Against Theological Triage
What Is Theological Triage?
The idea that Christian doctrines can and should be ranked according to their relative importance is not new. Augustine (but see Rupertus Meldenius) famously distinguished between matters central to the faith and matters on which Christians might legitimately differ. The medieval church developed the category of adiaphora, things indifferent, to describe practices and beliefs neither commanded nor forbidden by Scripture. The Reformers inherited and refined this category. In various forms, the intuition that not every doctrinal question carries equal weight has been a persistent feature of Christian theological reflection.[1. The standards themselves distinguish between things necessary to salvation and things not necessary; between matters God has fully revealed and things not expressly contained in Scripture. Nothing I say here should be taken as targeting these obvious, and much simpler, distinctions.]
The contemporary articulation of this intuition under the name “theological triage” is most closely associated with R. Albert Mohler, Jr., who introduced the framework in a 2005 essay. Drawing on the medical practice of triage, in which emergency responders prioritize patients according to the severity of their condition, Mohler proposed that theologians and church leaders should similarly sort doctrinal issues according to their relative urgency and importance. His framework divides doctrine into three tiers. First-order doctrines are those essential to Christianity itself, such as the Trinity, the full deity and humanity of Christ, justification by faith, and the authority of Scripture. Disagreement at this level constitutes a departure from Christianity as such. Second-order doctrines are those important enough to divide denominations and local churches, such as baptism and church polity, even among those who are genuinely Christian. Third-order doctrines are those over which Christians may disagree while remaining in close fellowship, such as many questions of eschatology.[2. R. Albert Mohler, Jr., “A Call for Theological Triage and Christian Maturity,” AlbertMohler.com, July 12, 2005, https://albertmohler.com/2005/07/12/a-call-for-theological-triage-and-christian-maturity.]
Mohler’s framework has been widely influential in evangelical circles and has been taken up, refined, and debated by numerous theologians since (to be clear, sometimes in ways Mohler might not appreciate). Rhyne Putman, in his work on theological disagreement, has explored the epistemological dimensions of doctrinal ranking, asking how Christians ought to calibrate their confidence across different areas of theology and what virtues are required for navigating disagreement well.[3. Rhyne Putman, In Defense of Doctrine: Evangelicalism, Theology, and Scripture (Minneapolis: Fortress Press, 2015); see also Putman, When Doctrine Divides the People of God: An Evangelical Approach to Theological Diversity (Wheaton, IL: Crossway, 2020).] Gavin Ortlund has advanced a similar case in his book “Finding the Right Hills to Die On,” arguing that Christians must learn to distinguish between doctrines worth contending for and those that should not become occasions for division, and that both an unwillingness to fight and an eagerness to fight are theological vices.[4. Gavin Ortlund, Finding the Right Hills to Die On: The Case for Theological Triage (Wheaton, IL: Crossway, 2020), 17–22.] Others in the Reformed and evangelical traditions have engaged the framework with varying degrees of enthusiasm and critique.
The appeal of theological triage is understandable. The framework presents itself as a corrective to two equally dangerous errors: the theological indifferentism that treats all doctrinal questions as equally open, and the rigid sectarianism that treats every disagreement as grounds for separation. Everyone practices some form of theological triage, and the concept is not without merit. Every church that has ever drafted a confession, set ordination requirements, or established membership standards has implicitly acknowledged that some doctrines matter more for institutional belonging than others, and nothing in this argument contests that practical reality. But the extrabiblical philosophy in question is far less clear-cut than its proponents suggest.
The aforementioned framework is not drawn from Scripture but imposed upon it; the framework defeats itself when subjected to its own criteria, its categories cannot bear the weight placed on them, and in practice, the framework has functioned less as a tool of theological maturity than as a mechanism for accommodating theological drift. I hear more about theological triage nowadays than I do the explicit gospel. The goal here is not to deny that some doctrines are more central than others in some sense, but to challenge the claim that theological triage as a system provides a reliable, biblically grounded method for determining which disagreements the church can tolerate and which it cannot.
