Theological “Triage”

In an emergency room, you often see a large group of people who need treatment at the same time for any number of illnesses and injuries. Who should get treated first? 

Nurses and doctors follow a method of treatment that keeps order and gives attention to those who are in the most dire need of care. The method is called “triage.” Here is a definition: “Triage is the sorting of patients’ treatment based on the severity of their condition.”* As doctors evaluate patients, they are able to use this system to place them in an order of priority so that those who have mortal injuries can be treated before those whose situations are non-life-threatening. 

Triage is not only used in the medical field. It can, and should, be used in theology as well. The Bible is filled with many doctrines that God calls His people to believe. These doctrines are all important (just like every patient is important), but they do not all carry the same weight. This is where “theological triage” comes into play.*  This is a practice of putting doctrines into three tiers, with the top tier being of most importance.  

We must practice theological triage because we must be clear about the gospel. If we are going to proclaim that the gospel is the belief that everyone needs to hear and receive salvation through faith in Jesus, then we have to agree on the doctrine of salvation. The truths of who Jesus is, what He has done, and what one must do to be saved are of utmost importance. There can be no deviation or compromise from what the Bible clearly says about these “first-tier” doctrines. 

Another reason it's important to practice theological triage is that some doctrines may lead to distinctions between denominations. These doctrinal distinctives, however, do not keep us from working together for the sake of gospel advancement. As we all know, there are churches and denominations that have come to differing positions on certain issues because of how they interpret some of the “second-tier” doctrines. 

One of these doctrines would be the doctrine of baptism. Baptists do not go to Presbyterian churches that hold to paedobaptism (the practice of baptizing babies) because they differ on that doctrinal issue. This concern is important enough that they have divided into different types of churches, but we would still say to many Presbyterians (and others), “You are our brothers and sisters in Christ. We disagree on this issue, but we can still work together in other ways.” 

There are others who practice paedobaptism, though, who we would not partner with. Not because of their doctrine of baptism, but because of their doctrine of salvation. If they do not hold to salvation by grace alone, through faith alone, in Christ alone, then it's not their beliefs about baptism that have separated us but their beliefs about salvation (a “first-tier” doctrine).

There are other doctrines that we can consider “third-tier” issues. A doctrine like eschatology (“end times”) shouldn’t divide true believers. God speaks about the end times, and we should do our best to understand what He has said, but there is room for genuine disagreement among Christians about such matters. The impact of the disagreement is less urgent and practical than with first-tier or even second-tier doctrines. 

In doing theological triage, we must be careful not to act as if some of what the Bible says is important and some of it is not. God's Word is God's Word, and we must strive to “rightly handle the word of truth”(2 Tim 2:15). We must take each doctrine seriously. We should all seek to know God’s Word better and continue to learn. We may even shift in our understanding of what we believe the Bible teaches. By His word and by His Spirit, God will improve our understanding of truth.

Let me close this article by sharing a simple framework I use to help me in this process. I call it the “open-handed and closed-fisted" model. There are doctrines that we hold to with a closed fist.  We will not budge in what we believe about these things, and if you differ from us on this, we cannot have Christian fellowship together. These would mainly be doctrines related to salvation, Jesus, and the Bible. Other doctrines, I would say, we hold but with an open hand.  We hold to them, but we don’t divide with other followers of Christ because of them. We can disagree with each other on these things and not consider one another to be heretics. 

There is a lot of division in our world. We, as Christians, must be able to see true believers as brothers and sisters in Christ who are fighting this battle with us. If we fight over all the open-handed doctrines, we will find ourselves fighting “our own” more than those who are truly against us.

* https://em.umaryland.edu/page/ems/triage

* The term “theological triage” was popularized by Albert Mohler.