A man walks into the ICU saying, “Help me, I can’t breathe”. A little girl walks in at the same time saying, “Help me, I have a splinter in my finger.” The nurse rushes the girl with the splinter into surgery but tells the man who can’t breathe to wait in the lobby. You ask the nurse, “Why?” She explains: “The man had a panic attack. It should go away in a while and we monitor him in the lobby in case it gets worse. As for the girl, she only saw the splinter. One look at her and I knew she was in serious trouble and needed surgery immediately.” In todays book review we will look at triage not in hospitals but in the theologicals.

Hi, my name is Terence and I’m your host for Reading and Readers, a podcast where I review Christian books for you. Every month I review Faithlife’s Free Book of the Month, and while waiting for the next free book, I pick a book of my choice. And today I review, “Finding the Right Hills to Die On: The Case for Theological Triage” by Gavin Ortlund.

Life or Death in Triage

The purpose of medical triage is to get limited and timely help to the right people. You ask, “What do you mean by right people?” If you have many people calling for help, you first get all the people who will live — they need medical attention but they will live — and move them to the left. Then get all the people who will die — no matter what you do for them, they will die — and move them to the right. Those who are left are people who if left untended would die and it is to them, we give the limited time and resources, a shot to live.

Similarly, theological triage sorts doctrines into three levels. First level doctrines are essential and non-negotiable to the faith like the divinity of Christ. Second level doctrines separate believers into their churches or denominations. I so strongly disagree with you, such that I live out my convictions in a separate church, but I still call you brothers and sisters in Christ. For example, you believe in baptism by sprinkling, while I believe baptism is by immersion. Third level doctrines are differences that should not separate fellowship within the local church, for example young-earth or old-earth creationism. Theological triage helps us know how much time and energy to invest in a doctrinal dispute or as the title of the book says, finding the right hills to die on.

While the idea of theological triage is simple — you just sort doctrines into three buckets — the sorting can be problematic.

Imagine a man who was told he will die. So we are moving him to the group on the left. He says, “My situation is not as bad as you think it is. I need medical help. I might live.” Or imagine a woman who is asked to go home. She says, “I’m not as well as you think I am. I need medical help. I might die.” Who decides these cases? Who is best positioned to do triage? Doctors and other medical professionals. They are not infallible but we trust them – we have to! – to do the hard job of, not treating, we have not reached there yet, but of sorting.

I came to Ortlund’s book hoping he can help me do triage. I have a doctrine in mind which I see as a first-level issue but some see it as a second- or even third-level issue. I think it’s urgent and important, while others are indifferent. Will Ortlund help me?

Structuring Triage

The book is divided into two parts. Part one is titled Why Theological Triage? Here he makes the case for theological triage in three chapters. Chapter 1 explains the danger of doctrinal sectarianism or division. Chapter 2 explains the danger of doctrinal minimalism. In Chapter 3, he gives his personal testimony for triage.

Part two of the book is titled Theological Triage at Work. The three chapters correspond to the three levels, they are: Why Primary Doctrines Are Worth Fighting For, Navigating the Complexity of Secondary Doctrines and Why We should Not Divide over Tertiary Doctrines.

The book ends with a conclusion titled A Call To Theological Humility.

Against Doctrinal Sectarianism

In the first part of the book, Ortlund argues we all lean either towards doctrinal sectarianism or minimalism. He quotes Martin Luther:

Softness and hardness … are the two main faults from which all the mistakes of pastors come.

Do you lean on the hard side? Do you see in every doctrine a fight, every doctrine a hill to die on? Only because all of Scripture is God-breathed and thus necessary to defend with all our might, right?

In the first chapter, we read that defending the inerrancy of Scripture does not mean all doctrines are created equal. He quotes Turretin, Calvin, Bavinck, Spurgeon and Baxter. These guys are fighters and they are saying not every doctrine is worth fighting for because, as Ortlund puts it:

The unity of the church is essential to the mission of the church.

Unity is not a codeword for surrender to minimalism. Unity is in the Bible.

While I appreciate Ortlund’s reminder to not be too hard because love and unity is essential to our faith, my problem I face is not that I’m divisive. While I’m conscious of that danger, I see a creeping danger of doctrinal minimalism around me.