Theological Triage Has No Scriptural Basis
The most fundamental problem with theological triage is that the framework appears nowhere in Scripture, not explicitly, not by implication, and not by example. Primary doctrines like the Trinity receive explicit affirmation in Scripture. Theological triage, by contrast, appears nowhere in the biblical text. The concept did not emerge from careful exegesis or from the church’s long engagement with Scripture. Theological triage is a philosophical construct, borrowed from the language of emergency medicine and imposed upon theology from the outside. As such, the framework carries no inherent biblical authority. Theological triage must answer to Scripture rather than presume to organize it.
Theological triage cannot be derived from good and necessary consequence. Unlike doctrines inferred from the totality of biblical teaching, no chain of reasoning from Scripture produces a tiered classification of doctrine as such. The framework does not arise from within the biblical-theological tradition. Theological triage arrives from without, bringing with it assumptions about epistemic confidence, ecclesial tolerance, and doctrinal priority that Scripture itself never sanctions!
When we examine the practice of Jesus and the apostles, we do not find them granting passes on doctrinal error. We do not find acceptable doctrinal differences between churches, nor anything resembling denominations. Even on ostensibly minor matters, Paul’s remarks on head coverings are striking: the churches of God have no other practice (1 Cor. 11:16). The uniform expectation of the New Testament is doctrinal agreement, not tiered tolerance.
No instance in the New Testament records substantial doctrinal disagreement between individuals or churches who nevertheless recognize one another as fellow believers. If theological triage were a biblical concept, we would expect to find the framework modeled somewhere in the apostolic era. We do not. What we find instead is a consistent apostolic insistence on doctrinal fidelity that sits in considerable tension with the triage framework, and which the triage framework, applied retrospectively, cannot easily accommodate.
Even mere faithfulness to the Great Commission requires treating all of Christ’s teachings as equally binding on disciples. Jesus commands his apostles to make disciples, “teaching them to observe all that I have commanded you” (Matthew 28:20, ESV). No triage appears in that commission. No asterisk marks certain commandments as lesser in importance and open to dispute without consequence. And we must not confuse passages about greater and lesser sins, punishments for those sins, or matters of conscience with proof-texts authorizing whatever doctrinal hierarchy we find convenient.
Theological Triage Defeats Itself
Theological triage claims to rightly order all other doctrines in terms of importance, governing ecclesiology, fellowship, and even questions of salvation. By its own logic, then, theological triage must itself be classified as a doctrine. Some have said triage is more of a hermeneutic. Either way, a problem presents itself. Which tier does the framework occupy?
If theological triage is a primary doctrine, we should expect the framework to be clearly taught in Scripture and to bear on salvation. Theological triage satisfies neither condition. The Bible nowhere requires belief in theological triage for salvation or church membership. One can be a Christian without ever having encountered the concept. If theological triage is a secondary or tertiary doctrine, then by its own framework, one need not believe it, need not consider it important, and need not apply it. The tool undermines itself.
Theological triage cannot justify its own use. Theological triage is a methodology that, when submitted to its own criteria, fails them. The framework may help hold a congregation together in some practical sense, but triage does not tell us much about Scripture’s own priorities. If triage is a real principle, we should expect the framework to function as a primary doctrine. The biblical evidence for such a system is entirely absent.
Theological Triage Creates Epistemic Confusion
Theological triage asks us to accept a peculiar inversion. We are told that we cannot be sufficiently certain about the biblical teaching on baptism, church polity, or the nature of the millennium to make these matters of binding confessional importance. Read that again. Yes, we may place these within our confessions, but the triage advocate asks us to hold them loosely due to our supposed lack of certainty about them. Yet we are apparently quite certain that theological triage itself is the correct framework for evaluating all such questions. The system that orders our doctrinal confidence is held with greater confidence than the doctrines the system orders.
