Church Abuse Scandals: Can We Learn from the Medical Profession?

Date Published: 24th March 2021

In that last few years, the evangelical church has been rocked by a series of appalling abuse scandals. The latest news centres around the 146-page independent report published yesterday, which details the repeated abuse committed by former Vicar of Emmanuel Church Wimbledon Jonathan Fletcher. The report describes how Fletcher repeatedly used psychological and spiritual manipulation to abuse young men under his pastoral care, leading to “coercion and control, bullying,… naked massages and saunas, forfeits including smacking with a gym shoe, and ice baths… One participant reported that JF told him to perform a sex act in front of him and when he did not, JF performed the act instead.”1

This grim report comes in the wake of another independent investigation released last month which documented the sustained sexually abusive behaviour of the late apologist Ravi Zacharias. It details how Zacharias consistently used his authority, status, power and wealth to repeatedly sexually exploit and abuse female massage therapists. Here is one of many examples from the report: “one therapist reported that Mr. Zacharias spent the first half of their first massage session asking about her spiritual journey and prior abuse. This set her at ease and made her feel that he cared for her as a person before he later asked her to massage his genitals.”2

Sadly these are only two out of several huge abuse scandals that have been recently uncovered in the evangelical church. In February 2017, a Channel 4 investigation exposed harrowing acts of violent abuse of public schoolboys by the late evangelist and lawyer John Smyth3. And in February 2020 the CEO of Acts 29 Ministries and elder in Crowded House Church Steve Timmis was removed over multiple reports of bullying, intimidation and spiritual abuse4.

These scandals are sickening, and must make all of us in the evangelical church think seriously and carefully about the changes that clearly must be made to identify and destroy the environments in which these abusive behaviours were allowed to fester. We must be unequivocal, for the sake of the victims of abuse, and for the repute of the name of Jesus- things have to change… drastically.  

So what can be done to prevent another Fletcher or Zacharias?

Clearly there is much to be said, and it would be naive to look for a single simple fix. But one of the most important things that I think is worth considering is the role of power imbalances in abuse. One of the common factors amongst all of the above scandals is that the abusers held positions of spiritual authority and leadership over their victims. In an interview with evangelist Glenn Scrivener, Lori-Anne Thompson, who was the first brave victim of Zacharias to come forward publicly (and who was subsequently publicly disgraced by Zacharias, RZIM and the church at large), compared the power imbalance of the pastor-disciple relationship to the doctor-patient relationship:

“We go into a doctor’s office and the doctor has the role of caring for your physical body. And so the doctor may hand you a garment and say ‘Disrobe’. And without question, what do we do? We just disrobe. We take off all of our clothing and we put on the medical garment. And then we lie down and we are assessed based on the fiduciary duty. That’s what happens in a religious setting, where the religious professional says ‘Here’s a garment, put this on. Disrobe- let us look at your naked soul’. And so when a cleric sexualises that relationship, it is catastrophically traumatic.”6

As a practising doctor and also someone who has been involved in a range of leadership responsibilities within the church, I found this comparison very thought-provoking and apt. I think Thompson is right; a big reason why the church appears to have been fertile soil for abuse is because the relationships between Christian leaders and their disciples involve large power imbalances which are in several ways akin to the doctor-patient relationship.

The question then arises: why has the medical profession not seen the same kinds of abuse scandals that have hit the church? Don’t get me wrong, there clearly have been medical scandals such as Harold Shipman, Alder Hay and Mid Staffs. And of course, there may well be abuse occurring within the medical profession that is yet to come to light. However, in my opinion, it does seem like the UK medical system has built up a fairly robust and comprehensive system of safeguards and accountability structures that appear to have prevented abuse scandals anywhere near the scales and horrors of those uncovered in the evangelical church.

And so, for the remainder of this blog, I’d like to unpack four key factors that appear to have kept the medical profession reasonably clear of abuse scandals, that I think the church can learn directly from.

1. External Accountability Structures

The medical profession in the UK is regulated by a powerful legal governing body called the General Medical Council (GMC). The GMC has several powers, including the authority to strike a doctor off the medical register and thus bar them from practising medicine. This can be done not only on competency grounds, but also on grounds of professionalism, character, integrity, and any other “fitness to practice” concern. I know one doctor who was called to a GMC “fitness to practice” hearing due to some offensive comments he had posted on Twitter. The rather intimidating power of the GMC over doctors is seared into the consciences of all clinicians, such that even the words “GMC investigation” sends chills down most of our spines. In the very first lecture I ever had at medical school, we were told: “if you get arrested for being drunk and disorderly during Freshers’ week, you could land up in front of the GMC and lose your license to ever practice medicine”. It made an impact; I still remember that lecture 8 years on!

I think the sheer legal power of the GMC and the respectful fear doctors have of the organisation, is one reason why medical abuse scandals appear to be rare.

In the church, there is nothing remotely comparable to the GMC. Perhaps these abuse scandals are showing us that there is a need for a new, independent, powerful, external, legal governing body for church ministers and leaders, that has the power to investigate any church leader and strike off those who are found to be abusing their power. I think the Church of England could easily set this up.

