After entering the exam room to greet a 4-year-old patient, I couldn’t help but notice bruises on her arms. Black, blue, green, and yellow—each was in a different stage of healing. Injuries on the arms and legs are typical for young children as they run, grow, and play. But her bruising pattern resembled the imprint of a wire hanger.

While looking through her medical chart, I asked what had happened. The little girl sheepishly explained that she fell while playing hopscotch with her friends. Her stepfather nodded in approval, but red flags erupted in my mind. I continued with her well-child check as if not overly concerned. But as I examined her frail body, more bruising was evident on her torso, back, and thighs—where children do not typically get hurt.

“How did you get so many boo-boos?” I asked. Shrugging her shoulders and lifting her hands, she said, “I don’t know.” That’s when her stepfather quickly interjected, explaining that she was clumsy and often tripped and fell at home. Though it was the first time I’d met her, I had difficulty believing his words, given the 4-year-old’s otherwise normal exam and unremarkable history.

After finishing the checkup, I left the room while contemplating next steps. In my heart, I suspected child abuse. Was the child in imminent danger? It was hard to say. The Spirit persuaded me to call the Division of Child Welfare for advice. After sharing my findings, they directed me to keep the child in my office until they arrived.

This patient was later taken into the custody of Child Protective Services. Unfortunately, a deeper investigation uncovered a pattern of physical and sexual abuse from her stepfather. After many tumultuous years, she now lives with Christian foster parents and is flourishing in a local youth group.

Child abuse doesn’t always leave a visible imprint. It includes physical, emotional, sexual abuse, and neglect. As a pediatrician, mandatory reporting of suspected child abuse was ingrained through my training. With every patient, I proactively looked for signs of potential abuse.

But now as a pastor, I’m surprised by the lack of uniformity in the laws governing clergy reporting between states—and the confusion this causes among my fellow church leaders.

Every state delineates the categories or professions of “mandatory reporters”—that is, individuals who have a legal duty to report actual or suspected child abuse cases. For such persons, withholding this information is a crime and could lead to misdemeanor charges, criminal penalties, and lawsuits.

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States like California and New York list specific professions that are subject to mandatory reporting laws—including teachers, social workers, physicians, nurses, counselors, hospital employees, psychologists, and law enforcement officers. And while California treats clergy and pastors as mandated reporters, New York does not.

In New York, this has recently been a topic of discussion as the Child Abuse Reporting Expansion act (CARE)—which would make pastors, priests, and other clergy members mandatory reporters—has been proposed but not passed. Recently, pastors at the Metro District of the Christian and Missionary Alliance (C&MA) and faculty at Alliance Theological Seminary where I serve have been prayerfully discerning how to advocate for abused children and those at risk.

On the surface, mandatory reporting for pastors seems black and white. Unfortunately, it’s much more complicated due to pastoral privilege. Also known as “clergy-penitent privilege,” this rule of evidence forbids legal inquiry into certain types of communication between clergy and congregants. The most commonly cited cases revolve around the Catholic tradition of confession.

Former Chief Justice Warren Burger once wrote, “the clergy privilege is rooted in the imperative need for confidence and trust. The priest-penitent privilege recognizes the human need to disclose to a spiritual counselor, in total and absolute confidence, what are believed to be flawed acts or thoughts and to receive consolations and guidance in return.”

In some cases, this privilege is granted but limited to communication with a pastor. In others, such privilege is denied in cases of child abuse. Still, in some states, the law does not allow for the exception of privilege at all.

An Associated Press review in 2022 showed that clergy members are exempt from the professions required by law to report suspected child abuse in 33 states. This immunity pertains to any information the church deems to be privileged, even if that is alleged or admitted sexual abuse of a child.

In 2020, the Montana Supreme Court unanimously reversed a $35-million dollar judgment against Jehovah’s Witnesses for failing to report sexual abuse. In the court’s view, church staff fell within clergy-penitent privilege according to laws governing child abuse reporting in Montana.

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Such ambiguity has caused a great deal of confusion among fellow pastors and clergy members. Some pastors wrestle with the confidentiality entrusted to them. Others are unsure how to best help families while protecting the church from scandal.

As a pastor, I understand the need for clergy privilege. Like many pastors, I’ve also been humbled to work with parishioners through deep-seated sin, which is sometimes egregious.

When the Holy Spirit convicts a congregant of sin in their life, I am often the first person they confide in. Brothers and sisters come to me in brokenness and vulnerability, often seeking my counsel with tears of repentance. They would never confide in me if not for the bonds of trust forged through fellowship, worship, and prayer.

James 5:16 encourages us to confess our sins to one another and pray that we might be healed. Without that disclosure, sin remains hidden and formidable. Shining a light on our iniquities grants us freedom in Christ. Repentance of sin requires a broken and contrite heart—and it is paramount to intimacy with Jesus.

And while most sins will never require disclosure to authorities, child abuse cases always involve offenses that are prosecutable by law.

Understandably, it would be difficult for pastors without training to identify red flags, behaviors, and warning signs around abuse. Many would question their instincts when confronted with these challenging situations. To ensure the safety of the next generation, churches should advocate, train, and educate their pastors, youth, and children’s ministry workers. For instance, Christianity Today’s sister site, Church Law & Tax, discusses 22 facts church leaders should know about mandatory reporting laws.

Thankfully as a pastor, I’ve yet to face suspected or confirmed child abuse cases on my watch—but if I did, I suspect my instincts as a pediatrician would define my actions. This decision is not based only on my civic duty, but on biblical principles.

Regardless of what the state law requires, we have a biblical mandate to protect those without power and a voice. We must speak up for the vulnerable and oppressed—including the unhoused, widows, single mothers, orphans, and innocent children. Time and again in the Scriptures, God calls his people to compassionate care for the least of these in society (Matt. 25:40).

But Jesus further demonstrates how precious children are to the community of faith when he says, “Let the children come to me and do not hinder them, for the kingdom of heaven belongs to such as these,” (Matt. 19:14). He also warns that it would be better for a person to drown in the sea with a great millstone around his or her neck than cause one of these little ones to stumble (Matt. 18:6).

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As pastors, our priority is to protect our flock from harm—especially the most vulnerable.

In the story of the Good Samaritan, it is remarkable that a foreigner would treat a Jewish man as his neighbor. But it should be even more striking that the Jewish priest nonchalantly walked by his dying brother in plain sight and did nothing to help him. By doing so, he relinquished a timely opportunity to share God’s love and rejected his sacred mandate to shepherd God’s people.

The Hippocratic Oath reminds physicians to “first, do no harm.” Yet the covenant pastors make with God during ordination goes far beyond any manmade oath. Paul exhorts church leaders to “be on guard for yourselves and for all the flock of which the Holy Spirit has appointed you as overseers, to shepherd the church of God, which he purchased with his own blood” (Acts 20:28)

Cover-ups of child sexual abuse scandals among priests have long tainted the witness of the church. What will we do when we suspect or witness child abuse in our congregations? We can either turn a blind eye and walk by on the other side of the road, or we can follow in the footsteps of the Good Samaritan and potentially save an innocent young life in the process.

Stephen Ko is senior pastor at New York Chinese Alliance Church and Adjunct Professor at Alliance Theological Seminary. He is the author of a forthcoming Zondervan book at the intersection of faith and health.

Learn more about mandatory child abuse reporting laws in the resources provided by Christianity Today’s Church Law & Tax, including this article on clergy-penitent privilege, this state-by-state guide, and this video series on how to reduce the risk of child abuse in your church.