"Are Any among You Sick?" The Health Care System in the Letter of James

Abstract

(Proquest Information and Learning: Foreign Text Omitted) Are any among you sick? They should call for the elders of the church and have them pray over them, anointing them with oil in the name of the Lord. The prayer of faith will save the sick, and the Lord will raise them up; and anyone who has committed sins will be forgiven. Therefore confess your sins to one another, and pray for one another, so that you may be healed. The prayer of the righteous is powerful and effective. (Jas 5:14-16 NRSV) This passage from the Letter of James provides readers with a precious glimpse into the understanding of illness and healing in an early Jewish Christian community.1 The author instructs anyone who is sick (...) in the community to call the elders, who will pray and anoint the individual with oil. The passage goes on to speak of the efficacy of prayer for healing and to develop links between sin and sickness, healing and confession of sin (w. 1516). At first glance straightforward, these verses in fact raise a complex of questions for the modern interpreter. Who are the elders who are called to heal, and why does James assume that they have a special healing ability or authority? If the elders are singled out as healers, why does James impute a healing role also to the community as a whole (5:16)? Why is the sick person to be anointed, when prayer alone would seem to be effective for healing (5:15a)? Why does James presuppose connections between illness and sin (qualified in 5:15b) and between confessing of sin and healing (5:16)? In general, what does this passage reveal about James's view of the etiology of sickness: Is it sent from God as punishment or correction? Does it derive from the devil? Does it originate from natural causes? Finally, does this passage provide information about actual, everyday treatment of illness in James's community? These and related questions regarding healing and illness in the community addressed by James cannot be answered in isolation. They are interrelated, and the task of the interpreter is to uncover their connections. To this end, my article adopts a holistic approach developed in medical anthropology: the analysis of a particular culture's understanding and treatment of illness as a care system.2 Recently, Hector Avalos and John J. Pilch have applied this systematic approach to the NT (particularly to Gospel studies); my purpose is to extend this method to the Letter of James.3 My article begins with a brief overview of medical anthropology's concept of health care I then describe some basic elements of the care system in James's community: the symbolic world of James and the understanding of illness and healing within that world, the system's etiology of illness, its therapeutic strategies, the identity of its healers, and its control of access to care. As the article proceeds, I reflect on the interrelationships of these elements within the system. Two notes of clarification are necessary before beginning. First, in applying this approach to James, I do not presuppose a detailed knowledge about the community to which James is written, nor about its author. Scholarship has come to no firm conclusions regarding either authorship or audience.4 The ambiguity about the audience should not be surprising, however, given that scholars such as Richard Bauckham have shown persuasively that James is best understood as an encyclical letter written to a generalized audience.5 Such a letter, then, can supply only generic information about the community (e.g., that there are rich and poor in the community, that there are disputes among factions). I do assume, however, that the letter gives access to the basic beliefs of the community (i.e., the symbolic world shared by an author and his or her audience).6 In discussing the care system in James, then, I presuppose that the letter provides access to generalized social information and, more importantly, to the symbolic world of the community, a conceptual system that includes the community's understanding of illness and healing. …