Seminary Viewpoints

“The Prayer of Faith Will Save the Sick”: Revisiting the Interpretive Difficulty in James 5:13–18

Brian Hand | October 12, 2023
Theology Thursday

Christians have long recognized the interpretive difficulty in James 5:13–18, “the prayer of faith will save the sick.” Put simply—it doesn’t seem to work, at least not very often or reliably. Because of this difficulty, three main explanations of the passage have arisen:

  1. James 5:13–18 pertained to healing only in the early apostolic age and is inapplicable in the present.
  2. James addresses sickness in every age, but his statement must be carefully qualified.
  3. James addresses primarily spiritual/emotional, not physical, weakness.

Of these options, the belief that James addresses the healing of physical sickness in every era has greatest numerical support among commentators; however, they also admit that there is usually no actual effect on the health of the sick person. This failure leads to an important caveat concerning James’s promised healing—James 5:13–18 applies only if the Lord wills.

While such a caveat shows biblical sensitivity to God’s sovereignty, it also introduces its own difficulties. Qualifying James’s healing of the sick in this way diverges from the Gospel accounts. Jesus and his disciples healed all manner of sickness every time (Matt 10:1). So if James 5:14 refers to physical healing, the reliability of that healing had deteriorated in the earliest stages of the Church even while the hope of healing remained intact.

Second, replacing “the prayer of faith” with “the prayer that believes that the Lord will do what he wills” does not resolve the problem. The text locates effectiveness in “the prayer of faith.” The main verb however insists on success in healing. So the resultant statement—“the belief that God will do whatever he wants to do will save the sick”—still asserts that the sick will be saved. These difficulties do not rule out the majority interpretation. They simply show how hard it is to explain all of the available data.

Contextual Clues

There might be a more complete solution. Several contextual features favor the perspective that James addresses spiritual weakness or discouragement rather than physical sickness.

The Meaning of “Sick” (astheneō) in James 5:14

James was among the earliest New Testament books written. It has strong connections with the Old Testament in both style and content, and it represents a blend of wisdom literature and epistolary writing. These facts likely influenced James’s word usage. The OT (LXX) never uses astheneō to mean sickness. Instead, every instance refers to weakness. Wisdom passages in Job and Psalms tend to use astheneō to reflect discouragement, depression, emotional weariness, or indecision. Only the Gospels, written after the book of James, use the Greek word consistently to refer to sickness.

Knowing that James follows the genre patterns of OT wisdom literature and that James did not borrow from the written Gospel accounts generates the reasonable inference that James 5:14 may refer to spiritual weakness.

The Meaning of “Sick” (kamnō) in James 5:15

The next word translated as “sick”—appearing in the key phrase “the prayer of faith will save the sick”—occurs only four times in Scripture—twice in the OT (Job 10:1; 17:2) and twice in the NT (Heb 12:3; Jas 5:15). In each instance, this word refers to being “bowed down” or low in spirit. Since spiritual weakness or discouragement is already a well-attested use of astheneō, kamnō strengthens the probability that the passage refers to spiritual or emotional weakness.

The Meaning of “Anoint” (aleiphō)

Oil had several functions in the ancient world. It could have been used for (1) medicine, (2) ceremonial/sacramental anointing, and (3) cosmetic or social function. The third use fits the context best. Oil refreshed those who were weary or weak (often due to the effects of an arid climate and hot sun). In fact, six out of eight instances in the NT use “anoint” to refer to social custom that included cosmetic adornment and refreshment among its purposes (Matt 6:17; Mark 16:1; Luke 7:38, 46; John 11:2; 12:3). Only once is a medicinal or sacramental meaning certain (Mark 6:13). Thus there is reasonable probability that James’s intended use here was as a social convention to encourage and refresh someone who was emotionally or spiritually weak.

Textual Allusions

Having given his terse description of “weakness” and its cure, James introduces Elijah as an illustration. But he does not refer to Elijah’s healing ministry. Instead, he points to Elijah’s prayer regarding rain. This prayer narrative ends in Elijah’s discouragement and flight from Jezebel. The prophet was despondent (1 Kgs 19:4), exhausted (1 Kgs 19:5), thinking irrationally, not exercising his previous implicit faith (1 Kgs 19:10, 14), and feeling completely alone (1 Kgs 19:10, 14). Elijah complained (1 Kgs 19:10, 14) about (1) the futility of faithfulness, (2) the powerlessness of the truth, (3) a feeling of isolation, and (4) fear. This fits very well with James’s description of Elijah as a man of like-passion.

God’s response to Elijah prefigures James’s instruction to the church. God provided physical nourishment (1 Kgs 19:5–7), a point likely paralleled by James’s anointing with oil (5:14). God provided spiritual companionship (1 Kgs 19:5, 7, 9, 13), a point paralleled by James’s call for elders (5:14). God also addressed Elijah’s wrong thinking (1 Kgs 19:11–12, 15–18). Essentially, God strengthened and recommissioned Elijah, told him he was not alone, and provided for his physical needs. These issues parallel James’s requirement for spiritually-mature people to intervene in the life of other believers and deal with their physical, social, and spiritual needs. The fact that James chose not to refer to Elijah’s healing ministry—where such a reference would have naturally and decisively undergirded an argument for healing in the church—calls the physical-healing interpretation of this passage into question.


The view that James addresses spiritual weakness, not physical sickness, is reasonable and theologically consistent with both the immediate context and the rest of Scripture. While physical trials can produce spiritual ones, James’s focus seems to be the faith of his readers, not their health.

The practical implications of holding a spiritual-discouragement view of this text are significant. If James is not addressing sickness, the church has a reasonable explanation for the apparent failure of its own attempts to heal the sick. This fact should not prevent the church from continuing to pray for the sick. It would explain, however, how an unqualified scriptural command and promise have met such stubborn resistance from the facts of historical experience.

Second, believers must seek help when facing crises of faith. Instead of pressing on in lonely silence, believers must accept help in times of spiritual distress. Spiritual weakness is not unusual. In fact, James’s use of Elijah as an illustration proves that even great servants of God can become so disillusioned that they wish to quit. James provides an answer consistent with the rest of his letter: people of faith meet crises of faith by requesting prayer from other believers on their behalf.

Third, James outlines a process of restoration. Spiritual weakness may have roots in physical causes (hence the need for anointing with oil) or in spiritual causes (hence the need for confession of sin). Neglecting either of these areas may leave discouragement intact. Those who are spiritually weak may be so worn down that they are unable to pray effectively for themselves. They need the intervening prayer of others.

Sensitivity to James’s word choice and the immediate (and broader) biblical context give warrant to the position that his real point is “the prayer of faith will rescue those who are spiritually weak.” This interpretation not only resolves the difficulty inherent in the fact that the prayer of faith does not, in fact, lead to healing in most instances of sickness, it also points the reader toward the overall theme of James: the nature and tests of real faith. True faith, even when discouraged and weak, looks to God’s prescribed method for spiritual restoration.

As discussed by Brian Hand on The Steve Noble Show on October 12