Download a PDF diagram that illustrates the content of this article: Theological Triage.
My wife, a healthcare administrator, recently explained her hospital’s approach to medical triage. Patients are sorted according to the severity of their condition and assigned a “level.” For example,
- Level 1: Acute danger
- Level 2: Severe injury
- Level 3: Minor injury
Every patient is important and deserves treatment. But medical professionals are right to prioritize urgent needs.
In recent years, triage has served as an analogy for how the Church ranks the importance of doctrines. The term “theological triage” gained currency after it was coined by Albert Mohler in his 2005 article, “A Call for Theological Triage and Christian Maturity.” Mohler explains, “theological seriousness and maturity demand that we consider doctrinal issues in terms of their relative importance.” In 2020, Gavin Ortlund published “Finding the Right Hills to Die On: The Case for Theological Triage,” and Rhyne Putman published “When Doctrine Divides the People of God: An Evangelical Approach to Theological Diversity.”
Essentials vs. Nonessentials
Theological triage (ranking doctrines according to importance) is biblical. Paul explicitly identifies some doctrines as being “of first importance” (1 Cor. 15:3). Level 1 doctrines include the death, burial, and resurrection of Jesus (1 Cor. 15:3–4), as well as the truths confessed in the ecumenical Creeds (Apostles’, Nicene, Athanasian). These are matters of Christian consensus: “what has everywhere, always, and by all been believed” (Vincent of Lerins). The gospel is at stake in these non-negotiable dogmas. Denying them places us in acute danger. They separate Christians from non-Christians. They’re worth dying for.
If some doctrines are of “first importance,” then others are not. If there are essentials, then there must be nonessentials.
If some doctrines are of “first importance,” then others are not. If there are essentials, then there must be nonessentials. Not everything belongs to the “one faith” (Eph. 4:5) which Christ handed down to the Church through his Apostles. If Peter could say of Paul’s letters, “There are some things in them that are hard to understand” (2 Pet. 3:16), then it should be no surprise that godly men and women often disagree on how to interpret them. At least some nonessentials should be left to personal discretion: “each one should be fully convinced in his own mind” (Rom. 14:5). Paul warns us “not to quarrel over opinions” (Rom. 14:1).
This makes some believers uncomfortable, since all truth is important, and we don’t want our distinctive doctrines (e.g., entire sanctification) to be minimized. But “nonessential” does not mean “unimportant.” I once heard a pastor flippantly claim that as long as we confess “Jesus is Lord,” everything else that divides us is like ice cream flavors: God is letting us choose what we like best. This mentality undermines the importance of all truth and the fact that secondary issues can have serious consequences for the church’s health. We should all do our best to understand what Scripture teaches on every point, and I’m passionate about many secondary issues. However, it is far more important that we agree on the truth of the Trinity than that we agree on our view of sanctification or on our application of biblical lifestyle principles. Mature Christians gladly affirm this and reflect it in their emphasis and attitude (Rom. 15:1–2).
A Triage Scale
All Christians begin with a “Level 1” on their triage scale (“first importance”). But as in the healthcare world, there are differences on how many levels to include after that. Some identify three or four levels of importance; others identify five, six, or even seven. If we’re not careful, we can create more and more levels of truth in order to justify splitting the church over minor issues. While Christian unity does not require complete institutional unity, the church is far more fractured than it needs to be. That’s why I prefer triage scales with three levels:
- Level 1: The faith of the whole Church.
- Level 2: The shared beliefs of a theological tradition, confessional community, or denomination.
- Level 3: Issues left to the discretion of individuals or local churches.
Secondary issues are important enough that Christians may separate into distinct worshipping communities; they are not so important as to divide from common causes. Historically, many Level 2 issues pertain to the doctrine of the church (ecclesiology). Consider, for example, the differences between the Westminster Confession and the London Baptist Confession. Presbyterians and Baptists are divided over whether or not to bring infants into the church’s membership through baptism. It’s difficult to coexist when you disagree on a matter as important as the nature of the church and who belongs to it.
On tertiary matters, Christians can reasonably “agree to disagree,” even within a local church.
Level 3 issues may be important, but they are usually not important enough to warrant distinct worshipping communities. On tertiary matters, Christians can reasonably “agree to disagree,” even within a local church. Differences over the millennium or the age of the earth, for example, are not legitimate reasons to divide a congregation or denomination.
A Personal Example
I once visited an Anglican Church (recall that Wesley was a lifelong Anglican priest). The priest learned that I was a Christian pastor, and we were able to enjoy meaningful communion because of our “one Lord, one faith, one baptism” (Eph. 4:5). Our communion was far deeper than “extending the right hand of fellowship” in a superficial way, or patronizing one another from a distance: “Some Anglicans/Methodists will probably be in heaven!” I called him “brother.” We shared “one bread” at the Lord’s Table (1 Cor. 10:17). We joined our voices to confess the Nicene Creed (Level 1 issues). While visiting churches on vacation, I have enjoyed similar fellowship with conservative Baptist, Presbyterian, Lutheran, and Eastern Orthodox brothers and sisters.
In the course of my conversation with the Anglican priest, however, I explained a few reasons (Level 2 issues) why I wasn’t ready to leave my denomination and join the Anglican Church of North America. We were able to have a robust but respectful discussion. Another clergyman remarked with a smile, “We’re long-lost cousins; you can come home any time you want!”
In his sermon, the priest made an argument for postmillennialism. It was the first time that I had heard someone defend this view in person, so I asked him about it after the service. He explained, “The Anglican Church doesn’t have an official position on it.” It’s left to the discretion of individuals or local churches (Level 3 issues).
