In the 15 years since Cardinal Bernard F. Law resigned in disgrace, the Catholic Church has removed hundreds of American priests accused of preying on children, and adopted new policies and training designed to prevent abuse.
But many abuse survivors and activists say reforms have been made slowly, inconsistently, and under pressure, and the church has not fully reckoned with the crisis.
In a troubling sign for victims, a Vatican commission on sexual abuse, headed by Cardinal Sean P. O’Malley, effectively lapsed this week, when its members’ terms expired. O’Malley said Wednesday that he expects the commission members to be reappointed, but the lapse has raised concerns the panel might be disbanded.
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“When we see things like that, we think the church may not be serious,” said Nicholas P. Cafardi, dean emeritus of the Duquesne University School of Law, who advised American bishops on the abuse-prevention policy they adopted in 2002, just prior to Law’s resignation.
Law’s death on Tuesday prompted many Catholics to reflect on the progress made in trying to prevent abuse and the challenges that remain in trying to hold the powerful accountable. It is, in the view of many observers, a record mixed with progress and some setbacks.
Terrence McKiernan, president of BishopAccountability.org, an online archive that tracks sexual abuse by Catholic clergy around the world, said Pope Francis, despite promising tough action, has not removed high-ranking church officials accused of covering up predatory behavior.
“The church has not faced real culpability, and that’s a major problem going forward because, if the managers are not paying a price for that behavior, I don’t think we’re going to see changes made,” McKiernan said. “Instead, we’re seeing a good PR machine that is spinning changes that were forced on the church — and that’s not a recipe for reform; that’s a recipe for looking better.”
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Still, there have been changes.
The Rev. Christopher J. Coyne, the bishop of Burlington, Vt., who served as Law’s spokesman during his final, tumultuous year in Boston, pointed out that, as a result of the abuse crisis, every priest, deacon, and volunteer in the country who comes into contact with children has to pass a criminal background check and undergo training to learn about appropriate boundaries and inappropriate behavior.
In addition, a Massachusetts law adopted in 2002, just before Law resigned, requires clergy and church employees to notify authorities of suspected cases of sexual abuse.
“The church in the United States, at least, has made great strides in putting in place policies that protect children and families,” said Coyne, who added that he considered Law a friend and a man of faith and visited him in Rome last year, as his memory was fading.
“I still think we have a lot of work to do continuing to help the victims of clergy sexual abuse and their families and to reach out to them, as they desire,” Coyne said.
Bernie McDaid, who was sexually assaulted by his parish priest in Salem in the 1960s, said the environment for victims has become more accepting since he first came forward with his story in the early 2000s and was greeted with hostility and disbelief.
“A little boy or girl can tell their parents, or a teacher, or a policeman now, and that wasn’t happening 15 years ago,” he said.
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But McDaid said he believes church leaders remain stubbornly indifferent to the problem of sexual abuse. “As far as I’m concerned, the Catholic Church is still as dirty as it was 15 years ago,” he said.
At least Law, he said, begged for forgiveness from him and other abuse survivors just before he resigned.
Cafardi said that, although few bishops have been held accountable, about 700 American priests have been removed from ministry. “And that’s a pretty big number,” he said.
Cafardi said the removals indicate that the zero-tolerance policy that he helped American bishops develop in Dallas in 2002 has been largely successful in preventing priests credibly accused of abuse from remaining in churches, where they can abuse again.
Still, he said, “It’s the sort of problem where you can never let down your guard and, even though we’ve come far, we can’t ever let down our guard on the Dallas norms ever. Ever.”
The Rev. James T. Bretzke, a professor of moral theology at Boston College, pointed out that Francis has removed bishops from the dioceses in Seattle and Minneapolis-St. Paul. But he said the pope faces resistance from some in the Vatican who oppose broader action.
“I think you could say not all hands are on deck yet because there is a clerical culture throughout the world, and in Rome, that does see as the primary value to protect the honor of the church,” Bretzke said.
That culture has been blamed for stymieing Francis’ commission on sexual abuse, which he created in 2013. In March, Marie Collins, the lone abuse survivor on the panel, resigned, citing a “shameful” lack of cooperation from some within the Vatican bureaucracy.
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Then, on Sunday, the commission members’ terms expired without comment from the Vatican, according to the National Catholic Reporter, which said the development “suggests that the protection of children is not as high a priority as statements from the Vatican say it is.”
At a Wednesday press conference, O’Malley said the 15-member commission is now waiting for Francis to make appointments. O’Malley said he expects some members will be reappointed, while some will be new. He gave no timeline for such appointments.

Archdiocesan spokesman Terrence Donilon said O’Malley is prepared to continue to serve on the commission, if that is the pope’s decision. O’Malley met with Francis on Dec. 14, according to published reports.
James O’Toole, a historian of American Catholicism at Boston College, said the most obvious change the Boston Archdiocese has undergone since Law’s resignation has been its shrinking footprint due to the closing and consolidation of parishes.
But he said that process actually began under Law and was driven by demographic changes that began in the middle of the last century, as the children of Catholic immigrants who once filled urban parishes moved to the suburbs.
Although the closings have accelerated under O’Malley, O’Toole said he was surprised that the church hasn’t shrunk even more. Part of the reason, he said, is the devotion many feel for their local parishes. He said about six Boston-area parishes even saw donations increase immediately after Law resigned.
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“These are people who said essentially, ‘This is my church, and I’m not going to let incompetent or evil leadership take it away from me,’ ” O’Toole said.
Such sentiments are part of a broader reshaping of the relationship between the laity and church leaders that began 50 years ago, during the Second Vatican Council, Bretzke said. But Law’s resignation accelerated the shift in power, as lay groups like Voice of the Faithful emerged as a major force pushing church leaders to adopt reforms.
“We don’t have any more of the model of the church as being centered in Rome, that all roads lead to Rome, and Rome has spoken and the case is closed,” Bretzke said. “That model is changing, but it’s not changing quickly.”
Bretzke said Law’s resignation also had a profound effect on the church’s role as a prominent voice on social issues. Law, for instance, frequently testified on legislation at the State House. O’Malley, by contrast, is hardly ever seen on Beacon Hill.
“The bishops themselves, as a moral force, lost credibility,” Bretzke said. “So when the bishops come out against abortion, same-sex marriage, and cloning, many Catholics are saying, ‘Well, who wants to listen to them, when they can’t even protect the people from pedophiles?’ And I think that’s a fair question.”

Michael Levenson can be reached at mlevenson@globe.com. Follow him on Twitter @mlevenson. Danny McDonald of the Globe staff contributed to this report.