In surgical pathology, it is common to grade the degrees of atypia in a precancerous lesion. Many years ago, a three-tiered system was implemented encompassing mild, moderate, and severe atypia. If a lesion was diagnosed with severe atypia, it suggested a higher likelihood of progression to cancer and would usually lead to a complete removal of the lesion. However, a difficulty arose when some pathologists began using terms that bridged the categories such as mild to moderate or moderate to severe. This decreased the reproducibility of the diagnoses when different pathologists reviewed the same case. It also made treatment decisions less clear, frustrating surgeons and oncologists.

Some years later, to increase interobserver agreement, a two-tiered system was adopted for several precancerous lesions. Atypia was diagnosed as either low grade or high grade. The former usually required follow-up at regular intervals while the latter diagnosis usually led to surgical removal. Yet, even this simplified system has received pushback from various groups of pathologists, claiming the grading is too restrictive and advocating for a return to a three-tiered system. Why is it difficult to be binary in our decision-making? There are many reasons and pundits readily proffer their opinions. As always God, provides the Truth. 

I will test you with the measuring line of justice and the plumb line of righteousness…

Isaiah 28:17 (NLT)

We are sinners, unable to deliver ourselves from our forlorn condition. God created us with a moral character, knowing right and wrong. Yet, we blur the distinctions and choose shades of gray. Whether it is with medical diagnoses or moral decisions, we are hesitant to select one choice over the other. Isn’t it better to have both? Marriage does not have to be between a man and a woman. Abortion is not murder if it is before 16 weeks. 

God gives us His absolute standard. He sets a plumb line of righteousness. It was not meant to be bent, twisted, or stepped over. There are no moral shades of gray with God. Every decision is always clearly illuminated by the light of His Truth through faith and belief in Jesus Christ. 

Love and trust in the Lord; seek His will in your life.