Finding the Right Hills to Die On: The Case for Theological Triage,by Gavin Ortlund. Wheaton, IL: Crossway, 2020. 163 pp. $17.99.
This book, whose title blends two metaphors to create the image of urgency as applied to Bible doctrine, is the kind of a book that ministers need to read periodically. As a former Emergency Medical Technician, one of the things we learned in training was that not all medical problems are of the same seriousness, particularly in a mass casualty situation. Once on scene at a catastrophe where there are multiple victims, the first medical responders on site assess the various injuries to determine a priority of treatment. Those injuries that are both life-threatening and have the greatest chance for survival are treated first, while lesser injuries or fatal injuries may be immediately passed over because there simply are not enough hands to care for those involved. This is medical triage. It has been applied appropriately in recent years to theological discourse to stress that while all doctrines are important, not all are equally important. Some doctrines matter more to the Church than others.
The second metaphor is a military one—knowing which hills in a military campaign can be passed by as unworthy of the cost in lives needed to secure them, while others are too important to be overlooked and must be taken at all cost. Some hills become a “hill to die on.” Applied to the Bible, some doctrines, while important because they are taught in the Scripture, do not rise to the level of a life-or-death struggle. Some doctrines are gospel-critical (the Virgin Birth of Jesus) while some, significant (baptism), and others, tertiary (end-time events). A person may be wrong on the latter and still find eternal rest in Christ, but to deny the former is to deny the uniquely divine nature of the Son of God.
This book is a fresh attempt to examine the importance of doing theological triage (section one) and suggests a strategy for evaluating the relative significance of doctrines to determine which are gospel-critical and which are tertiary. The author writes out of his experience of moving from Presbyterianism to becoming a Baptist during his college years as he came to conclude that credobaptism and not paedobaptism was biblical (64). Having been sprinkled as a baby, he was immersed as an adult upon his profession of faith. But was the mode and recipient of baptism an important enough doctrine to separate from other believers? This was a question he had to wrestle with. Also, he was amillennial in his eschatology, moving into a world of premillennialism. Did this doctrine rise to a reason for Christian division?
These are the kinds of questions that serious Christians need to ponder. As a product of a prominent, professing fundamentalist university, many of those whom I heard preach from the platform took a strong view on doctrinal issues that other Christians held to be tertiary, while criticizing some Christians for considering many important issues as tertiary. Theological issues that come to mind include baptism, eschatology, Calvinism vs. Arminianism, lordship salvation, Pentecostalism and related matters such as tongues, creationism vs. old earth or theistic evolution and especially Bible versions. Lifestyle issues also fall under these guidelines. Consuming alcohol as a beverage, music, movies, hair and dress styles, etc. were matters of Christian separation. As a young minister, if you did not use the “right” Bible, no matter what else you believed, you were considered a heretic or worse in some circles.
A book of this nature would have been very helpful to me as a young ministerial student just to appreciate the importance of theological triage—not all doctrines, biblical though they may be, carry the same weight. Gospel-critical doctrines must be treated more seriously in matters of Christian fellowship and cooperation.
So, from the standpoint of value, this book and those like it are important for ministers to read and subsequently reexamine their own doctrinal sensibilities. Which ones are really important and for what reasons? Few conservative evangelicals will find much to quibble with in the first section of the book, “Why Theological Triage?” More debate and criticism will result in Ortlund’s application section, “Theological Triage at Work.”
Granted that many will disagree with portions of this section, few will likely disagree with the fifth chapter which treats Gospel-critical issues. Ortlund offers a series of reasons why certain doctrines matter, following ranking systems of Erik Thoennes, Life’s Biggest Questions, (2011) and Wayne Grudem’s essay “Why, When and for What We Should Draw Boundaries?” (2003) (76–79). In chapter six, Ortlund moves from critical issues to lesser, even tertiary issues, some of which will find disagreement among conservatives. Baptism is important in a local church context but may not be a cause for division for wider Christian fellowship, unless one is talking about baptismal regeneration (101). The more contested example will be Ortlund’s discussion of cessationism vs continuationism (108ff). Ortlund locates this discussion in between a “broadly second rank doctrine (and, in some cases, a third rank [tertiary] doctrine).” Also ranked lower in Ortlund’s mind is the creationism debate. He offers numerous individuals from church history who held to something other than young-earth creation.
This highlights the key weakness in the book. Because an honored Christian of the past did not believe that a theological issue of contention in our day was an issue in his day, does not always bear on our consideration of the relative value of that issue now. Many in the nineteenth century did not see any problem with aspects of the evolutionary hypothesis and the theory seemed to be so irrefutable then. But through the progress of doctrine, many have come to see with a clearer eye the significance of views that older Christians simply did not have the capacity to grasp. This has always been true in the progress of doctrine. Few genuine Christians during Jesus’s earthly ministry doubted his deity. They could see it on display in his personal life. The same could be said with the doctrine of the Trinity. Jesus made claims to his equality with the Father. It was only after his death and into the first four centuries of the Church that the major trinitarian and Christological debates occurred and were settled. It may be true that Christians did not argue about eschatological issues then, but these became issues for the Church later, after the heavy issues surrounding Christ’s person were settled. The fact that the twentieth century became the so-called “Century of the Holy Spirit” because of the rising Pentecostal movement has little bearing on the truthfulness of the theological views espoused. Frankly, Ortlund’s sword cuts both ways. He wants Christians to accept creationism as a tertiary issue because of the old timers who did not hold to young-earth creationism, while at the same time accepting continuationism that has very little support in church history.
One’s understanding on doctrinal importance really amounts to how a tertiary doctrine is determined and by whom. Within the boundaries of a local church, for cessationism and continuationism to co-exist would likely mean that one group or the other does not take their view seriously. The same is true with creationism and complementarianism/egalitarianism. The same could be said about baptism. A prominent local pastor about fifteen years ago attempted to relegate baptismal form to a de facto tertiary issue. The attempt did not pass in the church.
While the church seeks to display the unity of the Spirit, the hard truth is that there are too many issues that divide us that we believe are too important to overlook within the confines of a local assembly. This is why we have denominations. These will not go away, try as we might. Ortlund’s tertiary issues are tertiary for him, but perhaps not for others, not because they are gospel-critical, but because within a local church, some issues simply shape the way the church sees its ministry. I just cannot envision a church saying, “Next Sunday is Young-Earth creation Sunday, in two weeks we will have Old Earth Sunday.” Talk about confusing the sheep.
Should we do theological triage? Absolutely, but to what end? In forming and ordering a church, if baptism is an important secondary issue, why may not creationism be as well? Or cessationism? This does not mean that we consign old earth supporters to the abyss. We may genuinely think they are wrong, and their view significantly damages the Gospel presentation they claim to affirm. We can and should have Christian fellowship with a broad range of believers with whom we agree regarding Gospel-critical doctrines. The closer our working relationship and the narrower the purpose, the narrower our theological sensibilities will become. These are hard conversations. The book is generally helpful, even if I do not grant a doctrinal issue as tertiary following Ortlund’s understanding. We look forward to that day when the King of kings will set everything right. Until then, we wrestle, in humility (Ortlund’s final excellent plea) to understand and uphold the Word of God.
