The term “Theological Triage” was introduced in 2005 by Albert Mohler1A Call for Theological Triage and Christian Maturity. Finding the Right Hills to Die On: The Case for Theological Triage (The Gospel Coalition) by [Gavin Ortlund, D. A. Carson]It is a “system of prioritization”2Gavin Ortland, Finding the Right Hills to Die On: the Case for Theological Triage, 2020 . Since I have spent most of my life in theological education, on one side of the desk or the other, this is an important issue for me. Distinguishing the relative importance of theological issues has been a very practical task in navigating relationships with others in ministry. Furthermore, the metaphor of triage resonates from the time I spent serving as a volunteer EMT for many years. So, when the Gospel Coalition published Finding the Right Hills to Die On: the Case for Theological Triage by Gavin Ortland earlier this year, I added it to my reading list. Though the book does not directly address missiological issues, its relevance to cross-cultural workers is underscored by the cross-cultural examples mentioned by D. A. Carson in the preface.3Ortland, 11-14.

Four categories

In the Introduction, Ortland spells out the categories of his fourfold ranking for theological triage:

  • First-rank doctrines are essential to the gospel itself.
  • Second-rank doctrines are urgent for the health and practice of the church such that they frequently cause Christians to separate at the level of local church, denomination, and/or ministry.
  • Third-rank doctrines areĀ important to Christian theology, but not enough to justify separation or division among Christians.
  • Fourth-rank doctrines areĀ unimportant to our gospel witness and ministry collaboration. 4Ortland, 19.

Why Theological Triage?

The book is divided into two parts: 1. Why Theological Triage? (chapters 1-3) and 2. Theological Triage At Work (chapters 4-6). The first two chapters address the danger of doctrinal sectarianism and doctrinal minimalism respectively. We tend to two extremes: every issue is a hill to die on or nothing is worth fighting for. He urges us to find our identity in the gospel, not our theological positions, hence the need for theological triage. 5Ortland, 42. Second-rank and third-rank doctrines preserve, picture, protect, and pertain to the gospel.6Ortland, 57.

The third chapter recounts Ortland’s personal journey on secondary and tertiary doctrines. He reflects on his denominational migration:

But through it all, I have become deeply convinced that in the church we need to do a better job at navigating theological disagreements. Unfortunately, it is common for Christians to divide from one another over relatively insignificant matters. In the worst cases, Christians part ways, often uncharitably, over the most petty and ignorant disagreements. In the other direction, many Christians wink at serious theological error, as if doctrine were unimportant. A balanced attitude about theology is much rarer. We desparately need to cultivate the skills and wisdom to do theological triage so that when a doctrinal division becomes necessary, it is done with minimal collateral damage to the Kingdom of God.7Ortland, 70.

The Practice of Theological Triage

Part Two then turns to the practice of theological triage. Chapter 4 explains why we should fight for primary doctrines.” The author gives examples such as the virgin birth and justification and then gives two overlapping reasons:

  • Some first-rank doctrines are worth fighting for because they mark a fault line between the gospel and a rival ideology, religion, or worldview (as with the virgin birth).
  • Some first-rank doctrines are worth fighting for because they constitute a material point of the gospel (as with justification).8Ortland, 75.

On the other hand, Ortland acknowledges that the secondary doctrines are hard to rank due to the risk of oversimplification in chapter 5, “Navigating the Complexity of Secondary Doctrines.” Some aspects of a doctrine may lean more to first-rank or third-rank. His examples in this chapter are baptism, spiritual gifts, and women in ministry. I will leave that discussion for you to read yourself, hoping to lure you into the book. Chapter 6 is about “Why We Should Not Divide over Tertiary Doctrines.” The days of creation and the nature of the millennium are the examples explored.

Theological Triage: A Spiritual Discipline

In summary, Finding the Right Hills to Die On provides the need and description of the triage process with some representative examples. It does not give us a ranking of all doctrines and we may disagree with some of them. But the book does make a strong and convincing case of the need for theological triage. It provides wisdom to guide us as we encounter disagreement. Theological triage is not simply an academic affair but a spiritual discipline as demonstrated by the author’s closing prayer:

Lord, where we have sinned either by failing to love the truth or by failing to love our brothers and sisters in our disagreements about the truth, forgive us and help us. For those of us who tend to fight too much over theology, help us to remember that you also died for the unity of the church, your precious bride. Give us softer hearts. For those of us who tend to fight too little over theology, help us to feel our need for courage and resilience. Give us stronger backbones. Help us to be people who tremble at your word and therefore ultimately fear no one but you. Lead us toward the healthy, happy balance of adhering to all your teaching while embracing all your people. Amen.9Ortland, 145