Ortlund writes:

I have often heard people say, “It’s not a gospel issue; it’s just a secondary issue.” And, of course, we should distinguish between the gospel and secondary issues. But if we stop at this basic distinction, we risk obscuring the significance of secondary doctrines. I worry that when people make this distinction, they mean something like “It’s a secondary issue; therefore, it doesn’t really matter.” While I sympathize with the instinct to focus on the gospel, we must recognize that distinguishing between the gospel and other doctrines is a complicated task. For example, doctrines can be “secondary” or “nonessential” to the gospel and yet still make a difference in how we uphold the gospel.

Against Doctrinal Minimalism

The bulk of chapter two is Ortlund arguing that nonessential doctrines are significant for Scripture, significant to Church History, significant to the Christian life and significant to Essential Doctrines.

I found most thought-provoking this quote from Gresham Machen: “Better to be wrong than indifferent”.

If you know someone who is divisive over doctrine, ask him to read chapter 1 of this book. If you know someone who is dismissive of doctrine, ask her to read chapter 2. This means, if both parties read both chapters, we will understand each other’s concerns. Just like how we can better understand Gavin Ortlund’s concerns as he works out triage in his own life.

Triage in Action

Baptised as an infant, he grew up Presbyterian. Naturally, the seminary he attended was also Presbyterian. Reflecting on his journey, he writes:

There is no way I can sufficiently emphasize my gratitude for my experiences.
Some of my happiest memories and deepest friendships in my life.
… combination of theological depth and relational warmth… We [Ortlund and his wife] sensed something healthy and beautiful about the theological culture at Covenant Seminary, and we have always felt discontent with pursuing anything less.

It’s such a glowing review of the Presbyterians that the reader almost signs up to join them and then Ortlund tells you he is leaving.

He is not leaving because of personal dissatisfaction, he was happy, but he is leaving because of doctrinal convictions.

Triage ruined the trajectory he was heading. But it’s okay, he got to write a book. In this chapter, we see triage in practice, not as detached what-ifs, a mental exercise, but as a believer wrestling to make decisions with real lasting impact. For Ortlund, that meant leaving the Presbyterians into the unknown.

I was searching for a grand old hymn to describe the tension in the triage but all I got was this:

I can hear you, but I won’t
Some look for trouble, while others don’t
There’s a thousand reasons I should go about my day
And ignore your whispers, which I wish would go away

What do you want ’cause you’ve been keeping me awake
Are you here to distract me so I make a big mistake
Or are you someone out there who’s a little bit like me
Who knows deep down I’m not where I’m meant to be

Who knew that Elsa’s song from Frozen 2 would make a fitting soundtrack for triage?

Making the Main Thing the Main Thing

Now we enter Part 2, Theological Triage At Work.
Now we come to the essence of the matter. How do we do triage? How do we classify doctrines into three levels?

It might surprise you to know that classification is a tough technological problem. Complex algorithms are invented to recognise voices and faces, to sort fruits into good or bad grades, to tell whether a painting is real or fake, and even which artist painted it. The way many of these technologies work is to first figure out what is the criteria and then check whether the voice, face, apple or painting fulfil the criteria.

And we do the same with doctrine.

Ortlund begins with Erik Thoennes’ eight criteria on deciding the importance of a doctrine:

1. Biblical clarity
2. Relevance to the character of God
3. Relevance to the essence of the gospel
4. Biblical frequency and significance (how often in Scripture it is taught, and what weight Scripture places upon it)
5. Effect on other doctrines
6. Consensus among Christians (past and present)
7. Effect on personal and church life
8. Current cultural pressure to deny a teaching of Scripture

Notice that according to Thoennes, the Bible is not the only criteria. We also also consider put historical and contemporary thought on the doctrine and how does this doctrine affect me and my church?

Wayne Grudem asks similar questions, eight of them cited in this book. And he also warns us to not ask certain questions. We should not ask:

• Are the advocates my friends?
• Are they nice people?
• Will we lose money or members if we exclude them?
• Will the academic community criticize us as being too narrow-minded?
• Will someone take us to court over this?

To me, Ortlund’s analysis on the criteria and questions are not ground-breaking. While it’s helpful to put them together and to talk them through, thoughtful readers working on triage would figure them out.

What Ortlund uniquely brings to the table are well-researched and well-written examples.

If you were to go back 100 years to the Church embroiled in the biggest controversy of that time, how would you decide on it? Is the virgin birth an essential doctrine? Or is it a doctrine that fellow Christians can agree to disagree?

Ortlund brings us through Machen’s defence on the importance of the doctrine of the virgin birth. Unlike justification by faith, the virgin birth seems so peripheral. Jesus never said, “I was born a virgin.” Nobody taught it in Acts. Nobody mentioned it in the epistles.

