Few words can describe the horror that comes from reading a Pennsylvania grand jury report on sexual abuse by Catholic priests in state dioceses over a 70-year period. At least 300 priests used their roles within the church to prey on the innocent. They groomed their victims with special favors, sometimes mixing church ritual with their depravity, passing around their child victims to other priests, even recording sex acts to create pornography they could share and indulge in long after. One priest targeted an entire large family of young girls, raping siblings successively over the years. These priests were men respected in their religious communities, welcomed into the homes of the faithful, entrusted with the spiritual care of believers. But most importantly, they never were punished, even when their transgressions became known. When their superiors learned of the priests’ behavior, many bishops sought ways to cover up the criminal acts. Because our criminal justice system imposes limitations on how long after crimes are committed the acts can be prosecuted, nearly all of the men who are still alive face nothing more than embarrassment for the destruction they wreaked. The church will face financial penalties, robbing the contributions of the faithful to pay settlements to victims. But no matter how large the sum, settlements will never undo the harm done. Can the Roman Catholic Church survive this crisis?

The Pennsylvania story of priestly abuse is only the latest scandal to rock the church. In the United States alone, the church paid out some $4 billion between 1950 and 2015 to victims of sexual abuse. And it’s not only here but around the world that these cases have come to light; Australia, Canada, Chile, France, Germany, Ireland and other countries have experienced major scandals involving Catholic clergy. Meanwhile, the Vatican has done little but issue condemnations and occasionally remove bishops and cardinals who either covered up or were participants in the abuse, the most striking case involving Cardinal Theodore McCarrick, the former archbishop of Washington, D.C., who resigned from the College of Cardinals after allegations that he had abused both minors and several seminarians over the course of decades. Pope Francis, who has a mixed history in terms of how he has handled abuse cases, has so far remained silent about the Pennsylvania study.

Something must change — and it must happen soon, or the church risks losing its flock and its influence. It may well be time for another Reformation. It has been more than 500 years since Martin Luther nailed his 95 theses to the door of the cathedral in Wittenberg. What followed was not just a schism in the church that created Protestantism; the Counter-Reformation of the Catholic Church itself came, too.