A Critique of Theological Triage
Having given reasons why young earth theology is essential to Christian doctrine as a whole, I now turn to a very popular argument that has been used against raising creationism to such a level. In 2004, Al Mohler wrote an influential article calling for theological triage.30 In that article, Mohler likens the sorting of doctrines according to priority with triage of variously ill patients in a medical emergency room. More serious injuries or illnesses are prioritized for faster response, whereas minor injuries are pushed toward the back of the line. Similarly, a doctrinal prioritization is visible in the historical development of doctrine in church history. Mohler calls for such sorting in today’s debates over doctrine and in the arrangement of churches and fellowships.
As a corrective to overreaction, Mohler wrote this in his article:
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.31
Despite this caution, the idea of triage seems to this author to be less than carefully applied by many church members, missionaries, pastors, and academics. It has been used as a mental tool to set aside important doctrines as if they are practically not very important at all, creationism included.
I believe this happens because the triage analogy fails in several key ways that make it an incomplete explanation of how Christians should handle the Bible’s doctrines. Granted every analogy has its shortcomings, but the three shortcomings that I will raise here weigh against the central thesis of Mohler’s model.
The first way that the triage model fails is that it presents the Christian life as a non-stop emergency. It is true that triage can be a helpful concept for certain situations. For instance, a person who is unsaved or newly saved does not need first of all to be taught on the essentials of young earth creation. He would more importantly require basic instruction on other doctrines of the faith, with only an introductory reference to God as creator. A church that is having a doctrinal problem needs instruction that is tailored to the error that is causing the problem. Certain doctrines would rank higher in the particular situation being addressed. We must note that such situations represent theological illness, like the medical emergency room. Triage is helpful in those kinds of situations. But it is not so helpful in describing how doctrine is to be handled by a healthy Christian or a healthy church. In other words, medical triage is not a helpful analogy for the whole Christian life.
I would prefer to look at the normal, healthy situation according to the analogy of a medical textbook on normal anatomy and physiology. In other words, triage is helpful when there is injury or pathology, but not when striving for wholistic health and describing what the whole Christian life and doctrine should look like. Healthy churches and individuals are not in a constant state of triaging theological problems into a priority order. Rather, they should be living out the healthy Christian life day by day in accordance to their “normal anatomy and physiology.” Christian and church life is not an emergency that requires triage.
In my analogy, normal anatomy is akin to a careful exposition of sound doctrine. Normal physiology is likened to biblical Christian practice. This explanation is advantageous because it highlights that Christians should be striving for good health in all departments. Certainly there are some “sick” Christians. But then there are those who are, by God’s grace, doing well. Their standard is the whole counsel of God, not just the doctrines that receive top priority in Mohler’s scale. Pastors, theologians, and Christian leaders must be called to a higher standard than believing only the doctrines that sort into the highest bucket, or practicing just some of the more important elements of the faith.32
The second way that the triage analogy fails is that it does not do justice to the interconnectedness of doctrines in the body of Christian truth. The initial setup of the explanation in Mohler’s article has the reader picture an emergency room with several patients with injuries of varying severity. These patients are independent of each other and, once sorted, can be treated without regard for the other patients.
But this is not true of doctrines. Doctrines are more like organs of an individual person than separate entire persons: they are members put together to form a unitary whole. The church body has many members just like a physical body; and the body of Christian doctrine has many truths carefully woven together into a single coherent whole.
To carry on with the medical analogy, the poor function of the heart can affect the kidneys and vice versa. The poor function of either radically affects the entire body. A small organ such as the thyroid affects many body systems. Its diminutive size belies its necessary and pervasive function. It is true that certain body parts can be amputated—feet, hands, legs, arms, gall bladder—without killing the patient, but the resulting quality of life is generally not as good. Even small body parts, when missing, can cause inordinate effects on the function of the body.
With the triage analogy, one has to wonder if certain doctrinal issues, like doctrinal ingrown toenails or slivers, would end up being dismissed entirely from the emergency room. The patient may go home and contract an infection from that little problem that could end up threatening life and limb. We must remember that sin started with a little question about God’s Word. It quickly blew up into a world-engulfing inferno.
In the same way, certain doctrines left out or not carefully preserved can have an outsized effect on the church or the individual. The poor treatment of one doctrine can influence other good ones. Such is the case with young earth creationism. When it is damaged, the whole body of doctrine fares poorly.
The third way Mohler’s triage model fails is that after a couple of key doctrines concerning theology proper and soteriology are triaged, there is little agreement on what should be included in the first, second, or third levels. Mohler offers an outline for his own sorting function in his article, but he offers little Scriptural justification for the levels he assigns to various doctrines. Some have even suggested that it is sin to assign a doctrine to a higher level than is wont.33 Where does Scripture specify which doctrines belong to which levels? Other than its general teaching on unity in the church that today is used to eliminate almost any doctrinal precision, it is not easy to find texts that tell us how to do this sorting.
Additionally, no one could undertake to triage doctrines without examining all of them first. Just like a good doctor knows the anatomy and physiology textbook completely, and just like he examines the entire patient to find out everything that is going on, the theologian has to take in the entire Scripture before he can have any confidence that he has gained the wisdom and discretion necessary to start to triage doctrines. This theological process is never fully completed. Doctrinal prioritization thus must be held with caution and humility, for in a few years a reader might discover that creation is more significant than is imagined while reading this article!
