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We read in James 5:14-16 (NIV);

14 Is anyone among you sick? Let them call the elders of the church to pray over them and anoint them with oil in the name of the Lord. 15 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. 16 Therefore confess your sins to each other and pray for each other so that you may be healed.

But, we see Jesus ruling out the association of sin to the physical deformity/ illness of a person, in the case of the blind man. John 9:3 (KJV):

Jesus answered, Neither hath this man sinned, nor his parents: but that the works of God should be made manifest in him.

My question therefore is: Why does James associate physical ailment to sin?

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James says "If they have sinned …".

This means that sin is a possible cause of illness, not that it is the only cause.

Irresponsible lifestyles are obvious examples of this (e.g. promiscuous behaviour leads to STDs; drug abuse to organ damage; criminal behaviour to physical violence).

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If we read both passages carefully, there is no contradiction:

  • Jesus did not rule out any association of sin with illness, only that we should not overgeneralize or think that this particular instance (The Sixth Sign) is the result of a generational sin. His words are to read in context of the question in v. 2 ("Rabbi, who sinned, this man or his parents, that he was born blind?"). The main point of the whole passage context (John 9) is about Spiritual Blindness.
  • James 5:14-16 is cited in the Catholic Sacrament of Anointing of the Sick which is interpreted and applied as healing both the spirit (forgiveness of sin) and the body. In the Rite, there is no cause-and-effect teaching implied between illness and sin either. If we further read the larger context (James 5:13-20), the main teaching is about earnest prayer by a righteous person (citing Elijah as example) for both repentance and physical healing (symbolized by rain so that the land can again produce fruit), consistent with the import of the Rite.

So when studying the Bible it's extremely important to interpret a verse in the larger context. When using a passage for a theological position it's also extremely important to be aware of the danger of over-generalization or reading non-existent cause-effect into the text.

A plausible answer to "Why does James associate physical illness to sin?" is that although specific sickness shouldn't be linked to specific sin (or sins of one's parents), the whole NT thought background DOES link death with sin (such as in Rom 5:12, Luke 13:1-5). I'm sure James is also aware of the false cause-and-effect committed by Job's "comforters", but would teach that sickness as a prelude of death should drive the sick to "focus the mind on doing business with God in repentance", involving the community of believers in the process because "suffering and sickness ARE caused in a general sense by the sin of mankind as a whole". Quotes are from a 2017 blog article Did my sin cause me to be sick by Adrian Warnock, a UK medical doctor, who offers one proper framing of the relationship between sickness/death and sin.

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