This is epistemologically backwards. The warrant for any organizing framework must derive from the data the framework organizes, not the other way around. If our confidence in particular doctrines is limited by the difficulty of the biblical material, then our confidence in a meta-level system for classifying those doctrines ought to be even more limited, not less. We stand closer to the scriptural ground when wrestling with what the Bible says about a given doctrine than when constructing an external grid to sit above it.
The person who says, “I am not sure enough about complementarianism to make the doctrine a test of fellowship, but I am sure enough about theological triage to use the framework as a universal organizing principle” has not demonstrated greater epistemic humility. Such a person has simply displaced certainty from Scripture to a system, and in doing so has elevated a human construct over the biblical data that should govern conclusions in the first place.
This problem is compounded by the fact that theological triage cannot itself be derived from Scripture. We are therefore being asked to hold with high confidence a framework that has no clear scriptural warrant, in order to hold with lower confidence doctrines that do have such warrant. Again, the tail is wagging the dog. This is precisely what we should expect when a philosophical framework is imported into theology from outside of Scripture rather than drawn from it. The framework does not serve the biblical data. The framework sits in judgment over it.
Does Theological Triage Measure Importance or Urgency?
A further problem lies within Mohler’s own presentation of the framework, and the problem has received too little attention. Mohler’s tiered system appears, on its face, to be a classification of doctrines according to their inherent and abiding importance. First-order doctrines are those most central to Christianity as such, the ones without which the faith itself collapses. This framing suggests a stable, objective hierarchy grounded in the nature of Christian truth.
But Mohler also writes that responsible Christians must determine which issues deserve first-rank attention “in a time of theological crisis.”[5. Mohler, “A Call for Theological Triage.”] This is a different claim entirely. A doctrine demanding first-rank attention in a time of crisis need not be a first-order doctrine in the sense of being more inherently important than others. Such a doctrine has simply become urgent given present circumstances. Importance and urgency are not the same thing, and the failure to distinguish them introduces a deep ambiguity into the framework that no amount of refinement can resolve.
The ambiguity is not merely academic. The triage system ends up doing two incompatible things at once. On one hand, the system purports to offer a stable classification of doctrines by their intrinsic weight. On the other hand, the system acknowledges that the practical priority of a doctrine is situationally determined, relative to whatever controversy is pressing upon a particular body of Christians at a particular moment. If the latter claim is true, the former claim is misleading. No fixed tier exists for any given doctrine, only a shifting assessment of what the present crisis demands. If that is the case, the three-tier schema does not actually tell us very much. The schema simply redescribes the obvious observation that some fights matter more right now than others, a piece of pastoral wisdom requiring no elaborate theoretical framework to state.
The confusion runs deeper still. If doctrinal urgency is situationally determined, then so-called third-order doctrines can at any moment become functionally first-order, depending on what is under attack. Complementarian convictions, questions of ecclesial polity, the theology of the body, and the doctrine of creation all may be said to occupy a lower tier in the abstract schema, but when these doctrines become the precise point of contention threatening the integrity of a church or denomination, they demand the same quality of attention and defense the framework reserves for first-order matters. The schema does not account for this. In practice, the schema tends to obscure it.
Theological Triage Privileges Soteriology at the Expense of Creation Order
A significant and underappreciated flaw in the triage framework is its implicit privileging of soteriological concerns over doctrines grounded in creation order and natural law.[6. This significant problem was helpfully pointed out to me by Nate Fischer.] Natural law is, of course, a topic near and dear to the hearts of those at American Reformer.The standard formulation of theological triage treats doctrines as primary when they bear directly on salvation, and assigns lesser status to doctrines that do not. This seems intuitive at first. But the intuition breaks down under examination, and the practical consequences of accepting it are severe.
