In every generation, the church is commanded to “contend for the faith once for all delivered to the saints.” That is no easy task, and it is complicated by the multiple attacks upon Christian truth that mark our contemporary age. Assaults upon the Christian faith are no longer directed only at isolated doctrines. The entire structure of Christian truth is now under attack by those who would subvert Christianity’s theological integrity.

Today’s Christian faces the daunting task of strategizing which Christian doctrines and theological issues are to be given highest priority in terms of our contemporary context. This applies both to the public defense of Christianity in face of the secular challenge and the internal responsibility of dealing with doctrinal disagreements. Neither is an easy task, but theological seriousness and maturity demand that we consider doctrinal issues in terms of their relative importance. God’s truth is to be defended at every point and in every detail, but responsible Christians must determine which issues deserve first-rank attention in a time of theological crisis.

A trip to the local hospital Emergency Room some years ago alerted me to an intellectual tool that is most helpful in fulfilling our theological responsibility. In recent years, emergency medical personnel have practiced a discipline known as triage–a process that allows trained personnel to make a quick evaluation of relative medical urgency. Given the chaos of an Emergency Room reception area, someone must be armed with the medical expertise to make an immediate determination of medical priority. Which patients should be rushed into surgery? Which patients can wait for a less urgent examination? Medical personnel cannot flinch from asking these questions, and from taking responsibility to give the patients with the most critical needs top priority in terms of treatment.

The word triage comes from the French word trier, which means “to sort.” Thus, the triage officer in the medical context is the front-line agent for deciding which patients need the most urgent treatment. Without such a process, the scraped knee would receive the same urgency of consideration as a gunshot wound to the chest. The same discipline that brings order to the hectic arena of the Emergency Room can also offer great assistance to Christians defending truth in the present age.

A discipline of theological triage would require Christians to determine a scale of theological urgency that would correspond to the medical world’s framework for medical priority. With this in mind, I would suggest three different levels of theological urgency, each corresponding to a set of issues and theological priorities found in current doctrinal debates.

First-level theological issues would include those doctrines most central and essential to the Christian faith. Included among these most crucial doctrines would be doctrines such as the Trinity, the full deity and humanity of Jesus Christ, justification by faith, and the authority of Scripture.

In the earliest centuries of the Christian movement, heretics directed their most dangerous attacks upon the church’s understanding of who Jesus is, and in what sense He is the very Son of God. Other crucial debates concerned the question of how the Son is related to the Father and the Holy Spirit. The earliest creeds and councils of the church were, in essence, emergency measures taken to protect the central core of Christian doctrine. At historic turning-points such as the councils at Nicaea, Constantinople, and Chalcedon, orthodoxy was vindicated and heresy was condemned–and these councils dealt with doctrines of unquestionable first-order importance. Christianity stands or falls on the affirmation that Jesus Christ is fully man and fully God.

The church quickly moved to affirm that the full deity and full humanity of Jesus Christ are absolutely necessary to the Christian faith. Any denial of what has become known as Nicaean-Chalcedonian Christology is, by definition, condemned as a heresy. The essential truths of the incarnation include the death, burial, and bodily resurrection of the Lord Jesus Christ. Those who deny these revealed truths are, by definition, not Christians.

The same is true with the doctrine of the Trinity. The early church clarified and codified its understanding of the one true and living God by affirming the full deity of the Father, the Son, and the Holy Spirit–while insisting that the Bible reveals one God in three persons.

In addition to the Christological and Trinitarian doctrines, the doctrine of justification by faith must also be included among these first-order truths. Without this doctrine, we are left with a denial of the Gospel itself, and salvation is transformed into some structure of human righteousness. The truthfulness and authority of the Holy Scriptures must also rank as a first-order doctrine, for without an affirmation of the Bible as the very Word of God, we are left without any adequate authority for distinguishing truth from error.

These first-order doctrines represent the most fundamental truths of the Christian faith, and a denial of these doctrines represents nothing less than an eventual denial of Christianity itself.

The set of second-order doctrines is distinguished from the first-order set by the fact that believing Christians may disagree on the second-order issues, though this disagreement will create significant boundaries between believers. When Christians organize themselves into congregations and denominational forms, these boundaries become evident.

Second-order issues would include the meaning and mode of baptism. Baptists and Presbyterians, for example, fervently disagree over the most basic understanding of Christian baptism. The practice of infant baptism is inconceivable to the Baptist mind, while Presbyterians trace infant baptism to their most basic understanding of the covenant. Standing together on the first-order doctrines, Baptists and Presbyterians eagerly recognize each other as believing Christians, but recognize that disagreement on issues of this importance will prevent fellowship within the same congregation or denomination.

Christians across a vast denominational range can stand together on the first-order doctrines and recognize each other as authentic Christians, while understanding that the existence of second-order disagreements prevents the closeness of fellowship we would otherwise enjoy. A church either will recognize infant baptism, or it will not. That choice immediately creates a second-order conflict with those who take the other position by conviction.

In recent years, the issue of women serving as pastors has emerged as another second-order issue. Again, a church or denomination either will ordain women to the pastorate, or it will not. Second-order issues resist easy settlement by those who would prefer an either/or approach. Many of the most heated disagreements among serious believers take place at the second-order level, for these issues frame our understanding of the church and its ordering by the Word of God.

Third-order issues are doctrines over which Christians may disagree and remain in close fellowship, even within local congregations. I would put most of the debates over eschatology, for example, in this category. Christians who affirm the bodily, historical, and victorious return of the Lord Jesus Christ may differ over timetable and sequence without rupturing the fellowship of the church. Christians may find themselves in disagreement over any number of issues related to the interpretation of difficult texts or the understanding of matters of common disagreement. Nevertheless, standing together on issues of more urgent importance, believers are able to accept one another without compromise when third-order issues are in question.

A structure of theological triage does not imply that Christians may take any biblical truth with less than full seriousness. We are charged to embrace and to teach the comprehensive truthfulness of the Christian faith as revealed in the Holy Scriptures. There are no insignificant doctrines revealed in the Bible, but there is an essential foundation of truth that undergirds the entire system of biblical truth.

This structure of theological triage may also help to explain how confusion can often occur in the midst of doctrinal debate. If the relative urgency of these truths is not taken into account, the debate can quickly become unhelpful. The error of theological liberalism is evident in a basic disrespect for biblical authority and the church’s treasury of truth. The mark of true liberalism is the refusal to admit that first-order theological issues even exist. Liberals treat first-order doctrines as if they were merely third-order in importance, and doctrinal ambiguity is the inevitable result.

Fundamentalism, on the other hand, tends toward the opposite error. The misjudgment of true fundamentalism is the belief that all disagreements concern first-order doctrines. Thus, third-order issues are raised to a first-order importance, and Christians are wrongly and harmfully divided.

Living in an age of widespread doctrinal denial and intense theological confusion, thinking Christians must rise to the challenge of Christian maturity, even in the midst of a theological emergency. We must sort the issues with a trained mind and a humble heart, in order to protect what the Apostle Paul called the “treasure” that has been entrusted to us. Given the urgency of this challenge, a lesson from the Emergency Room just might help.