When should the sick call for the elders of the Church? <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
This question is raised in view of the teaching found in James 5:13-20.
Please read the passage in its entirety: 
13 Is any one of you in trouble? He should pray. Is anyone happy? Let him sing songs of praise. 14 Is any one of you sick? He should call the elders of the church to pray over him and anoint him 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 him up. If he has sinned, he will be forgiven. 16 Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous man is powerful and effective. 17 Elijah was a man just like us. He prayed earnestly that it would not rain, and it did not rain on the land for three and a half years. 18 Again he prayed, and the heavens gave rain, and the earth produced its crops. 19 My brothers, if one of you should wander from the truth and someone should bring him back, 20 remember this: Whoever turns a sinner from the error of his way will save him from death and cover over a multitude of sins."
From this text, we learn that sickness and sin will be part of the life of the Church. We are not promised perfect health or sinless perfection in this life. Some day the dwelling of God will be with his people in such a way that sickness and sin will be banished. On that day, "God will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away." (Revelation 21:3-4). Until that day, we groan and long for the completion of the work God has begun in and among us (Romans 8:18-30).
Because of the realities of sickness and sin, God outlines his plan for dealing with them. James 5 offers one part of that plan. The text begins with reference to a sick person calling for the elders of the Church. This implies some type of official involvement of the leadership of the Church. It seems best to understand this as a case of sickness needing the attention of the elders in some official way. This is not an invitation for each person to call the elders for every possible occasion of sickness.  If that were the case, the elders would function more like doctors and be overly focused on this role.
Instead, several things in the context lead us to believe that the sickness mentioned has a relationship to some specific sin. There is a reference to the possibility of sin (15), confession of sin (16), Elijah praying in relation to the sin of the people (17-18), and reaching out to those (sinners) who wandered from the truth (19), turning a sinner from the error of his way (20). This emphasis on sin in connection with a call for the Church leadership could be understood to imply a situation involving Church discipline that has led to a sickness in the life of the one under discipline.
The sick person mentioned in this text does not call for people with gifts of healing but for the elders. The elders do two things: "pray over him and anoint him with oil in the name of the Lord" (14). If the sick person is made well it is the Lord who raises him up in response to the prayer offered in faith (15).  After this point, the text connects the focus on sin mentioned above. It is significant to notice that in a more general way, James 5 instructs prayer for yourself when suffering (13) and prayer for each other: "pray for each other so that you may be healed" (16). It is not only the elders who must pray.
Another reason to relate this text to a matter of Church discipline is the emphasis on the certitude of the outcome: "…the prayer offered in faith will make the sick person well; the Lord will raise him up" (15). There is nothing unclear about this language. The confidence of healing has been a source of confusion to those who have made a more general application of this text. If, however, it relates to a specific case of discipline and a resulting sickness, the prayer would be very focused and offered in the context of confession of the sin that occasioned the official act of discipline. This would also contribute to the emphasis on "the prayer offered in faith" (15) (relating more generally back to James 1:5-8).
If the circumstance of James 5:14-20 is not one involving specific sin and/or Church discipline, it would at least refer to someone who is "…so weak and bedridden that they can't get out easily to the gathered church. We see this condition in the phrase "pray over" (probably signifying their being on a bed with the elders around); and we see it in the statement, "the Lord will raise him up" (implying that they are laid low). So the situation when the elders are called probably involves a physical condition that keeps a person from getting out to the fellowship." (John Piper).
If a more general application is taken, it is best applied to the situation described above or to extremely severe sicknesses. In such cases, however, the elders should honor the context of James 5 in relation to potential sin. The one seeking prayer based on James 5 should be instructed of the potential sin in relation to sickness in the context and offered an opportunity to respond.  
Those who are not bedridden or facing severe sickness of this nature should be encouraged to seek the prayer of the Church when they gather for fellowship. Church elders should also faithfully pray for those who struggle with sicknesses when they gather as a leadership team.
Finally, use of oil for anointing is an optional part of the equation. The text emphasizes that "the prayer of faith" is what God responds to. There is no power in the oil. If not for medicinal purposes, the oil was used symbolically with reference to God's presence. Mention of anointing with oil is found in relation to the healing ministry of the apostles (Mark 6:13), but is not found in most accounts of healing by Jesus and his disciples. Some churches choose to continue the tradition, others like our own do not anoint with oil.  
Steve Cornell