The scriptures referred to are James 5:13-20.
All things in this life have a cause. The cause is either known to us or unknown. The known causes of events may be ourselves, something or someone other than ourselves or a combination of the two. And yet not everyone accepts all of this. Especially when we are talking about suffering.
Though it is obvious that some of our suffering is caused by what we do or neglect to do, as in the case of drinking too much or of not eating our vegetables, there are people who refuse to acknowledge their part in their own suffering. They blame others, or the universe, or God. Equally there are people who blame themselves for everything, such as illnesses or misfortunes that their loved ones suffer, even if there was no way they could have caused it or that they could have prevented it. The first instance is denial; the second is magical thinking.
What complicates matters is when the causes of our suffering are partly our actions or inaction and partly things over which we have no control. Like when we inherit a predisposition to a certain condition, say, a family history of heart disease, and then we do things that ensure it, such as smoke, eat bad foods and refuse to exercise. Your family history is not your fault. However, doing things that exacerbate it or hasten its manifestation in your life are on you. Again some people are born with Type 1 or juvenile diabetes. That's not their fault. But once they find out, if they do not take the proper steps to manage it, like take their blood sugar regularly, take their insulin, watch what they eat, etc. any preventable medical complications are at least, in part, their fault.
Substance abuse works the same way. Some of us are very susceptible, given that it runs in our family or that we have suffered major trauma, especially in childhood. We should take steps not to trigger an addiction. Or, having the addiction, we should get help. Today there are therapies and support groups for just about everything. Again denial of all responsibility is not helpful, nor is taking all the blame and wallowing in helplessness.
In medicine, determining the cause of a disease or disorder helps determine the treatment. They used to think stomach ulcers were caused only by stress. The treatments weren't very effective. My grandmother died of complications following ulcer surgery. Her recovery was compromised partly due to her diabetes and partly due to her smoking. But what's sad is that a few years later an Australian doctor discovered that most ulcers are caused by a bacteria and could be cured by antibiotics. Which is why I don't despair but hold onto to hope that the cause of ME/CFS will be discovered, especially since it is nearly identical to long-haul Covid and other post-viral forms of fatigue many are suffering, including a lot of doctors. Effective treatment depends on determining the actual cause. It's why, if the cause is a virus, you don't treat it with a medicine designed to take care of parasites in a different species.
The human penchant for making everything binary—not my fault or all my fault—complicates dealing with suffering. It doesn't help when people bring that mindset to the Bible. Because you can pick and choose passages of scripture that, taken in isolation, seem to blame all suffering on ourselves, or on Satan, or even on God.
There are passages that attribute some diseases to sin. Like our reading from James. He writes, “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.” Taken by itself, without reference to other scriptures, it seems to imply a direct connection between being sick and sinning. As when the paralyzed man is lowered through the roof by his friends, and Jesus says to him, “Son, your sins are forgiven.” And he is healed. (Mark 2:1-12)
So are all illnesses caused by sin?
No. When they see a man born blind, Jesus' disciples ask whose sin caused his disability, his or his parents. Jesus says, “Neither this man nor his parents sinned, but this happened so that the work of God might be displayed in his life.” And he heals him. (John 9) Notice that not only does Jesus dismiss sin as the cause, he doesn't give an alternate cause. Instead, he sees it as an opportunity to show God's power and grace.
In other cases, Jesus simply says to the person that their faith has healed them, such as with the woman who had been bleeding for 12 years. (Mark 5:34) There is no reference to sin or forgiveness. And significantly, when he is said to have thrown demons out of people, he doesn't mention any sin on the sufferer's part. (Mark 1:23-26) Those people, most of whom we would classify as having a mental or neurological illness, are seen entirely as victims of their affliction. (Mark 5:1-15; 9:20-27) And not all of his healings involved casting out demons. Just like a modern physician, Jesus recognized that different diseases have different causes.
Nor, parenthetically, does Jesus attribute all disasters to sin. He points out that the 18 people killed when a tower in Siloam fell on them were not worse sinners than anyone else. (Luke 13:4-5) Job asserts that none of the disasters nor the disease he suffered were due to sin. And God agrees and sides with Job over his so-called comforters who tried to defend God by saying that bad things do not happen to good people. (Job 42:7) They do. And God's reply to Job implies that it is sometimes beyond our understanding. (Job 38-41)
As a nurse and as a pastor, I have talked to people who thought their illness was a punishment from God. Rather than argue the cause, I asked if they had confessed whatever their sin was to God. They said yes. And I quoted them 1 John 1:9: “If we confess our sins, he is faithful and righteous to forgive us our sins and cleanse us from all unrighteousness.” Then I told them they could stop beating themselves up because Jesus took all the punishment for our sins. In this way I was at least able to help heal their spiritual ills.
Yes, sometimes we are responsible for our suffering. If you get shot doing a drug deal, or hurt in a car crash caused by driving when you're drunk, or break bones trying to do a back flip off your garage roof into a pool while your friend videos it for the internet, then you are simply suffering the consequences for your own decisions and actions.
But if you get injured because a drunk driver hit you, or you're shot by a stray bullet not meant for you, or get sick because someone else has refused to take rather simple precautions to prevent spreading a pandemic, you are suffering the consequences of someone else's actions. It's their fault. But why does God allow you to suffer? Books have been written on this but let's just consider two things.
First, we live in a physical world and so our actions have physical consequences not just for ourselves but for others. We can hug people or strangle them, using the very same hands. We can create medicines or create poisons, using the very same brains. We can comfort someone or make them sadder, using the very same mouth. So what possible mechanism could allow us to do one but not the other?
