Then he prayed again, and rain was restored.

Conclusion

Anointing is frequently perceived as a service for physical healing. But that is a limited view. While the promise of physical healing is not negated, it is offered only as a probability—a strong one, but a probability, nonetheless.

James’s primary concern seems to be spiritual restoration, as seen in the promises of salvation and forgiveness, as well as in the possible ref­erence to the eschatological resurrection.

His primary spiritual concern is also evident in the conclusion of the pericope, where James declares that a person who brings back someone who has wandered from the truth will “save his soul from death” (James 5:20); probably, the eschatological death is in view here.

As pastors, we should never hesitate to anoint the sick. It is not our reputation that is at stake if the person does not get better. The service is not about us but about the sick person’s well-being.

Properly understood, anointing affirms the sick person’s standing before God and the congregation, while the heartfelt prayer may also lead to physical restoration. The anointing service is a God-given tool in the work of restoring fallen humanity to the image and likeness of God.

  1. Scripture is from the English Standard Version.
  2. Daniel B. Wallace, Greek Grammar Beyond the Basics (Grand Rapids, MI: Zondervan, 1996), 448.
  3. Wallace, 461.
  4. See, e.g., Bill Mounce, s.v. “δέησις,” accessed February 23, 2024, https://www.billmounce.com/greek-dictionary/deesis.

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Kim Papaioannou, PhD, pastors in Cyprus.

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