Paging Father M.D.

by Ryan T. McGuire, Law Clerk

You are driving home from work and are stopped behind a bus at a busy Phoenix intersection. You see what you assume is a mother tugging her toddler by the arm, perhaps trying to get the child ready to get on the bus as it approaches the stop. The kid appears to be having a tantrum, and you see the mother strike the child in the back with her cell phone. You see the child gasping for air as the mother drags him onto the bus.

In Arizona, you have no obligation to call the police or DCS. You are not legally mandated to report child abuse. Aside from any moral obligation, you are free to pass the bus and continue on your day as if you did not just witness child abuse. Arizona, like all states (as required by CAPTA) [1], has mandatory reporting laws designed to protect children by requiring certain individuals to report suspected abuse to authorities.

Reporting obligations are not always clear-cut. Some professionals, like religious clergy, have privileges that restrict them from disclosing confidential information. [2] Mandatory reporting laws exempt clergy from reporting confidential communications and confessions they deem “reasonable and necessary within the concepts of the religion.” [3] But what if the clergy is also a doctor? What if the confidential information learned is about child abuse? A recent Arizona Court of Appeals case analyzed this complex situation.

This blog post will analyze Doe v. Lenzner Med. Servs., LLC and what it says about mandatory reporting obligations.

Mandatory Reporters

Under Arizona law, Arizona Revised Statutes § 13-3620 requires immediate reporting when someone “reasonably believes that a minor is or has been the victim of physical injury, abuse, a reportable offense, or neglect.” [4] The report must go to law enforcement, the Department of Child Safety, or tribal authorities for Native American minors.

The statute identifies several categories of mandatory reporters:

Healthcare Professionals: Physicians, nurses, psychologists, counselors, social workers, and other medical professionals must report when they develop a reasonable belief “in the course of treating a patient.”

Law enforcement and child welfare workers: Peace officers, child welfare investigators, and child safety workers must report.

Family members: Parents, stepparents, and guardians of the minor must report.

School and advocacy personnel: School personnel, domestic violence victim advocates, and sexual assault victim advocates must report when they develop a reasonable belief “in the course of their employment.”

Care providers: “Any other person who has responsibility for the care or treatment of the minor” must report.

Supervisors: Immediate supervisors and administrators of the above categories must report, unless they reasonably believe the person required to report has already done so.

The statute provides some limited exceptions. Members of the clergy may withhold reporting of confidential communications or confessions if they determine it is “reasonable and necessary within the concepts of the religion.” This exception applies only to the communication itself, not to personal observations. No reporting is required for consensual sexual conduct between minors aged 14–17. Elementary school playground accidents that are clearly accidental need not be reported if parents are notified and the school documents the incident.

Doe v. Lenzer Med. Servs., LLC

In the Lenzer case, Dr. John H. served dual roles as both a licensed physician and lay bishop in the LDS Church. [5] He was the family physician for Paul A., his wife, and their three children from 2009 to 2018. In November 2011, Paul A. confessed to Dr. H., in his capacity as a Bishop, that he had sexually abused his daughter. Dr. H. instructed Paul A. to tell his wife and seek counseling. However, Dr. H. did not report the abuse to authorities due to his religious vow of confidentiality. Paul A. continued to abuse all three children until his arrest in February 2017. The children later sued Dr. H. and other medical defendants for failing to report the abuse.

The Arizona Court of Appeals focused on the precise language of the statute. The court emphasized that physicians must report only when they develop a reasonable belief “in the course of treating a patient.” The court found no genuine dispute that Dr. H. learned of the abuse through Paul A.’s confession as a bishop, not through medical treatment of the children. The Does failed to present evidence that Dr. H. developed a reasonable belief of abuse while actually treating the children as patients.

The court affirmed summary judgment in favor of Dr. H. and the medical defendants. Dr. H. had no duty under Arizona’s mandatory reporting statute because he learned of the abuse in his capacity as a bishop through a privileged confession, not as a physician treating a patient. The court rejected the “two hat” theory that Dr. H.’s dual roles created liability. The confession was privileged under the clergy exception, and the statute specifically limits when physicians must report.

What is the significance of this opinion?

First, this opinion demonstrates the limits of mandatory reporter obligations. Specifically, mandatory reporters like doctors are only obligated to report suspected child abuse they encounter in the course of treating patients. This means that a doctor on vacation is not a mandatory reporter. She would be no more obligated to report suspected child abuse than any other person. To further demonstrate the significance of this point, imagine the same doctor was driving home from her shift and witnessed a child being abused by their parent on the side of the road. She is also not legally obligated to report the abuse. Even if she saw patients a few minutes ago and would be obligated to report suspected abuse in that context, she is no longer a mandatory reporter because she is no longer treating patients. The court ruled that because Dr. H. did not learn of the abuse in the course of treating a patient, he was not obligated to report it.

Second, this opinion exemplifies the complex intersection between mandatory reporting and clergy-penitent privilege. Typically, anything said in confession is confidential. U.S. common law typically recognizes this privilege and allows clergy to refrain from testifying in court about confessions. Additionally, A.R.S. § 13-3620 includes an exception from mandatory reporting for clergy who hear about child abuse in confession. However, this exception does not apply to clergy when they are not receiving confessions. If a priest or bishop suspects child abuse based on what they witness outside of confession, they are mandatory reporters legally obligated to report. Since Paul A. told Dr. H. of the abuse in confession, the court held that Dr. H. was not obligated to report the abuse.

Conclusion

In conclusion, the Lenzer case highlighted two important aspects of mandatory reporting laws. First, doctors and other medical professionals are only obligated to report suspected abuse they discover in the course of treating patients. They lose that obligation when they stop treating patients. Second, a major exception to mandatory reporting laws is the clergy-penitent privilege. If a member of the clergy learns of child abuse in confession, they are not obligated to report it. This is true under current Arizona law. However, many other jurisdictions are changing this approach. Some believe child abuse should still be reported even if a clergy member learns of it in confession. For example, in 2020, Parliament in Queensland, Australia, passed new laws that would send clergy members to jail for three years if they fail to report child sexual abuse. [6] This raises important questions. Should a society that values the child safety still allow an exception for clergy-penitent privilege? Or should the privilege be eliminated entirely in cases involving child abuse?

Sources:

[1] S.1191 – 93rd Congress (1973-1974): Child Abuse Prevention and Treatment Act | Congress.gov | Library of Congress

[2] A.R.S. § 13-3620(A); Also see Boston Globe Spotlight series.

[3] Id.

[4] A.R.S. § 13-3620

[5] Doe v. LENZNER MEDICAL SERVICES, LLC, Ariz: Court of Appeals, 2nd Div. 2025 – Google Scholar

[6] Queensland passes law to jail priests for not reporting confessions of child sexual abuse – ABC News

Author:

Ryan T. McGuire is a law clerk at Woodnick Law PLLC and a second-year student at the Sandra Day O’Connor College of Law. He leverages his master’s degree in philosophy to produce thorough legal research and writing, with a focus on family law matters. Ryan brings a strong foundation in legal analysis and academic interests spanning family, criminal, and intellectual property law.