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It's been a decade since the priest sex abuse scandal erupted in the United Sates. This week, Catholic religious officials from around the world gathered in Rome to discuss the painful topic. They held a symposium endorsed by the Vatican called Toward Healing and Renewal.

NPR's Sylvia Poggioli says the aim was to change the culture of how the church deals with cases of pedophile priests.

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SYLVIA POGGIOLI BYLINE: One of the highlights was a late afternoon penitential Mass. It was apparently the first time a service to ask forgiveness of abuse victims was conducted in Rome by a senior Vatican official.

In his homily, Cardinal Marc Ouellet, who runs the Vatican's Congregation for Bishops, called the crisis a source of great shame and enormous scandal.

CARDINAL MARC OUELLET: The first step on this road is to listen to them carefully and to believe their painful stories.

SYLVIA POGGIOLI, BYLINE: But there was only one victim to listen to at a symposium that gathered many bishops and religious superiors. Sixty-five-year-old Marie Collins recalled how she was raped as a 13-year-old by a hospital chaplain in her native Ireland. In her prepared remarks, Collins described how those fingers that would abuse my body the night before were the next morning holding and offering me the sacred host. And she insisted on accountability for the harm and destruction done to victims through cover-ups and mishandling of cases.

MARIE COLLINS: The guidelines must have something backing them in the way of a penalty or a consequence for any religious leader or bishop who decides not to implement them.

POGGIOLI: American Cardinal William Levada, who heads the Vatican office that deals with clerical sex abuse, delivered the keynote address. He defended Pope Benedict, saying he has been instrumental in cracking down against pedophile clergy.

CARDINAL WILLIAM JOSEPH LEVADA: Unfortunately, the pope has had to suffer attacks, especially by the media, over these past years in various parts of the world, when, in my view, he should receive the gratitude of us all, in the church and outside it.

POGGIOLI: But Levada acknowledged that the more than 4,000 cases reported to his office in the past decade revealed the inadequacy of applying canon law alone. The Vatican, however, has yet to rule that all abusive priests be reported to civil authorities, whether required by law or not. Several victims' advocates criticized the symposium as cheap window dressing. They have long demanded that the Vatican make public decades of secret files on clergy sex offenders and their enablers.

One symposium speaker, the Vatican's prosecutor in sex abuse cases, Monsignor Charles Scicluna, said canon law already provides sanctions for bishops who do not report predator priests. But Vatican analyst John Allen of the National Catholic Reporter wonders whether the sanctions will be applied.

JOHN ALLEN: I don't think the problem is law. I think the problem is will to enforce it. We have heard senior Vatican personnel commit themselves to a tough new standard of accountability for bishops too. The question is going to be: Are we actually going to see that enforced in the real world?

POGGIOLI: Still, Allen says that the symposium could be a sign that within the Vatican, on the issue of clerical sex abuse, the center of gravity is moving away from the deniers and toward the reformers. Sylvia Poggioli, NPR News, Rome.

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