When I (Brian) worked as a paramedic, we did triage in the field. Here is what I mean. We used tags in four different colors to mark the severity of a person’s injuries. A black tag was used for someone who had already deceased. A red tag was given to someone who had experienced serious trauma and was in critical condition. A yellow tag was a more significant issue. An individual marked with a yellow tag needed to get to the hospital, but the situation might not be as urgent. Green tags were for those we called the “walking wounded;” we might be able to treat and release them with a first aid kit. 

Because of that time I spent as a paramedic, the term theological triage has always resonated with me. Dr. R. Albert Mohler, Jr., president of Southern Seminary, is classically given the credit for developing the theological triage metaphor. It’s a way of thinking about theology—a heuristic for students, ministers, and parishioners—that gives different weights to various levels of theological doctrine.

Let’s walk through four levels of theological triage one by one the way that I (Gavin) did in my book Finding the Right Hills to Die On: The Case for Theological Triage (Crossway, 2020):

Black Tag: Essential Doctrines

Some doctrines are first-rank. In other words, they are essential to the gospel itself and therefore essential to being a Christian. If you don’t affirm these, you’re really outside of orthodoxy. 

One example of a first-rank issue would be the Christian doctrine of the Trinity. This doctrine is our basic conception of God that distinguishes Christians from other religions. We find this doctrine defended in Christianity’s earliest creeds and councils. 

Another example is justification by faith—the basic claim that we’re made right with God by grace and that we’re not meriting our salvation. That’s at the heart of the gospel itself. Remember what Paul says about this doctrine in his letter to the Galatians: “If anybody is preaching to you a gospel other than what you accepted, let them be under God’s curse!” (Gal. 1:9). Paul feels strongly that the gospel and justification are front-line issues! 

Red Tag: Urgent Doctrines

Second-rank doctrines are urgent for the health and practice of the local church. What you believe about these doctrines doesn’t determine whether or not you are a Christian, but it might affect what kind of church you go to. Christians usually separate over these doctrines at the local church, denominational, and/or ministry level. 

Examples include the way we understand baptism and church government as well as what we believe about the role of women in ministry. When there are differences in urgent doctrines that make a practical difference for faith and practice, it’s hard to come together and coexist in the same local church, denomination, or ministry organization. These kinds of disagreements often make it impossible to remain together, because you cannot practice both views at once.

It’s legitimate to recognize one another as fellow believers but then we bless one another and go our separate ways as part of different church groups. I (Gavin) am a Baptist, but I’ve been deeply influenced in my faith by many wonderful Presbyterians. So, we can love people who differ from us on second-tier doctrines deeply. And even though we don’t go to the same churches or even belong to the same denomination, we recognize that we’re still together within the larger family of God. We’re all part of the Christian faith.

Yellow Tag: Important Doctrines

Third-rank doctrines are important to Christian theology, but they’re not important enough to justify a separation or division among Christians. We should certainly study these doctrines. We shouldn’t stop thinking about them, but we don’t need to divide over them. 

Two pastors at the same church could have a different view on the end times—a different perspective on the millennium in Revelation 20 for example—but their local church unity and fellowship aren’t hanging on whether or not they agree about that passage. This disagreement might affect a sermon on an end-times Bible text, but it’s not nearly as consequential for everyday life and ministry. 

Another example of a third-rank doctrine is the length of the days of creation in Genesis 1. We want to study that, and we even want to get it right, but two Christians can have a very different view on that issue and still fruitfully interact with each other, take the Lord’s Supper together, and serve together in the same local church body. 

We’d even put the Calvinism-Arminianism debate at the third-tier level. Calvinists and Arminians can often be a part of the same church and serve together fruitfully. However, we should note that with this issue, your beliefs tend to impact your overall theological worldview. And, for that reason, the implications can sometimes move this debate up to the yellow tag level.

Green Tag: Not Important for Our Gospel Witness and Ministry Collaboration

Fourth-rank doctrines are those things that don’t matter at all as it relates to our gospel witness and ministry collaboration. Certainly, all truth is God’s truth and no doctrine is superfluous. But these doctrines—while they may be interesting to think about—have very little bearing on life and ministry.

Back in medieval times, for instance, there was a lot of discussion about how many angels exist or whether or not redeemed human beings are meant to replace the number of fallen angels. Even today we might think about how many different kinds of angels there are and what the differences are between cherubim and seraphim for example. Those sorts of debates might be stimulating and they do affect the way we understand particular Bible passages. However, they don’t make a big impact on how we follow Jesus. 

One common objection to theological triage is the question of who gets to be the arbiter of what theological concepts fit where. You might be asking, “Who are Dr. Ortlund and Dr. Arnold to say what doctrines belong in what category?” 

A rigid legalist would be tempted to put a black tag on every theological concept. A theological liberal might do the same with the green tag, thinking that nothing is essential. Our goal is to give you a tool to think through your own approach to doctrine. We believe that every Christian needs to think through these categories at least at a basic level because making decisions about other Christians with whom you will unite or from which you will divide is unavoidable. All you have to do is live a few years or less as a Christian and you’ll face practical questions about how you can fellowship and partner with other believers. Every Christian needs to embrace this task.

Do some doctrines matter more than others? We’d both say the answer to that is an emphatic yes. Some doctrines are heresy/orthodoxy-level issues, and some of them, like the color of the carpet, don’t seem to matter nearly as much as the others.

How does theological triage help you articulate which doctrines are worth dying for?

Article by Drs. Brian Arnold and Gavin Ortlund

Gavin Ortlund (PhD, Fuller Theological Seminary) is a husband, father, pastor, and writer. He serves as senior pastor of First Baptist Church of Ojai in Ojai, California. Gavin blogs regularly at Soliloquium. He is the author of Theological Retrieval for Evangelicals: Why We Need Our Past to Have a Future (Crossway, 2019) and Finding the Right Hills to Die on: The Case for Theological Triage (Crossway/TGC, 2020). You can follow him on Twitter.

Brian Arnold (Ph.D.) serves as the fourth President of Phoenix Seminary. Dr. Arnold earned his Ph.D. from The Southern Baptist Theological Seminary in 2013 and has since authored two books, Justification in the Second Century (de Gruyter; Baylor University Press) and Cyprian of Carthage: His Life and Impact (Christian Focus), and a number of journal articles. He has been married to Lauren since 2007 and has two children, Jameson and Natalie.