Meaning of "sick" in James 5:14

What is the Meaning of "sick" (astheneo) in James 5:14?

Options	Biblical Usage	Commentary/Lexical	Advantages/Disadvantages
Physically sick or ill	Mt. 10:8; 25:36, 39; Mk. 6:56; Lk. 4:40; Jn. 4:46; 5:3, 7; 6:2; 11:1, 2, 3, 6; Ac. 9:37; 19:12; Phil. 2:26, 27; 2 Ti, 4:12	Bauer, Kittel, Kent, Moo, Hiebert, Kistemaker, Davids, Adamson, Burdick, Henry, Mayhue	The word always takes on a physical weakness in the Gospels. James, writing before the other epistles, was most influenced by the teachings of Jesus. Anointing with oil, mentioned only twice in the NT in reference to healing (Mk. 6:13; Lk. 10:34) clearly indicates a physical healing. *iaomai ("healed"-vs. 16) is commonly used in the NT for physical healing (exceptions: Heb. 12:13; 1 Pet. 2:24). * Translation Support: NAS- "sick," KJV- "sick," NIV- "sick," YLT- "infirm," NJB- "ill," NLT- "sick" and ASV- "sick" BUT- Why call for the elders? Yes, some physical sickness could be the result of sin (1 Cor. 11:30; 1 Jn. 5:16) and pastoral care is always necessary, but wouldn’t a doctor (Col. 4:4)/gifted healer (1 Cor. 12:9) be more of a priority? It seems other "sicknesses" would precipitate a greater need for spiritual support from the spiritually strong. Also, would not the sickness and a needed pastoral visit be rather obvious? However, a spiritual weakness is often more difficult to publicly detect precipitating the need to "call."
Physical weakness of any kind	Rom. 8:3; 2 Cor. 11:21, 29; 12:10; 13:3, 4, 9	MacArthur, Hayden, Armerding, Winter	The verb translated "sick" in 5:15 is kamno. Hebrews 12:3 (only other occurrence) translates the verb "weary" and there is no doubt that this does not refer to a physical sickness or sin. Although this word is used in secular literature to refer to an illness (and even death) at times (see BAGD, 402), its primary usage pertains to growing weary or becoming fatigued (Thayer, Bullinger). Astheneo is almost always translated "weak" in the epistles. Since these folks are spiritually weak, they are to call for the elders, the spiritually strong (c.f. Gal. 6:1). Astheneo (negative form, alpha-prefix) comes from the verb sthenoo, which means, "to strengthen." The Lord promises to "restore" (sozo) and "raise…up" (egeiro) the sick person. This promise is only universal on a spiritual and not physical basis (2 Cor. 12:8-9). Lexical Support: BAGD- "To be weak, powerless," KITTLE (Ab)- "Weakness of any kind," STRONG- "To be weak, feeble," UBS- "Be sick or ill; be weak," FRIBERG- "Be weak, powerless," LN- "To be in a state of incapacity or weakness" and LS GREEK- "To be weak, feeble, sickly."
Unsaved or morally weak	Rom. 4:19; 14:1, 2; 1 Cor. 8:11, 12	None	Certain Greek words in these verses are commonly used in the NT in a spiritual sense: sozo* (15) "restore," egeiro (15)- "raise him up," iaomai (16)- "may be healed" BUT- These people already profess to be in Christ ("anyone among you"-5:13, 14) BUT- The condition clause in verse 15 makes sin only a possibility. BUT- When astheneo is used of spiritual weaknesses the meaning is made clear by a qualifier (i.e. "conscience…weak"- 1 Cor. 8:12, "weak in faith"- Rom. 14:1) or by context.
Weak economically, in need	Ac. 20:35	None	BUT- Though in the context (4:13-5:6), these people would have little need for the elders’ anointing and Lord’s restoration.