Does Sin Cause Sickness?

A couple of years ago when I was preaching through the letter of James, a church member asked if we were going to be looking at “the dodgy bit at the end,” by which they meant these final verses of chapter 5:

Is anyone among you in trouble? Let them pray. Is anyone happy? Let them sing songs of praise.  Is anyone among you ill? Let them call the elders of the church to pray over them and anoint them with oil in the name of the Lord.  And the prayer offered in faith will make the sick person well; the Lord will raise them up. If they have sinned, they will be forgiven. Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous person is powerful and effective. (James 5:13–16)

3 Things This Passage Can’t Mean

As with any “difficult” text, it helps to rule out what it can’t mean.

1. James isn’t describing the Roman Catholic practice of extreme unction, or last rites.

A careful look shows this can’t be what James has in mind. First, the confession James calls for is “to each other,” not to a particular leader or priestly figure (v. 16). Second, and more importantly, the passage gives the expectation that the sick individual will not die but rather recover (v. 15).

2. James isn’t talking about healing rallies or particular people having healing ministries.

For starters, the ministry James describes seems to take place in the sick person’s home—not at a rally or church meeting. Further, the initiative to receive ministry comes from the person suffering. They call for people to pray for them. And it’s run-of-the-mill elders who are called for, not some specially gifted “healer.” Whatever James is describing, he’s certainly not talking about a healing service. Further, James isn’t teaching that believing prayer will always lead to healing, since that doesn’t fit with the wider teaching of the Bible (for example, see 1 Tim. 5:23).

3. James isn’t describing only spiritual restoration.

Some have argued for an understanding of James 5 that does away with any suggestion of miraculous healing. The word James uses for “illness,” they argue, could mean “weakness,” and being “made well” could mean one is “strengthened.” Hence they will eventually be raised up (James 5:15)—that is, resurrected at the end of time. This reading is certainly possible, but I think it’s unlikely James has this in mind. While we want to avoid an unbiblical overemphasis on miraculous healing, it’s stretching the text to suggest there’s no mention of it here.

We can and should rule out these interpretations. This is helpful; for, as Sherlock Holmes often said to Watson, eliminate the impossible and what remains, however unlikely, must be the truth!

Connecting Sickness and Sin

It’s vital to understand the context in which this discussion of sickness and healing takes place. The pressing issues that occasioned the letter are spiritual drifting—James has called it “double-mindedness” and “spiritual adultery”—and the need to return to God in wholehearted faith. In chapter 5, James seems to identify sickness with sin, and healing with repentance:

The prayer offered . . . will make the sick person well [literally sosei, “saved”]. (5:15)

Confess your sins . . . so that you may be healed. (5:16)

Notice the results appear the “wrong way round” here: the sick person is saved, and the sinner is healed. Ordinarily, we’d expect the sick person to be healed and the sinner saved. But James is drawing a connection between the person’s sickness and sin.

The New Testament urges great caution in making this sort of connection. In general, sickness is part and parcel of life in a broken and fallen world. It’s part of the fallout from our collective rebellion against God, and in that sense is indiscriminate (see John 9:1–3). But there are a few occasions in the New Testament where sickness results from sin. For example, Jesus warned the healed invalid: “See, you are well again. Stop sinning or something worse may happen to you” (John 5:14; cf. 1 Cor. 11:30). Instances of sin-prompted sickness are meant to provoke repentance, so the fatherly discipline can be lifted.

This makes sense of James’s instructions. In the context of enormous double-mindedness among God’s people, James urges the sick to call for the elders precisely because it may be a matter of spiritual discipline, where Christian leadership is required. The elders are then to pray for repentant sinner’s health to be restored. If the sickness is indeed divine discipline, it will be lifted; the sick person will be made well (James 5:15)—both in body and spirit.

Anointing with oil is an appropriate practice in such a situation, since anointing in Scripture symbolizes being set apart and consecrated to God—given over fully to him and his purposes. This is exactly what repentance should mean for the double-minded.

Again, we must be careful. Most sickness does not arise from personal sin, and Scripture cautions us against making glib connections between the two. We must make no assumptions. In certain contexts of collective double-mindedness, some sickness can be part of God’s disciplinary plan. It’s wise, then, to practice self-examination when we are sick. If and when we become aware of specific sins we haven’t been repenting of, it’s appropriate to involve our church elders in the way James outlines. Healing is not automatic, but—much more importantly—forgiveness is.

One-Another Ministry

There is another, broader application here. Confession and repentance involving church leaders will be necessary in some situations, but James also commends this as a “one another” ministry (James 5:16). Repentance is a church-family concern, and we are all involved. We each have a responsibility to one another in this area.

It’s essential, then, to have the kind of friendships where we can share our struggles. We need friends to whom we can confess major and persistent sin, and we need to be humble enough to do so. And we simply won’t be positioned for this unless we spend time cultivating meaningful, safe, open friendships with others in our covenant family.

Also, others must feel comfortable enough with us to confess their sins. Are you someone others find approachable? Are you known to be sensitive, gentle, and trustworthy? Would a friend at church be wise to share a painful and shameful sin with you? Would you know how to respond, and how to pray for them? Or would you excuse or belittle the sin, or condemn the confessor? If, as James instructs, we are to confess our sins to one another, we must do all we can to create a culture in our churches that makes this possible, so that it becomes a normal part of body life.

Editors’ note: This is an adapted excerpt from Sam Allberry’s new expository guide, James For You: For Reading, for Feeding, For Leading (The Good Book Company, 2015).  

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