Creation order is not a soteriological category per se. We must distinguish between nature and grace, as well as earthly and heavenly ends. The doctrines of male and female, of the nature of the body, of the ontology and complementarity of the sexes, of marriage as a creational institution, and the like, are grounded not merely in Pauline soteriology or in the economy of redemption, but in the structure of creation itself, in what God made and called good before the Fall, before the law, and before the cross. To classify these doctrines as secondary or tertiary on the grounds that affirming, denying, modifying, or otherwise disagreeing about them does not determine one’s standing before God in a strictly soteriological sense is to misunderstand both the doctrines and the basis on which they rest.
The triage framework, in its standard operation, implicitly assumes that the most important doctrines are those most directly bearing on justification and union with Christ. This assumption reflects a particular and contestable theological anthropology, one that centers the human person primarily as a sinner in need of redemption rather than as a creature bearing the image of God within a creational order that makes normative demands on human life entirely apart from the question of how sinners are made right with God. Make no mistake, such areas of discussion are exceedingly important, especially right now. The two concerns, soteriological and anthropological, are not opposed, but neither are they identical, and collapsing the one into the other produces serious distortions.
The practical consequences of this distortion are visible in contemporary evangelical debates over sex and gender. The argument regularly deployed against those who press for confessional accountability on these matters is that such doctrines are not primary, since one can believe in justification by faith and still hold an egalitarian anthropology, or still affirm a revisionary account of sexual ethics. The triage framework lends this argument its apparent force. But the argument proves too much. Doctrines of creation, body, sex, and gender are not peripheral embellishments on the core of Christian theology. They are constitutive of a Christian metaphysic of the human person, grounded in divine revelation, and their denial does not leave the gospel untouched. The gospel is not proclaimed in a metaphysical vacuum. Undermine the creational order in which the gospel is embedded, and what remains of the gospel will not long survive.
The soteriological and ecclesiological concerns that dominate the triage framework are real and important. But granting them exclusive or near-exclusive priority over doctrines grounded in natural law and creation order is not a conclusion that nature or Scripture warrants. The God who justifies sinners is the same God who made the heavens and the earth and ordered human life within them. The framework that can only see the first truth while obscuring the second has not yet understood either one.
Theological Triage is Inherently Unstable
Even granting theological triage as a useful concept, its categories are inherently unstable and contested. Nobody agrees on them. Mohler places most eschatological debates in the third tier, yet a claim that Christ has already physically returned would, for most Christians, constitute a first-tier issue. Meanwhile, Mohler allows room for disagreement on the eternal functional subordination of the Son, a dispute he would otherwise classify as touching first-tier Trinitarian doctrine.[7. Mohler, R. Albert, Jr. “Heresy and Humility – Lessons from a Current Controversy.” AlbertMohler.com, June 28, 2016. https://albertmohler.com/2016/06/28/heresy/. See also Mohler, “A Call for Theological Triage.”] The scheme produces exceptions in both directions, further complicating rather than clarifying doctrinal disagreement. Introducing the concept of triage in the midst of genuine theological controversy compounds the disagreement by leaving everyone to wonder where a given doctrine belongs on a largely imaginary scale of importance. The question of where to place a doctrine on the scale becomes its own dispute, layered on top of the original one.
Importance is relative, not fixed. Mohler argues that Christians must determine which issues deserve first-rank attention in a time of theological crisis. But this determination is made relative to whatever crisis is at hand, not relative to a fixed conceptual scheme. Complementarian convictions, for example, may be classified as secondary in the abstract, but when those convictions constitute a defining commitment of a body like the Southern Baptist Convention or the Presbyterian Church in America, and come under sustained attack, the convictions assume first-tier urgency in practice. A framework that cannot account for this is not a reliable guide. A map drawn for a terrain that does not exist offers no reliable guidance.