Ortlund writes:

Machen distinguished between affirming the virgin birth and affirming it as a first-rank doctrine. He recognized that in his day “there are many who tell us that, though they believe in the virgin birth themselves, they do not think that that belief is important for all men or essential even to the corporate witness of the Church.” In contrast to this approach, Machen argued that the virgin birth is not a matter of private judgment but is essential to the church’s worship, witness, and vitality. To support this claim, he developed three considerations.

If you want to know what are the three considerations, you can read Machen or Ortlund.

Now imagine you are transported not 100 years to the past but 500 years. Sitting beside you is Martin Luther. Imagine he is having second thoughts. He questions out loud, is justification by faith alone worth dying for? He remains convinced that it is true but how important is this truth when the Church seems to have moved along fine for a thousand years without it? Or coming back to our time, how essential is justification by faith alone, when Christians are saved without knowing it? Ask yourself: “When you first believe Jesus is Lord, did that belief came together with an accurate grasp of sola fide, faith alone?” Ortlund covers these questions and more.

It is Complicated

In the next chapter, he navigates the complexity of secondary doctrines.

You would think and hope that after we all agreed on the criteria for first rank doctrine, it would be easy to agree on what is a first rank doctrine. No. Earlier, I mentioned the dying man who thinks he has a shot to live.

Let me give another example. Why are bats not considered birds? They don’t lay eggs. Hmmm… then why is a platypus not considered a bird? It has a duck’s beak and it lays eggs but it is classified as a mammal, not a bird. Curious, isn’t it?

Now imagine when the platypus was discovered, an old ornithologist received news that a new bird species was discovered in Australia. He sells all he has, packs everything and plans to spend the rest of his life studying the new bird. When he realises it’s not a bird, but an unique mammal, would he just lazily comment, “Curious, isn’t it?”

If we don’t get the category right, we can over-commit, like the ornithologist flying to Australia to study a duck face mammal. When it comes to doctrinal debates, Christians often over-commit or can’t care less, falling into the two extremes. We need a middle category.

Ortlund writes:

This chapter is the most difficult and complicated of the whole book.

And I agree.

If you could name the top five controversies among evangelicals, what would they be? Ortlund wades into not one, not two but three controversies in his heroic attempt to show to us, “It is complicated.”

He does not attempt to resolve them. Just how to rank them and our posture. Listen to what he writes here on the question of women in ministry:

Complementarians conceive of egalitarians as compromising liberals, and egalitarians regard complementarians as sexists who oppress women. It would be better to recognize that there are a variety of expressions of each view and to look for points of contact between the more thoughtful and careful proponents of each side, yet without downplaying the differences. There are godly and intelligent Christians on each side. We must be wary of labeling this a second-rank issue on paper but allowing it to occupy a first-rank position emotionally and practically.

The tensions exist. The differences should not be dismissed. But don’t pick this hill to die on. Don’t die here.

Don’t Sweat the Small Stuff

The next chapter is on third rank doctrines. For example, where do you stand on Creation or the Last Days? Ortlund comments:

But it is a historical irony that American evangelicals have tended to divide over the peripheral aspects of creation and eschatology while ignoring the more central aspects of these doctrines. Thus, many evangelicals focus more on the timing of the rapture, the identity of the anti-Christ, and the nature of the millennium (all, in my view, third-rank doctrines) than they do on the second coming of Christ, the final resurrection, or the final judgment (all, in my view, first-rank doctrines). Similarly, many evangelicals are intimately familiar with the “creation wars” but have never given any sustained reflection to more basic questions about the goodness and contingency of creation, on which the early church expended so much energy, and which are vital to a Christian worldview.

What I got from him here is doctrines can be sliced into first, second and third rank. Let me ask you. Is Creationism a first, second or third rank doctrine? That’s a vague question pre-loaded with assumptions. You assume I know what you are asking.

But do you mean Creationism, as in whether God created the world? If you don’t agree that God created the world, how can you call yourself a Christian? That’s a clear first rank doctrine.

Or do you mean Creationism, as in whether the days in Genesis 1 refer to twenty-four hour days or not? Is this a second rank or third rank issue? Ortlund points out that some would argue any other interpretation undermines the inerrancy of the Bible, thus making this a first-rank issue.

Reflection on What I Read So Far

Allow me some reflection after reading this book.

What is the difference between the three levels in theological triage?
In the first level: “Because we both believe in the Bible, I must do A, and you must do A also.”
In the second level: “Because we both believe in the Bible, I must do A, and you must do B.”
In the third level: “Because we both believe in the Bible, I do A, and you should accept A, or vice versa.”