Second, if you remove the negative consequences to bad decisions and actions, many people will continue to make bad decisions or do bad things. Removing the results would be like magically making it so that a child touching a hot stove doesn't get her finger tips burned. That child will do it again. We try to teach our kids not to do such things to prevent that but sometimes they don't listen. Suffering the consequences drives the lesson home for most. But some people continue to do evil or stupid things despite suffering the consequences. Removing the consequences would not improve their moral or critical thinking and would probably lead even more people to not care what they do.
Nor would we really like that. There is an old Twilight Zone episode called A Nice Place to Visit about a petty crook named Rocky Valentine who feels he never gets a break. He is killed in a shootout with the cops and finds himself in the afterlife. His genial host caters to his every whim. He can drink all the booze he wishes with no hangover. He can have all the women he wants. He can play any gambling game he wishes and he always wins. He can even plan a heist and it goes perfectly. Though he can now indulge himself in any vice without any negative consequences, these activities give him no pleasure. Facing an eternity of this, he tells his host that maybe he doesn't belong in heaven. He ought to be in the “other place.” To which his grinning host replies, “Whatever gave you the idea you were in heaven, Mr. Valentine? This IS the other place!”
Asking God to remove the possibility of evil is asking him either to remove our freedom to think and make our own decisions, rendering us puppets or robots, or to remove the effects of our actions, rendering us impotent and all we do meaningless. As Mr. Valentine learns, you should be careful what you wish for.
Finally, there is the suffering that comes from neither ourselves or others, like natural disasters or certain diseases we don't bring upon ourselves. Some attribute them to the devil. Indeed Jesus justifies healing a woman on the Sabbath by saying, “Does not each of you on the Sabbath untie his ox or his donkey from its stall, and lead it to water? Then shouldn't this woman, a daughter of Abraham whom Satan bound for eighteen long years, be released from this imprisonment on the Sabbath?” (Luke 13:15-16) But if Jesus can release her, why did God permit her suffering in the first place?
There are passages that attribute everything, even things we consider evil like calamities, to God. (Isaiah 45:7; Jonah 3:10) It need not be his direct action; it may be merely that he permits it. Even in Job, Satan is not allowed to do anything to Job beyond what God permits. (Job 1:12; 2:6) So if he is in charge, and allows undeserved suffering, isn't God ultimately responsible for it? And if God is love, what are we to make of this?
I don't want to shut down consideration of the problem by saying things like “God has a plan,” though he undoubtedly does. And it may be that God permits suffering because of some greater good. For instance, the pain of a vaccine shot and the brief unpleasant side effects some of us experience are offset by the protection against severe illness and death it confers. Sometimes pain is an acceptable price for life, as we see in childbirth. Still those kinds of pain are easily related to the positive outcomes that result. Some suffering doesn't seem to be connected in any causal way to any specific good result.
For example, the vaccinations we give babies seem to them totally random painful events permitted by parents who otherwise love them. They can't understand what good it does them. It doesn't seem to bestow any positive benefits, like superpowers. Its effect—not getting horribly sick in the future—is not something they can see. We might be in the same situation as these infants, unable to understand just why our heavenly Father is allowing painful things to happen to us.
The appendix used to be considered worse than useless, with no purpose other than getting inflamed and bursting, spreading potentially deadly infection. Surgeons used to routinely remove healthy ones if they happened to be operating in the lower abdomen. Now we realize the appendix has several useful functions, like storing healthy bacteria and supporting the immune system. Just because something doesn't seem to have a reason doesn't mean it has none. It may be we just don't see it. Or we don't see it yet.
And that may be why God does not always grant us healing. Paul had been given the gift of healing others. (Acts 14:8-10; 20:9-12) Yet in 2nd Corinthians 12 he tells us that he had some unspecified affliction he called a “thorn in the flesh, a messenger of Satan to torment me.” We don't know what it was, though I think it was some vision problem. (Galatians 4:15; 6:11) He says that he asked God on 3 occasions to remove it. “But he said to me, 'My grace is enough for you, for my power is made perfect in weakness.'” (2 Corinthians 12:9) Paul, the brilliant and tireless apostle for Christ, who spread the gospel over more of the Roman empire than anyone else, was reminded he was not in control of everything in his life, not even his body. And he realized it kept him from getting arrogant. (2 Corinthians 12:7)
And as C.S. Lewis points out, the existence of evil makes possible what he calls “complex goodness.” In a perfect world you can exhibit simple goodness, like being nice. But only in a world with evil and suffering can there exist forms of goodness like courage, comfort, healing, peace-making, forgiveness, self-control and self-sacrifice. These are the tools God gives us with which to face suffering and mitigate or alleviate it.
Nor is God a stranger to suffering. Through his Son, he knows hunger, thirst, exhaustion, betrayal, ridicule, pain, loss and death. Whatever relationship God has to the causes of suffering, on the cross he took his own medicine. After an eternity in the presence of the Father, the Son of God even experienced separation from him. He descended into the hell of abandonment by God on a more profound level than any of us with a temporal relationship with the divine can ever experience. And he did it for us. His suffering served the greatest purpose of all: to save us from suffering the full extent of the consequences of our sin, that same separation from God, the source of all goodness.
In the last book of the Bible, we are given a glimpse of a new heaven and a new earth, a new creation for people who are new creations in Christ. And we are told, “God himself will be with them. He will wipe away every tear from their eyes, and death will not exist any more—or mourning, or crying, or pain, for the former things have ceased to be.” (Revelation 21:3-4) And that's what keeps me going. I will endure mourning and crying and pain and even death in this world if it means that one day they will be no more forever. And on that day, at least some of the tears Jesus' scarred hands will wipe away from my eyes will be tears of joy.