For pastors

1. Within the hearing of a sick person, even if in a coma, the pastor should exercise the principle of careful speech.

The faithful and concerned minister of the gospel is entrusted with the communication of the same in the most effective manner. This happens practically through the means of preaching (to a sizable audience) and sharing it quietly (to individuals).

When a person is sick and confined to a bed, he is more conscious of his transience and weakness than at any other time. The minister visits him not to ease his conscience of having done his duty, but with a very specific aim in mind. That is to strengthen and comfort him in his faith (if he is known to be already a believer); and in the case of a lost person, to be able to share the way of salvation with him.

Our tongue shows our inmost thoughts and life; it must be guarded at all time and never give in to frivolity, much less in hospital or in the house of the sick. The way we speak, for how long, in whose presence, are all factors to be taken into account. If the sick is fully conscious, then a pastor may feel more at liberty to expound his heaven-sent message. If he is in a coma or visibly suffering, then the case calls for a concise presentation, with tenderness, sensitivity but with all clarity.

The eternal destiny of the sick person must be brought up, lovingly encouraging him to face the issues and reminding him that life, eternal life, is found only in the Lord Jesus Christ. This is the spiritual help, the best and ultimate succor, that the pastor can give. Having the message is one thing; delivering it with due sensitivity is another. In hope he must believe that the sounding forth of the gospel will not be in vain; God will surely accomplish his purpose through it.

2. It is important to speak plainly about sin and hell, even to the so-called lovable rouge, even on his death bed.

The minister of the gospel is never to be a man-pleaser. He is a steward of the mysteries of God; a herald to warn of the wrath to come and an announcer of good things through the God-appointed deliverer, Jesus Christ.

Even well-meaning Christians would most of the time prefer to brush aside "religion" when the crisis presents itself. They would prefer to lay down their arms in a truce, and "not to speak about it." Thus they were friends and remain friends.

But a pastor worth his salt is not to behave like that. He is a firm believer in the righteous God, who is a consuming fire, who will by no means clear the guilty. He knows the deceit of those who speak about mercy for everyone, indiscriminately. Mercy indeed, but mercy comes to us through the Son. He who has not the Son has not life. The pastor knows this, and is willing to shake the status quo; and even though it be a death-bed, he will find the ways and means to approach the lovable chap (who, being Christless, is heading for eternal punishment) and seek to bring up before his understanding and conscience the issue of life and death. "Behold I set before you today life and death: choose life, that you may life."

To do this a pastor must be bold, Spirit-filled and seeking the honor of the One who sent him. Christ is the Saviour from sin and its hideous consequences and ultimately from hell itself; but the issue must be brought up and faced by the individual even if he is on the brink between life and death. And if he is to be saved, he must repent in order that he might believe (Matthew 21:32).

If the issues of sin and hell are brushed aside, for the sake of politeness and courtesy, then the pastor would be confirming the sick in his transgressions and sealing him, so to speak, in his impenitence and eternal damnation.

The Christian gospel pricks and even wounds before it heals. The first stage should never be minimized or skipped. The pastor is called to spearhead the awesome spiritual battle taking place around and in us all. Often he is the sick man's last resort; and if he fails there, who else would care?

3. The injunction "to visit the fatherless and widows in their affliction" may not be laid aside.

James presses upon the Christian assembly, and particularly its elders, the prime importance of faith being shown or expressed through works. Works of charity and a holy conversation must be evidenced in the truly religious that their profession of the gospel might be proved to be sincere and blameless.

Obviously he does not set down the whole nature of the Christian faith, but only some concrete testimonies concerning it. True religion also requires faith and worship, but the truth of these is made clear by a charitable and holy life.

Visitation of the needy is pin-pointed: the duties and labour of love find a wide field here. To visit signifies to comfort them in their misery, but not simply by speaking tender and compassionate words, but much more than this, to actually relieve them in their misery, to provide for their necessities as the opportunity presents itself.

Orphans and widows, more in the first century than today, are objects of charity, as are also the poor, the sick, the captive in prison, and the stranger, which are all mentioned throughout the Scripture (e.g. Matthew 25; Psalms 146:9; Proverbs 15:25; 23:10). But the fatherless and widows are most usually liable to be neglected and to suffer oppression from society at large.

"Let him that stole steal no more: but rather let him labour, working with his hands the thing which is good, that he may have to give to him that needeth" (Ephesians 4:28). The so-called Protestant work-ethic comes into play here, and the pastor is to be the exemplar in all this, how we are to influence society for the glory of our heavenly Father.

In this way, having the spirit that motivated Wilberforce and Carey (in succeeding to abolish the Indian law of widow-burning), the Christian ministry would be the epitome of fulfillment of Jesus’ words, "Ye are the salt of the world."

4. The role of a pastor in a stress situation: what should he look out for and what can he do?

Stress is the sinful human reaction to change. It results in suffering, pain or disease. Outside pressures constrain the person to some sort of answer to his situation; the results, if not tackled the biblical way, is to be all stressed up.