Adjusting Our Emphasis and Attitude
Those who fail to practice theological triage harm the church. In his essay on church membership and levels of importance in truth, Philip Brown tells of a child who assumed that a group of women with long hair and dresses were Christians, but changed her mind when they didn’t align with another similar expectation. This is a heart-wrenching example of elevating a tertiary matter to a gospel issue. Did this child’s parents ever say, “Someone who wears such-and-such isn’t a Christian”? Probably not. But the child encountered an emphasis and attitude that led her to this conclusion.
This is not an isolated example. A denominational leader once sent me an article on whether or not people outside his movement would be saved. He identified it as a common question among his constituency.
Something is seriously wrong if we preach more frequently or emphatically on our church’s distinctives than we proclaim “the faith that was once for all delivered to the saints” (Jude 1:3).
Our emphasis and attitude in preaching should reflect the importance of the truths that we are proclaiming. Level 1 issues should be preached with uncompromising certainty, at all times and in all places. We should never hesitate to proclaim “Jesus Christ and him crucified” (1 Cor. 2:2). Level 2 issues can still be preached frequently and confidently (as I do with the doctrine of entire sanctification), but our tone should be charitable, and we should use wisdom when speaking to unaffiliated audiences. It is unnecessary and unChristlike to cast shade on good brothers and sisters who disagree, posture ourselves over them, or patronize them by saying that “they just don’t have the light.” Finally, Level 3 issues should be preached rarely, tentatively, and with very familiar audiences.
Something is seriously wrong if we preach more frequently or emphatically on our church’s distinctives than we proclaim “the faith that was once for all delivered to the saints” (Jude 1:3). Our theological distinctives must take second place to a clear exposition of creedal doctrines such as the Trinity, incarnation, ascension, unending kingdom, “one holy catholic and apostolic Church,” “one baptism for the remission of sins,” or resurrection of the dead. In fact, failing to first establish a gospel foundation leads to distorted and harmful teaching on secondary matters.
A Call to Repentance and Wesleyan Charity
In his “Crucible for Conservatives,” H. E. Schmul identified a failure to practice theological triage as a systemic problem within the CHM. Carefully read the following quotes:
The error is defining what is spiritual and deciding who is spiritual based on the interpretation of secondary truths instead of emphasizing our agreement on fundamentals.
We face grave danger in elevating secondary truths to the level of primary truths and judging one another’s spirituality based on our understanding of these truths.
Since we are 100% agreed on the fundamentals, speak the truth in love on secondary issues.
The solution to our tension is not labels, “radical” or “liberal,” but to pray and love one another “maintaining the unity of the Spirit” that the world may believe on the Lord Jesus Christ and be saved.
We did not get where we are, in our movement, by accident. We are reaping twenty years of a preaching emphasis that has polarized around men and issues; men die and issues change, but Christ and His Word abide for ever. Some of our younger men feel strongly that our leadership bears a large share of responsibility for where we are, because we have permitted the emphasis that has produced this effect. They hear the call for humbling and confession for revival and fail to see leaders setting a genuine example. They feel if anyone needs to admit failure, it’s the leadership. I fear they will continue to turn away from us unless we repent and change our ways.
Schmul’s call to repentance is still relevant in these divided days. The 2005 “Call to the Conservative Holiness Movement,” written by the President and Faculty of the Division of Ministerial Education at God’s Bible School and College, more recently articulated this concern:
Too often we have smugly disconnected ourselves from our Christian past; and in so doing we have become theologically shallow, spiritually weak, and blind to the work of God in the lives of others. We have withdrawn ourselves into protected enclaves, congratulating ourselves on our superiority over other Christians, sometimes refusing fellowship with them because of our disagreement in doctrine or in practice, and ignoring the continuing work of the Holy Spirit throughout all the universal Church. At best this is lamentable ignorance and at worst, sectarian bigotry. We call therefore, with John Wesley, for a “league offensive and defensive with every soldier of Christ,” reclaiming the richness of our Christian heritage and our essential unity with all who truly confess Him as Lord.
John Wesley was a strong advocate of theological triage for the sake of Christian unity and charity. His sermon “Catholic Spirit” is a must-read for every Wesleyan:
Although a difference in opinions or modes of worship may prevent an entire external union, yet need it prevent our union in affection? Though we cannot think alike, may we not love alike? May we not be of one heart, though we are not of one opinion? Without all doubt, we may. Herein all the children of God may unite, notwithstanding these smaller differences. (Sermon 39)
Paul identified an eagerness to maintain unity around the essentials as a mark of a mature Christian (Eph. 4:3), while calling for divisive and contentious people to be disciplined (Titus 3:10; Rom. 16:17). As we unite to “contend for the faith that was once for all delivered to the saints” (Jude 1:3), let us join Charles Wesley in his prayer of confession for allowing a sectarian spirit to infect his emphasis and attitude:
The spirit of my foes I caught
The angry bitter zeal,
And fierce for my own party fought,
And breath’d the fire of hell.
To propagate the truth, I fought
With fury and and despite;
And, in my zeal for Israel, sought
To slay the Gibeonite.
Lord, I abhor, renounce, abjure,
The fiery spirit unclean,
The persecuting zeal impure,
The sin-opposing sin.
But O! my gracious God, to me
A better spirit impart;
The gentle mind that was in thee,
The meekly loving heart.
This article was originally published in the Bible Methodist Magazine.