"therefore confess your sins to each other and pray for each other so that you may be healed." (James 5:16, NIV'78)παραπτωματα ("paraptomata") is broken down into the following components:εξομολογεισθε αλληλοις τα παραπτωματα και ευχεσθε υπερ αλληλων οπως ιαθητε
exomologeisthe allelois ta paraptomata kai euchesthe uper allelon opos iathetebe out-same-wording to-one-another the besides-fall/slip-effects and be-vowing over one-another so-that you-may-be-cured
The "-μα" ("-ma") is important here, and you don't really see that in the translations. That makes the word not refer to the thing, but the "effect" of the thing.
In fact, if you take the "-μα" ("-ma") away from the word, you get the word παραπιπτω ("parapipto"), which just means "beside-fall/slip." Even James Strong missed that. Compare Strong's G3900 to G3895.
But the "-μα" ("-ma") makes it "beside-fall/slip-effect," or "shortcoming-effect," as would be better translated into English. The KJV renders it "fault," which I think is the right base word but, again, it really isn't the "fault," but the "fault-effect," the "effect" of the "fault," or "shortcoming."
Now, the way this fits back into the passage so beautifully, is that in context it is talking about sick people going to elders to get healed. The healing is depicted as a guarantee, based on the faith of the elder. Some sacred cow teachings just quote James 5:16 in isolation, out of context, to try to say that a person can't get healed if he has sin or unforgiveness or something like that, but we know this isn't true, since both sins and healing are paid for and therefore guaranteed, based on faith in what Jesus did, faith that God's Word is true.
That said, willful sin, unforgiveness, bitterness, among many other things, like fear, grief, and so on, are perfectly capable of getting one sick, sowing and reaping sickness. Even unbelievers know this. And believers should recognize that these things represent a lack of faith in God to begin with. That is another issue, the issue of getting sick. But regardless of how you got sick, healing is guaranteed, because Jesus paid for it in full. Believers will lay hands on sick people, and they will get well (Mark 16:18).
So, now you should start to see the connection to the context, and it is simple: A sick person needs to confess, not the sin or fault or offense or shortcoming, but the effect of it, so he can be prayed over to be healed. It is that simple.
Unfortunately, this is yet another case where the translators leave out the little detail (the "-μα" tag), because the whole word cannot be easily translated without being awkward. There is no single English word for "besides-fall/slip-effect."
Here's the implication: You have the sacred cow doctrines that want to look at the "root" of a sickness, or what caused it, in order to get a person healed. But the "-μα" ("-ma"), those two little Greek letters in the word, make it so that we are not talking about the "root" of anything, but the "effect" of it. The "effect" is that they are now sick. The effect is the manifestation of pain, the physical problem, or whatever. The sick person need only confess that, so that the elder or person praying over him can address it.
Also see
Footnote: See this link for my discussion of the παραπτωματα vs. αμαρτιας manuscript discrepancy.
I grant this work to the public domain.