Theodore McCarrick, the highest-ranking Catholic cleric in the United States to face charges in the church’s ongoing sexual abuse crisis, is not competent to stand trial, a judge in Massachusetts ruled.

The disgraced former cardinal, who is 93, was declared unfit by a Dedham District Court judge on Wednesday.

Mr. McCarrick faced three counts of indecent assault and battery in Massachusetts, based on an accusation that he repeatedly sexually assaulted a teenage boy at a family wedding reception in 1974.

The charges in Massachusetts were seen as a milestone in victims’ efforts to hold abusers in Catholic settings accountable. Thousands of clergy members in the United States have been accused of crimes in the sprawling reckoning with sexual abuse, secrecy and cover-ups in the Catholic Church. But because most of the alleged assaults took place decades ago, successful prosecutions have been relatively rare.

Mr. McCarrick pleaded not guilty in the Massachusetts case in 2021. His legal team filed a motion to dismiss the charges in February, saying that its expert had assessed him as not competent to stand trial.

An expert for the state of Massachusetts came to the same conclusion this summer, after an assessment performed in person in Missouri, where Mr. McCarrick lives. The state’s conclusion was announced in July, but the report itself was not made public at the time.

At a hearing on Wednesday, a forensic psychologist employed by the state, Kerry Nelligan, testified that she had assessed Mr. McCarrick at his residence over the course of two days in June, and found significant cognitive problems and “deficits of his memory and ability to retain information.”

Mr. McCarrick was not in the courtroom on Wednesday, but he joined the hearing through a video conference. He appeared to be frail but alert. He did not speak.

Advocates for victims of clerical abuse expressed disappointment about the ruling.

“It would be a landmark decision to have a conviction of a cardinal in the Catholic Church in the United States of America,” Stephen Sheehan, an activist who attended the hearing, said in the hallway outside the courtroom.

Mr. Sheehan seemed skeptical of the idea that Mr. McCarrick was incapable of standing trial. “Losing words and names and short-term memory, I do that all the time,” said Mr. Sheehan, who is 90.

He pointed out that it has taken decades for victims of sexual abuse to come forward, and the perpetrators who are still alive are often very old.

Mr. McCarrick’s lawyers did not immediately comment on the ruling.

Mr. McCarrick was once one of the most prominent clerics in the U.S. Catholic Church, serving as archbishop of Newark, and then of Washington, D.C. In 2001 he was made a cardinal, a rank in the church that is second only to the pope. Mr. McCarrick was also a prolific fund-raiser for the Vatican, charming presidents, donors and celebrities.

The complaint in Massachusetts, filed in 2021, said that the assaults took place outdoors at the victim’s brother’s wedding reception at Wellesley College. It said that Mr. McCarrick had asked to take a walk with the victim outside to discuss his “mischievous” behavior, and then when the 16-year-old stopped to urinate, Mr. McCarrick assaulted him. A second assault took place that night inside a coat room near the reception area, the victim said in the complaint.

The victim told investigators that he had been assaulted repeatedly by Mr. McCarrick, a family friend, beginning when he was a young boy and continuing into adulthood.

The charges in Massachusetts were able to proceed after so many years because of a feature of Massachusetts law: Since Mr. McCarrick was not a resident of Massachusetts, the clock on the statute of limitations there stopped when he was not in the state.

Mr. McCarrick was expelled from the church in 2019 after a Vatican trial found him guilty of sexually abusing minors and adult seminarians over a period of decades.

Mr. McCarrick also faces a criminal sexual assault charge in Wisconsin, stemming from an accusation from the same victim that Mr. McCarrick and another man assaulted him in the water at Lake Geneva in 1977. Wisconsin prosecutors have charged Mr. McCarrick with one count of fourth-degree sexual assault, under the same strategy used to file charges in Massachusetts. That charge is a misdemeanor.

Maya Shwayder contributed reporting.

Ruth Graham is a Dallas-based national correspondent covering religion, faith and values. She previously reported on religion for Slate. More about Ruth Graham

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