A handful of bishops already have made changes, ousting dozens of priests accused of molestation and working more closely with prosecutors. However, some Catholics - particularly liberals - say reform is needed beyond how the church addresses misconduct in its ranks.
``The old system is dead,'' said the Rev. Richard McBrien, a theologian at the University of Notre Dame. ``It's just a matter of how long it takes before it completely implodes.''
The Rev. Richard John Neuhaus, a conservative and editor of the religious magazine First Things, disagreed. He predicted the church will emerge from this trial with a renewed commitment to its most basic values.
``The problem is not with celibacy. The problem is with priests who aren't celibate,'' Neuhaus said. ``The problem is not with the teaching of the church. The problem is with the people who don't live the church.''
It's clear the case of former Boston priest John Geoghan has led to a wider discussion of sexuality and the priesthood. In the Vatican's first public comments about the Boston crisis, Joaquin Navarro-Valls, chief spokesman for Pope John Paul II, told The New York Times the church needed to prevent gays from becoming priests.
Dignity/USA, an advocacy group for gay and lesbian Catholics, bristled at any link between the molestation scandal and homosexuality, accusing the church of targeting gays to deflect attention from its own wrongdoing.
Some see sexual contact with minors as part of a world of priestly sexual activity - gay and heterosexual - forced underground by an unreasonable demand for celibacy.
``There's a need to look at the deeper issue of human sexuality,'' said the Rev. Thomas P. Doyle, a co-author of a 1985 report to U.S. bishops warning more must be done to stop abuse. ``What is it about our lifestyle? Why do we have this high instance of sexually active homosexuals? Why do we have a high instance of pedophiles?''
The Rev. Stephen Rossetti, a psychologist and consultant to the United States Conference of Catholic Bishops, said making a connection between molestation and celibacy is simplistic.
``I think it's very dangerous in charged times like these to make sweeping statements that are misleading,'' said Rossetti, who has written extensively on sexuality and the church. ``I think any good clinician knows that celibacy has nothing to do with sexual abuse.''
The Boston case has also been cited as evidence the church needs to democratize, expanding the role of parishioners as a check on bishops' power. Court documents in civil suits filed against Geoghan show Boston church officials ignored warnings he molested children and allowed him to continue to serve.
``The crisis all along has been one of clerical governing. It's not just what you do with men who abuse children,'' said Jason Berry, author of ``Lead Us Not Into Temptation, Catholic Priests and the Sexual Abuse of Children.''
More than 130 people say Geoghan, now serving a 9- to 10-year prison sentence for groping a 10-year-old boy, molested them during his decades as a priest.
Demands for reform are coming from beyond the United States.
Last week in Spain, about 70 priests protested against celibacy and in support of ordaining women after a priest revealed to his parishioners he was in love with a woman, another priest was charged with involvement in an Internet pornography ring and a third announced he'd been leading a gay life for decades.
Little change is expected immediately at the top levels of the church, since John Paul is in poor health and seen by many as being in the last years of his pontificate. But McBrien thinks the next pope will face enormous pressure to reform the church.
``This problem is not confined to Boston. It is not confined to Cardinal (Bernard) Law,'' McBrien said. ``It's a systemic problem.''