Ortlund’s aim in this book is not just presenting the challenges and the methods to sort doctrines into different levels. More importantly, is the posture of the Christian in the three levels.

The way I put it is like this:
In the first level: You bring a gun. It’s demolish every argument time.
In the second level: You bring a rapier. We fence, we score points, we hope to win each other over, but we shake hands after the match.
In the third level: You bring a pillow. We fight but we still sleep in the same house.

If we enter into a theological conflict knowing the rules of engagement, whether to bring a gun, rapier or pillow, being clear where the doctrine sits, we can have more meaningful exchanges. Perhaps the first question to ask is not, “Why do you believe this is true?” but “Why do you believe this is important?”

As I hope you can tell from this review, theological triage is not easy and people will not agree. But that’s true of doctors that’s why a terminal cancer diagnosis leads to second opinions. Astronomers don’t agree. Pluto was a planet since it was discovered in the 1930s. Then, in 2006, Pluto was demoted.

What is the most important attitude when it comes to theological triage? Ortlund concludes the book with a chapter titled: “A Call To Theological Humility.”

Ortlund writes:

In doing theological triage, humility is the first thing, the second thing, and the third thing. It is our constant need, no matter what issue we are facing.

More Things You Can Do With Triage

After reading this book, I have this idea that maybe a listener to this podcast can take up.

Let’s do a triage survey. We sort of know the positions many church leaders take. On women in ministry, spiritual gifts, millennium, creationism, virgin birth and salvation. My idea is do we know how the experts would rank their importance?

What if every pastor, preacher, theologian, missionary was to rank the millennium question as third rank? Maybe that would settle the ranking question. Or what if all of them say it’s a second rank, then that is a different signal. Notice that the experts may firmly hold conflicting positions but if they all agree on the ranking, on how important it is, that helps us to reflect on our posture towards that doctrine. Whether to bring a gun, a rapier or a pillow to the fight.

Now say they don’t agree. Opinions are scattered even within the same denomination. Some insist it’s first, some argue it’s second, and some are indifferent. I suggest that variance could be an indicator of an emerging controversy. For example, Critical Race Theory and the Church. Is it a gospel issue or is it a lot of hot air over nothing?

Let me give you another issue. Churches closing down for Covid. If you disagree with your church’s position on this, is this cause for separation? Finding the Right Hills to Die On doesn’t explore the Covid question but Ortlund wrote a response to Pastor MacArthur in his blog at gavinortlund.com.

In that blog you will also find chapter questions for this book. Questions suitable for a weekly small group setting or individual reflection.

So what next after this? Is there more room to explore on triage? I suggest yes.

Before this book was published I was studying theological triage on a particular doctrine: the New Apostolic Reformation or the concept of modern day apostles. I treated it like a first rank doctrine, a matter critical to the faith and requiring a decisive position in my church.

After talking with other thoughtful believers, further reflection and reading this book, my view has shifted. I remain adamant on my position on the New Apostolic Reformation, I remain fully convinced on what the Bible speaks on this matter, but I no longer see it as a first-rank issue. In my mind, it’s demoted to second-rank. It’s important enough for me to leave my church but not so important that I would see opposing views as heresy. It’s at the boundary though. It’s pushing near first-rank.

That is why I think there is room to explore in triage. I know I’m right. I just want to know how far do I take this argument. Not just in the local church but in the circles of influence I have. And that question applies to you too.

So I hope this book on triage is the beginning of a conversation that continues on. Triage is a tool for us to understand and contribute to past, present and future theological debates with the purpose to make us better Christians: quick to listen, slow to speak, humble, bold and steadfast to build up, not tear down, the Church.

This is a Reading and Readers review of “Finding the Right Hills to Die On: The Case for Theological Triage” by Gavin Ortlund.

So if you had to do triage on this podcast where would I be? Would it be:
A. A great Christian Book Review podcast that everyone you know should subscribe to. Or…
B. A podcast with potential to live a good and meaningful life if it gets the care, meaning subscribers, it needs. Or…
C. A dying podcast that just doesn’t know it’s dying yet. And if so, I’d like a second opinion. Can you get someone else to listen to this podcast? Perhaps if more listeners shared your view, I would agree.

In any case, it is quite clear, you need to tell more people to listen to the Reading and Readers Podcast. Thanks for listening.

Book List

Finding the Right Hills to Die On by Gavin Ortlund. Amazon. Logos.