One week after the release of a scathing 7,000-word letter from Vatican ex-ambassador Archbishop Carlo Maria Viganò, Vatican watchers say Francis — who has yet to directly address the veracity of the accusations — is facing the greatest challenge of his papacy.

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Some Catholics have criticized him for what they describe as an insufficient response to the crisis. A few bishops have suggested that he call an extraordinary meeting to address sexual abuse in the church. And he faces pivotal decisions about whether to release abuse-related documents or green-light a who-knew-what investigation into McCarrick — with the possibility that such a probe could point fingers back to the Vatican.

“I think he’s aware that the wheels of history are turning,” said Austen Ivereigh, a Francis biographer. “This is a watershed moment, and how he responds — how the entire church responds — is crucial. We could easily go the Trump route where as Catholics we start tearing into one another with mutual allegations. This is what happens at times of tensions. I think he, as the church’s spiritual leader, is trying to guide this as a process — hold the church together.”

But some say Francis has not yet done enough. In a letter that had collected nearly 30,000 signatures, a group of Catholic women wrote that Francis’s earlier remarks about Viganò’s letter — when he’d said the document “speaks for itself” — were “inadequate.” The editors of America magazine, a Jesuit journal, wrote that the pope was perhaps trying to “stay above the fray rather than dignify a venomous ideological attack.”

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“Nonetheless,” the editorial said, “the pope’s refusal is an insufficient pastoral response for a church that is deeply wounded.”

At a Mass on Monday, Francis made what many interpreted as an oblique reference to Viganò. “With people lacking goodwill, with people who only seek scandal, who seek only division, who seek only destruction, even within the family: silence, prayer,” Francis said.

No matter how the Vatican handles Viganò’s accusations, it is facing a much broader problem, with sexual abuse scandals unfolding in several countries. Even before the letter, a Pennsylvania grand jury report lifted the lid on systemic clerical abuse within the state, accusing more than 300 priests of sexually abusing children over seven decades.

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Bishop Philip Egan, from the diocese of Portsmouth in the United Kingdom, wrote to Francis suggesting that he convene an “extraordinary synod” — a church meeting — that could discuss accountability and potentially lead to changes in canon law.

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In the United States, bishops are considering calling for a Vatican investigation, conducted with expert laypeople, into how McCarrick was able to climb the ranks of the church despite rumors about his behavior.

“The recent letter of Archbishop Carlo Maria Viganò brings particular focus and urgency to this examination,” said Cardinal Daniel DiNardo, president of the U.S. Conference of Catholic Bishops. “The questions raised deserve answers that are conclusive and based on evidence.”

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Viganò’s letter, released by several conservative Catholic outlets, laid out the purported details about more than a decade of the Vatican’s handling of McCarrick. One of Viganò’s key assertions is that Pope Benedict XVI, several years before his abdication, levied sanctions against McCarrick, forbidding him to lecture, travel, or celebrate Mass publicly. But that assertion is belied by McCarrick’s actions during the final years of Benedict’s papacy, when he appeared on “Meet the Press,” traveled overseas, spoke at fundraisers and news conferences, and met with Benedict at the Vatican.

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On Friday, a journalist at the National Catholic Register, one of the original publishers of Viganò’s letter, cited a source close to Benedict who said the sanctions were “just a private request.” Some of Francis’s allies have since suggested that Viganò’s claims are falling apart.

Viganò has declined numerous requests for comments. Cardinals mentioned in the letter as being able to corroborate Viganò’s claims have declined or not responded to requests for comment.

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In the letter, Viganò made other accusations, too, including that he notified Francis in 2013 about McCarrick, telling the new pope that the Vatican had a “dossier this thick” about him. Viganò says Francis nonetheless made McCarrick his “trusted counselor.”

A debate has since broken out over an event not mentioned in the letter: an encounter in 2015 between Pope Francis and Kim Davis, a Kentucky county clerk who briefly became a conservative cause celebre for her refusal to issue marriage licenses to same-sex couples. The debate about their meeting is something of a proxy battle over the trustworthiness of both Viganò and the Vatican.

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The Vatican has long said that the pope’s meeting with Davis was not meant as an endorsement of her views and that it was orchestrated by Viganò, who was working at the time as the Vatican’s ambassador in Washington. Viganò on Friday provided his account of the meeting to LifeSite News, a conservative Catholic outlet, saying he had gotten the pope’s consent for the meeting.

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Two former Vatican press officials responded Sunday night, with one acknowledging that Viganò had spoken with the pope and his advisers the night before the meeting. But he also said the “responsibility” for the meeting was on Viganò.