2. Internal Accountability Structures

In addition to the external governance of the GMC, the medical profession has clear internal accountability structures. All hospitals have computer systems where staff can log concerns and untoward events, liaison services for patients to raise complaints, and staff teams solely tasked to look after junior doctors’ education and well-being. In addition, when junior doctors start in new jobs, we expect to be told who we are accountable to, who we should escalate problems to, and who to go to if our problem is with the person we are accountable to. In my inductions to new jobs, I am often told by my new supervisor “If you are having problems with a colleague come to me, if your problem is with me, go to Dr X”. It is worth mentioning that the NHS has had problems with the silencing of whistle-blowers, which was one of the key issues identified by the Francis Report into the Mid Staffordshire Hospital Trust7. However, there are still far more internal accountability structures in place in the NHS than in the church.

I have worked on several leadership teams in churches and para-church organisations. I have very rarely been told who to escalate to if I have concerns over my team leader. In fact on one occasion, I raised concerns about my direct team leader, and was made to feel like I was complaining unnecessarily and was labelled as “unteachable”.

I think we need proper, clear accountability structures in place within churches which include:

  • Publicly known channels in place for people to safely escalate concerns
  • Named individuals that congregation and team members can go to if their concerns are with their direct leader/ overseer.
  • An ergonomic, perhaps online, portal through which congregation members can raise any concerns and log untoward events, rather than leaders simply saying “contact our safeguarding team if you’re being abused”

3. A Detailed Rulebook

Another important aspect of accountability within the medical profession is a detailed and lengthy rulebook published by the GMC, called “Good Medical Practice” (plus appendices) which lays out the responsibilities and expectations of all clinicians. Doctors are expected to know this rulebook and are asked about it in exams. A substantial amount of Good Medical Practice is directed towards keeping patients safe in light of the power imbalance between doctors and patients. For example the guide dictates unequivocally:

  • You must not use your professional position to pursue a sexual or improper emotional relationship with a patient or someone close to them.
  • Trust is the foundation of the doctor-patient partnership. Patients should be able to trust that their doctor will behave professionally towards them during consultations and not see them as a potential sexual partner.
  • You must not end a professional relationship with a patient solely to pursue a personal relationship with them.8

These rules are hardly surprising or controversial. And yet when we move to the church context, I have encountered, on several occasions, church leaders pursuing romantic relationships across the leader-disciple power imbalance. Furthermore, I have raised concerns over these only to have had them dismissed as unimportant.

I would argue that we need some sort of clear, detailed and written rulebook for Christian leaders within churches, and I personally would like that to include a clear prohibition of romantic pursuits between church leaders and those who are directly under their personal pastoral care (for example, between a leader of a student bible study group and one of their students).

4. Standardised Education on Responsibilities

Fourth and finally, doctors have standardised education which includes strong emphasis on our moral responsibilities. The GMC sets standardised educational requirements for medical schools, which includes a repeated and sometimes overwhelming emphasis on the immense trust the public has in the medical profession, and thus the high level of moral responsibility we are taking on. This makes it into our exams; I have sat multiple “situational judgement tests” in which predictable scenarios include things like:

  • You find yourself attracted to a patient. What do you do?
  • A patient says your colleague examined their breast/ genitals, but there’s no documentation of this. What do you do?
  • Your consultant makes romantic advances on you/ your colleague. What do you do?
  • You find your colleague holding hands with a patient on the street. What do you do?

Thus, as part of standardised medical education, we are taught in detail about the responsibilities we have as doctors and how to hold our powers and responsibilities in ways that maximally safeguards patients, even in tricky ethical dilemmas. I would suggest that similar moral “situational judgement” components ought to standard parts of theological training and examinations in bible schools.  

It worth saying here, that this necessarily means that church leaders need to have some sort of standardised training. Or to put it conversely, I am getting increasingly uneasy about the numbers of individuals being employed into church pastoral leadership who have never had recognised standardised training. We all expect doctors to have gone to medical school. Why is it different for church ministers?

I think this is especially true for ministry to students and young adults. One of the commonalities between all the abuse scandals mentioned in the first part of this blog is that almost all the victims fell into the “young adults” age bracket. Clearly young adults are particularly vulnerable to abuse, especially those who are away from parents for the first time, or those seeking mentorship and/or spiritual guidance from older Christians. If there is one specific area where we shouldn’t be employing pastoral leaders who have never had formal standardised training, I would argue it should be in ministry to students and young adults. And yet I reckon these are some of the most common ministries that are headed up by lay people in evangelical churches.

Now it is worth mentioning that I know and love many lay church leaders who do an excellent job, and obviously there are many formally trained leaders who commit abuse (including Fletcher, Timmis and Smyth). But I do think a review of theological education alongside an examination of the numbers of employed church pastoral leaders with no formal qualifications is important as we try to build a framework that prevents abuse in the church.


This is without doubt one of the most uncomfortable blogs I’ve ever written. I take no pleasure in criticising my own church family and denomination. But sadly, I think the church abuse scandals of recent years require this sort of radical and painful analysis of how church has gone so badly wrong. I do think the medical profession has done reasonably well in building structural safeguards against abuse. Thus I think the church can learn a lot from the medical profession. The question is, are we willing to change?