Theological Triage Almost Always Cuts One Way
Theological triage, in theory, should produce greater openness in both directions, toward conservatives and progressives alike on secondary and tertiary matters. If a doctrine is truly of lesser importance, then those who hold the more conservative position on the doctrine should be more welcome, not less. Genuine epistemic humility should make one more open to hearing the traditionalist’s case, not more dismissive of it. Consistent application of the framework would grant the so-called fundamentalists a more patient hearing, not a shorter one. In practice, however, theological triage is almost exclusively deployed to justify movement in one direction: leftward. The charge of “fundamentalism” is wielded against conservatives defending doctrines the triage-user has classified as secondary or tertiary, while progressive departures from those same doctrines are accommodated under the banner of Christian charity and doctrinal humility.
In the midst of genuine theological disagreement, triage serves chiefly to soften the blow to the conscience of the one persuaded by false doctrine and to reassure those entertaining such positions that their salvation, at least, is secure. Triage functions as a mechanism for making people feel better and for assuaging guilt, and the framework does nothing at the practical level to resolve the disagreement itself. The person with a guilty conscience finds in triage a ready instrument, not for honest theological engagement, but for dismissing pushback against his position as the belligerence of a lesser mind. “You are treating a secondary matter as though it were primary,” he says, and with that pronouncement, the conversation is meant to be closed. The person told to stand down, however, has every right to ask whether the call for calm represents a genuine appeal to theological proportion or simply a way of running out the clock.
This is not theological triage. Theological liberalism wearing the costume of maturity is what this is. Those who find themselves consistently using these categories to dismiss conservatives while welcoming progressive revision are not exercising epistemic humility. Such persons are, at best, providing cover for those who would dismantle the doctrinal commitments of their tradition.
Theological Triage Does Nothing to End “Division”
The claim that eagerness to contend is a vice conflates two things that must be kept separate: contending for a position, and causing division. These are not the same thing. Vigorous, passionate, even sharp theological debate is not division. Vigorous debate is the ordinary currency of serious doctrinal engagement. The church has always argued, and argued fiercely, over matters of real consequence. To treat the intensity of one’s contention as itself a symptom of vice is to pathologize exactly the kind of theological seriousness the present moment requires. Moreover, we must never grant that all division is bad. Much of it is good, precisely along the lines of rightly affirming and defending what God’s word says.
Any warning against making doctrines an occasion for division raises an obvious question: division from whom, and along what lines? In many cases, the division already exists. Denominations are themselves the institutional expression of doctrinal disagreement. Baptists and Presbyterians are already divided over baptism. Complementarians or traditionalists and egalitarians are already divided over the ordering of the sexes. The specter of division that advocates for triage invoke is, in many of the most pressing cases, a division that has already occurred, or that is in the process of occurring, regardless of how carefully anyone frames an argument. To invoke the danger of division in these contexts is not a theological argument. At best, this amounts to a counsel of conflict-avoidance, and at worst, the invocation functions as a way of preemptively delegitimizing those who would press the matter further.
The suspicion is difficult to avoid that the appeal to triage and the warning against eagerness to fight functions most readily as a tool in the hands of those who have already moved, or are moving, away from a received doctrinal position. I would argue that this is, in fact, exactly what we’ve seen, hence the repeated refrains involving the rhetoric of theological triage in virtually every questionable theological “development” as of late. The framework supplies a respectable vocabulary for telling one’s interlocutors to stand down, to lower their voices, to treat the matter as less urgent than they believe it to be. This is not theological maturity. The appearance of theological maturity deployed in the service of theological retreat is what this is.
What Theological Triage Gets Right
We can acknowledge what Mohler’s framework is reacting against. A real error exists in treating every doctrinal disagreement as equally weighty, dividing over minor matters as though the matters were salvific. That error should be avoided. Nobody benefits from a church that splits over eschatological fine points while the foundations are under assault. I get it.
