Thesis statement: Anointing with oil is properly understood as being only for those who believe they are sick due to some sin they have committed, and the anointing itself is a superficial sign or symbol, since it is the prayer that saves and heals. If anyone wants to be anointed with oil, he must confess the sin that he feels he needs cleansing from, and then be anointed.
James 5 opens with a few lines of advice. "Is anyone among you suffering? Let him pray. Is anyone among you cheerful? Let him sing praise. 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."
What does this commandment really mean? Should today's church still be anointing people with oil?
To answer that question, I think we need to look at what anointing means. Exodus 30 actually gives very detailed instructions for how to make this anointing oil; it involves olive oil, cinnamon, and a few other nifty things. Moses is instructed to pour it all over Aaron, the priests, and everything that they touch in their priestly duties: "You shall consecrate them, that they may be most holy. Whatever touches them will become holy." That's the purpose of anointing; it's a symbol that something is being made holy. In case you're fact-checking my passage there, and you happen to read the commandment not to pour this oil on an "ordinary person" but only on the priests, don't flip out. We as Christians are all priests. 1 Peter 3 refers to us as "a royal priesthood, a holy nation" and Hebrews explains that we don't have to go through priests to get to God the way the Israelites used to, because we have direct access to God through the person of the Great High Priest, who is Jesus.
This is also why we ordinarily have no need of anointing oil today. We are already holy, already consecrated, as a result of our sins being forgiven through Christ. We don't need to be consecrated like the Hebrews did, because we are new creations in Christ, already holy and righteous (see 2 Corinthians 5).
The bigger question, though, is why we're suddenly talking about the use of oil for curing illnesses, something it had never been used for in the entire history of the Bible. The answer is obvious. If oil is used to make something holy, then the sickness being cured with it must have something to do with holiness - or a lack of it. In other words, we are not talking about physical sickness at all, because that's not what oil is used for. We're talking about inward sickness, unholiness, and the outward sickness is merely one symptom of the deeper inner problem.
1 Corinthians 11 explains that it's possible to get sick as a result of sin. Paul chides the Corinthian church for taking the Lord's supper wrongly, and then goes on to explain, "This is why many of you have fallen ill, and some have even died." Not every sickness is caused by sin - please understand this. Sickness is often simply a consequence of living in a fallen world surrounded by germs and bodies that break down. It is not always judgment for sin. Sometimes, though, it is, and it is this kind of sickness that James is talking about. If oil - consecrating, holy-making oil - is the medicine for the sickness, then the sickness must be caused by a lack of holiness.
In other words, he's not talking about anointing someone every time they come down with the flu. He's talking about someone who knows that they have not been acting in holiness, and has suffered judgment as a result. Please understand that this person has not stopped being holy in God's sight. The blood of Christ has washed away all sin, past, present, and future. However, they have not been practicing holiness. If they know it, and they know that their sickness has been caused by this lack of holiness, then the solution must involve consecrating oil.
Further proof for this idea comes from the fact that James' very next instructions are: "Therefore, confess your sins to one another and pray for one another, that you may be healed." The outward physical sickness is tied to sin. If the sin is confessed, the sickness goes away and healing occurs. You will note here that the oil serves no purpose at all. James says that it is the prayer, offered in faith, which saves the sick person, and that the fervent prayer of a righteous man is powerful and effective. The oil itself is merely a sign or symbol to show the cleansing, the reconsecrating, that is accomplished by prayer and taking place in a person's heart.
So, then, the person who wants to be anointed must believe that he is sick due to some sin in his life. In order to be fully cleansed, he must confess this sin to the elders who have come to anoint him. I can imagine this being a painful and awkward process, but it is necessary. Sin practiced in private is hard to stop; we all know this. Darkness flees the light. Only by bringing sin into the light can we be rid of it, and the light in this sense means the knowledge of other people - a few trusted others, the elders, not the whole congregation. Then the elders pray for him, and this prayer brings forgiveness. Forgiveness addresses the inner sickness, the unholiness, and since the outer sickness is only a symptom of the inner, it as well goes away once the unholiness is resolved.
In summary, this passage is only talking about people who believe they are sick due to some sin they have committed. (They might be wrong - James says "if he has committed sins," indicating that the person may not have, and his sickness may be mundane.) Oil is not used to help illnesses; oil is used to help unholiness. That means the person must be cleansed of unholiness. This includes confessing the suspected sin to the elders, having the elders pray for the person, and then having the elders pray for the person, because "the fervent prayer of a righteous man is powerful and effective" (James 5:16b) and "The prayer of faith will save the one who is sick (James 5:15a). The oil itself is a purely ceremonial, symbolic substance which has no part in actually cleansing or forgiving a person; James says that only prayer does those things.
Should we be anointing people with oil today? In certain limited situations, yes. If we run into such a person, who believes that he is ill due to some specific sin he knows he has committed, then we can give this person the opportunity to confess his sins to the elders of the church, who can pray for him and then anoint him with oil. Use of it in any other situation is utterly contrary to both the teaching in James and the whole counsel of Scripture teaching that oil is only used for making things holy; since we as believers are already holy due to the blood of Christ, the oil for us is strictly symbolic. The emphasis in James is on exposing sin and purifying the sick person from sin through confession and intercessory prayer - not at all on pouring a liquid over his head.
The one unresolved question is: how do I know when I am sick due to a sin in my life, and how do I know when it is just a mundane illness? I don't really have an answer because I haven't been in that situation, as far as I know, so I don't know what it feels like. I suspect that you'll just know; the Spirit of God will make it known to you. However, I think this kind of thing is exceedingly rare. When you consider the amount of sin that each of us live in daily, sins of greed and gluttony and jealousy and sexual perversion and promoting injustice - many of which we commit simply by living in America and treating ourselves to such a high standard of living while so much of the world suffers - we have to admit that God does not judge people with sickness very often at all. I think it is probably reserved either for gross perversions of God's truth, such as the Corinthians mistreating the Lord's supper, or else sins that a person has skillfully hidden for so long that the sin absolutely will not go away unless it sees the light of day, and the person has no intention of bringing it to the light of day unless somehow forced. This is guesswork up to a point; what I am saying is that this is very rare and will probably never happen to any of us. We certainly don't want it to, at any rate, because our goal is pursuing the upward call of God in Christ Jesus, and as long as we focus on that, we need not worry about what will happen should we fail to do so, because God will not let us fail to be conformed to the image of his son.
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