In medical practice, doctors dread misdiagnosing a patient’s symptoms and distress. They know it can condemn a patient to more pain and suffering, and even death.
There is no possibility for healing without an accurate diagnosis of the pathology.
Clergy sexual abuse presents a tragic example of misdiagnosis. It was identified as early as the Council of Elvira (306) and has been dealt with as a matter of internal discipline, focusing on rules for the offender and protection of image.
There has been persistent misdiagnosis of the systemic and cultural causes of abuse of power, position, and trust — and related dynamics of clericalism and hierarchy.
Predictably, this has resulted in ongoing abuse of many throughout history with devastating consequences.
The cost of minimising trauma
I weep at the misdiagnosis and minimization of the magnitude and depth of the trauma, in total contradiction to Jesus’ words and witness about children.
As a pediatrician, caring for the raped and sodomized, I have had an empathic understanding of the devastating physical, emotional, and spiritual harms to victims.
Spiritual harm includes loss of belief and trust in a loving God, loss of faith, community support, and self-image as lovable and forgivable.
Forced to confront abuse
Since the 1970s, the Church has been forced to confront the issue because of public awareness of the widespread social problem.
In 2014, the first year of his pontificate, Pope Francis created the Pontifical Commission for the Protection of Minors, which has had a rocky history of resistance.
A summit and new resolve
His February 2019 Rome Summit on clergy sexual abuse committed to zero tolerance but has been inconsistent in application.
On October 20, 2025, Pope Leo XIV met with the board of Ending Clergy Abuse, an international coalition of survivors and victim advocates, to discuss how to make “zero tolerance” real now.
Walking with survivors
France’s Bishop Thibault Verny, the new head of the Pontifical Commission, has committed to “walking alongside victims and survivors… and including their voices for change” on this “path of conversion.”
Hope for a correct diagnosis is found in a revitalized Pontifical Commission for the Protection of Minors’ Annual Report 2024, which established “conversional justice” as the pastoral-theological framework for conversion of minds, hearts, and culture.
Conversional justice and safeguarding
The Commission’s March 2024 Universal Guidelines Framework committed church leadership and culture to safeguarding.
The Second Annual Report, released on October 16, 2025, provides practical help for incorporating the pillars of truth, justice, comprehensive reparations, and institutional reform:
- Conversion from an ecclesiology of clericalism and hierarchy to a culture of safeguarding children and the vulnerable.
- Conversion from a culture of secrecy, silence, denial, and avoidance of scandal to truth and justice, and ongoing education of all on the profound harms.
- Conversion from cover-up to welcoming, listening, and caring for survivors; partnering with survivors, families, and communities; and comprehensive reparations with apologies and spiritual and psychotherapeutic support.
- Continuous improvement offers connections with the United Nations and other external international bodies to learn safeguarding best practices today.
A prognosis for hope
The prognosis for healing has improved if we can follow the prescription and take our medicine.
- Nuala Kenny is a Sister of Charity in Halifax, Nova Scotia, and a pediatrician. An officer of the Order of Canada since 1999, she has published several books, including Healing the Church (Novalis, 2012) and Rediscovering the Art of Dying (2017). She is co-author of Still Unhealed: Treating the Pathology in the Clergy Sexual Abuse Crisis (Novalis and Twenty-Third Publications, 2019). She most recently published A Post-Pandemic Church: Prophetic Possibilities (Novalis and Twenty-Third Publications, 2021).