In this connection, it is helpful to remember that our Lord enjoined the Pharisees to carry out the weightier requirements of the law without neglecting the lighter ones (Matt 23:23). We might call this an “all of the above” approach to handling theological issues. It is granted that this can be criticized as a kind of everythingism, but it is hard for me to categorize some things into a box labeled “neglected.” Furthermore, the critic should justify his critique in the face of the fact that all Scripture is God-breathed and that the Pharisees should have carried out the small matters of the law with fidelity while caring for the “big” ones as well.
To further address the everythingism concern, I suggest that instead of emphasizing priority or urgency, we should take care to maintain the right weight or proportion in our doctrinal formulation and practice. In so doing, we must care for the entire theological textbook as it describes how we should believe and live. I am advocating for an everyday embrace and practice of the whole body of Christian doctrine in the proportion that it is found in Scripture. This will obviously give some doctrines a larger cut from the cake than others, but we should still eat the whole cake. The size of the various pieces should be proportioned as they are in Scripture. This is why a regular expositional diet of Scripture is the best, as it will treat all the issues that Scripture does.
The proportionality of which I speak is not necessarily a proportionality of Scriptural frequency, for then certain doctrines such as the Trinity would be almost nonexistent in our theological dialog. Still, the weight of a doctrine certainly can be affected by frequency of mention.
For instance, phrases like “I am the Lord who created” by their very frequency call the reader to take note. Other doctrines must be weighted by their effect on other truths that logically rest upon them, or by how their own tentacles reach through Scripture’s perfect web of theological truth. Narrative incidents that are disconnected from the larger network of theological truth have a proportionally lower weight (e.g., 1 Chron 11:22). Creation, sin, the doctrines of God and Christ, justification, the church, and eschatological renewal among others have much higher weight. None should be left behind.
If we apply this idea of doctrinal proportionality in the area of young earth theology, we will see that although the young earth doctrine concerns a small fraction of world history a long time ago, it is interconnected with so many other portions of Scripture and biblical doctrines that it has a proportionally higher weight than chronology alone would indicate. On it rests everything in world history and doctrine. Since God made us, he is to be regarded with the ultimate respect that a human being can offer. Young earth theology is situated as a key element to the most central of Christian truths.
Is young earth creationism a man-made doctrine? We answer with a resounding no! God has given us the innate ability to collect, organize, and summarize information in all areas of life, including the Scripture. Young earth theology is the result of such activity concerning Scripture’s teaching on the beginning of the world from an originalist perspective. When we carefully apply such a method of study to the Bible’s doctrine of creation, we find that there are certain aspects of the doctrine that percolate to the top. These are the defining and organizing concepts that describe young earth theology that we have outlined in this essay.
Young Earth Theology is the area of systematic theology out of which grow all the other areas of theology. The existence of the Triune God in contradistinction to that of his creation is found in young earth theology. The origin and constitution of man is found there. The origin of sin is found there. The need for the gospel originates there. The origin of angels is there. Important principles of bibliology, namely literal hermeneutics and the sufficiency of Scripture, are at issue there. And eschatology is wrapped up in the initial creation, for the first utopia was ruined and will be replaced with a second, even better one. God created the first heavens and earth. We believe he will create the second set with the same miraculous power and literalness as he did the first. Without YET, Christianity is not really Christianity, for if God did not create the world supernaturally as he described in the Bible, our faith is futile.
Could God have created the world in a longer or shorter time? Could he have used more or less direct means? While we can extend a limited affirmation to such hypotheticals,34 what is important is this: what did God say that he did? All Scripture that concerns creation is breathed out by God. It is profitable for teaching, reproof, correction, and training in righteousness. By itself it is not the complete equipment that the man of God requires to live a life of good works, but it is most certainly an important part of it.
30 Albert Mohler, A Call for Theological Triage and Christianity Maturity, May 20, 2004, http://www.albertmohler.com/2004/05/20/a-call-for-theological-triage-and…, accessed April 5, 2016.
31 Ibid., par. 17.
32 To put this into concrete terms, so-called conservative Christians should not be struggling over whether baptism is for believers or not (it is); whether miraculous gifts have ceased (they have); whether creation was recent or not or whether God used macro-evolution; or whether there will be an earthly millennial kingdom with Israel at the head of the nations (there will be). These are clear teachings of Scripture.
33 I have even experienced a case where a missionary left a mission because he perceived the mission’s longstanding doctrinal statement wrongly included one doctrine, thus sorting it higher than it should have been.
34 We cannot affirm that God could have used evolution, because then he would used death to accomplish creation, and that is not “very good” nor just, nor does it harmonize with Romans 5:12. The evolution-hypothetical is impossible because it is not in agreement with God’s nature nor with other portions of his Word.
Dr. Postiff has served as Pastor of Fellowship Bible Church since 2006. He holds a PhD in computer engineering from University of Michigan and ran an engineering consulting firm specializing in design and simulation of computer microprocessors. He earned his ThM from Detroit Baptist Theological Seminary in 2010.