Trials or hardships is the first subject that James addressed in his epistle (1:1-12). He returned to that subject in the last chapter (5:1-11). In chapter 1, he indicated that as Christians we will encounter many different kinds of trials, and in chapter 5 he specifically refers to persecution and offers the prophets as examples of those who patiently endured the suffering of persecution.
James begins the last passage of his epistle (5:13-20) by posing a series of questions to his Christian readers who expected to experience trials. “Is anyone among you suffering?” “Is anyone cheerful?” “Is anyone among you sick?” The suffering should pray. The cheerful should sing. The sick should call for the elders of the church to pray for him. Sickness is certainly one of the trials of life that we should expect to encounter. The sickness here has so seriously weakened the person that he appears unable to go to the elders but they must come to him. They are to anoint him with oil and pray for his healing. In response to their prayers of faith the Lord will raise him up. It is possible that his sickness has occurred because of sin and if so, his sins will also be forgiven. The admonition to confess sins to one another in this context may indicate that his sins may have been committed against others in the church (see 5:9). It appears that these sins must be confessed before healing can occur.
The faith of the elders is emphasized in this passage. Their prayer of faith is said to “save the sick” some of which were sick because of sin (see 5:19-20). “The effective, fervent prayer of a righteous man avails much.” Elijah is given as an example of one who prayed earnestly. We should be encouraged in our prayer lives given that Elijah was no super saint, but a man with a nature like ours. He was subject to discouragement, doubt and depression and yet God used his prayers to accomplish His purposes.