But the solution is not a fixed taxonomy of doctrinal tiers that itself becomes the supposed defining mark of theological acumen and importance. The better approach is situational discernment, recognizing that the urgency of a doctrinal issue is determined by the particular threats facing a particular church or communion at a particular moment. Triage is a fitting metaphor only in this limited, reactive sense: address the wounds most likely to prove fatal right now. The metaphor does not work as a universal, static classification of all Christian doctrine, and it was never going to. Fix the categories, and the crises change.
The doctrines of sex, gender, and the nature of the human person, especially in light of wicked woke ideology of the past decade plus, are under sustained assault, along with the creational metaphysic in which those doctrines are embedded. The ideological capture of Christian institutions proceeds apace. These matters demand first-rank attention, whatever tier a theoretical framework might assign them. A framework that cannot tell us that is not telling us very much at all. Throw it out.
Texts That Do Not Teach Theological Triage
Again, proponents of theological triage frequently appeal to certain biblical passages as though those passages provide warrant for a hierarchy of doctrinal importance. Closer examination of each passage reveals that none of them teach anything of the sort. This pattern of appeal is itself telling. When a framework must be read into passages addressing something else entirely, that pattern constitutes evidence that the framework did not originate in Scripture.
Romans 14 is perhaps the most commonly cited passage in support of theological triage. Paul addresses disputes over food offered to idols, the observance of special days, and similar matters. But Paul is not adjudicating between competing doctrines. Paul addresses areas that doctrine does not cover at all, matters of personal conscience in the realm of genuine adiaphora, things neither commanded nor forbidden. No hierarchy of doctrines appears here because no doctrines are in dispute. The “weak” and the “strong” do not hold different theological positions on a tiered scale of importance. They hold different convictions about areas Scripture leaves open. To import this passage into a discussion of doctrinal triage is a category error, and a revealing one.
When Jesus declares the greatest commandment or acknowledges that some matters of the law are weightier than others (Matt. 22:36-40; 23:23), proponents of triage sometimes read this as endorsing a hierarchy of doctrinal importance. But the text does not support that reading at all. Jesus is not constructing a methodology for ranking theological propositions or determining which doctrines may be disputed without ecclesiastical consequence. Jesus speaks about the moral law, its summary, and the priorities governing ethical obedience. That love of God and neighbor encompasses all the commandments, or that justice, mercy, and faithfulness are weightier than tithing herbs, tells us nothing about whether baptism belongs in the second tier or eschatology in the third. These are different questions entirely, and conflating them does not strengthen the case for triage. Conflating them reveals its scriptural poverty.
The Bible’s acknowledgment that some sins carry greater guilt or greater judgment (John 19:11; James 3:1; Luke 12:47-48) is sometimes enlisted in support of triage. But a gradation in culpability or consequence does not entail a knowable hierarchy of doctrinal urgency. That some sins are worse than others, or that some false teachers incur stricter judgment, does not tell us which doctrinal disagreements should divide churches and which should not! The move from “some sins are graver” to “therefore, some doctrines are categorically less essential to Christian fellowship” is a non-sequitur. Scripture’s moral gradations and its warnings about false teaching point in a quite different direction from what the triage framework requires.
None of these passages teach that Christian doctrine can be sorted into tiers of primary, secondary, and tertiary importance such that disagreement on lower-tier doctrines is ecclesiologically tolerable. In each case, the passage addresses something else entirely, which is the liberty of conscience in non-doctrinal matters, the summary of the moral law, or the gradation of moral guilt, respectively. The appeal to these texts in support of theological triage is, at best, an overreach and, at worst, a distortion of what Scripture actually says. That proponents of triage must reach this far, and still come up empty, is further confirmation that the framework is a philosophical import rather than a biblical inheritance. We have clearly moved here beyond theological triage being extra-biblical to its being anti-biblical when we find ourselves twisting prooftexts in order to try and make it work. Perhaps, then, this entire thing is a distraction from other anti-biblical arguments that cannot stand on their own, but with which our supposedly nuanced, triaged, theological betters want to burden us in the midst of woke social upheaval affecting our confessional and denominational realms right now.