The ambitious and the worriers are at high risk of physical illness. Only Christian conversion and the life in the Spirit gives new motivation, new direction and new status. Growth in grace aids in self-knowledge, and lead to modifying some traits and learning new patterns of living. That's why is so important for the elders to see that the church is being taught faithfully the Word of God.

The results of harmful stress include anxiety in its many forms. Symptoms of depression may follow any loss. Prolonged harmful pressures lead to stress-related disorders like high blood pressure, thyroid problems, neurodermatitis, colitis and peptic ulcer. These are to be pointed out.

No-one is exempt from stress, and Christians are often subject to extra pressure because of high expectations. The workaholoc, continually on the go, needs to be reminded tat God has ordained a period of rest, one day out of seven. The pastor should also remind his people that regular rest, both daily and weekly, and holidays and retreats, are good and tend to cater towards a holistic view of the human being. Time off to relax and to enjoy recreation and refreshment is a self-evident human need: witness Jesus who told his disciples to go to a private place and rest a while. Burning out for God, pious as it may sound, is not wise.

The pastor should then look of for signs of physical hangover, weaknesses, lack of alertness, despondency, signs of depression, in all the members of his flock. He will then be able to minister the Word to them according to their particular need, teaching them, among other things, the value of arguing with themselves, such as we find in the Psalms, "Why are you downcast, O my soul?" (42:5,11; 43:5). And also pinpoint the solution, of trusting in God and continuing in obedience to him.

Many times, in dealing with such situations, the Christian may need to be referred to his medical doctor for a complete physical check-up. Lack of sleep, an unbalanced diet, and other factors, corrected, will help immensely.

But at no time may a pastor refer God's people to the psychiatrist, for the latter's profession actually undermines the Christian ministry. Through the Scriptures and the ministration of the Spirit the pastor is fully equipped for the task. He should see to it that he is fully competent to give counsel and help.

5. Is the pastor a righteous man whose prayer is effective?

In James 5, the phrase righteous prayer indicates that the one offering prayer and intercession is to be leading a distinctively holy life, in conformity to the Law of God, the pattern of all righteousness. It is prayer issuing out of the heart of a God-loving person who seeks to please his Redeemer in every respect. It is a Spirit-motivated prayer.

6. The need of fervency in prayer, especially in a pastoral visitation of the sick.

James 5:16 reads: "The effectual fervent prayer of a righteous man availeth much."

The author uses a sublime and emphatical form of expression that a translation will hardly convey. It is the form of prayer wrought in us by the Holy Spirit, as being possessed of Him. It is an excited prayer, implying the efficacy and influence of the Holy Spirit, and the force and vehemence of an earnest spirit and affection.

This is how true prayer should be, the prayer that moves mountains, the prayer that brings down the fire. It is the kind of prayer compared to wrestling with God, Genesis 32:26 and Hosea 12:4. It is the way of prevailing. Other kinds of prayer, though they may fill the vacancy of the moment and fulfill an expected duty, do not accomplish anything before the throne of grace.

It is the kind of prayer that resembles immodesty and would take no denial, Luke 11:8; importunate prayer. It is language in groans, and sighs are articulate. But we should beware that our earnestness does not arise from fleshly lusts and concerns. The sacrifice of prayer and thanksgiving is not to be burned with strange fire.

We are to lift our affections up (Psalms 25:1) but once that are up, it is hard to keep them up, like Moses' hands, that needed support.

In prayer we should not only look after the qualification of the duty, but of the person. God first accepts the person (the example given is Elijah), and then the duty. On of such is the prayer said to avail and succeed.

In visiting the sick, oftentimes what happens is a mechanistic recital of some mumbled prayer, quick and formal. Formality is as killing in true religion as anything. It is no better than the scribes' praying "as a pretext." Such an attitude is to be jealously guarded against. In sickness the Lord brings us face to face with our frail frame and teaches us our weakness. It is the situation where our spirits are invited all the more to soar towards Him, and to be renewed like the eagle's, even though the body may be dejected.

We do not pray so that others will be impressed; that's what the Pharisees used to do, and were condemned for such practices. But this does not mean that we are excused not to pray with the sick person just because there are lost relatives close by - Paul thanked the Lord for bread in the presence of all while on the ship (Acts 27). Our relationship with the Lord, if it is vital and strong, will not be hindered by the mocking and whisperings of others. God desires to be acknowledged and truly worshipped even in adverse circumstances.

If it is not fervent prayer, then the integrity of the asker is brought into question. Peter's "Lord, save me," was certainly fervent; he wanted to be saved above everything else. And that's what he asked for. Does the pastor really believe the Lord will heal the patient?

It must be fervent prayer, for only fervent prayer is the heart-cry to God from whom alone comes our help. Fervent prayer spells a humble spirit, broken and all-dependent on the Father of spirits. Fervent prayer is the cry of a child, lost in darkness and appealing for deliverance. But certainly fervent prayer does not mean shouting and screaming, as sometimes I've heard happening in charismatic circles.