View Photo Gallery: His program rocked by a child sex abuse scandal involving former assistant coach Jerry Sandusky, the winningest coach in Division I college football history has been fired.

As details emerge from the Penn State case, the negligence of top officials, including Joe Paterno, just seems more and more egregious.

Many of us imagine that if we ever witnessed a child obviously being harmed, we would intervene.

It turns out that the hypothetical is often different than the reality. A report out of Boston this week revealed that when doctors were confronted with clear signs of child abuse, they often did not report the injuries to protective services.

Researchers led by Dr. Robert Sege of Boston Medical Center looked at how a group of primary care physicians handled 92 cases of child injury. Here’s an excerpt from a Boston Globe post about the study:

“They found that reporting was warranted in 13 of the 63 cases doctors chose not to report to authorities. Most of those cases involved leg fractures or bruises to the face or ear, and in six cases the physicians themselves had identified a high likelihood of abuse.”

The researchers concluded that the doctors had adequate training in recognizing abuse, but were not as well informed about why they should report it.

The story goes on: “Doctors may question their own judgment of whether an injury is enough to meet the standard of reasonable suspicion for abuse, the threshold for reporting in Massachusetts, Siegel said. Or they may worry that a parent will become angry or blame them.”

This sort of reasoning seemed to be at play in the Penn State case, where officials knew of several incidents when the respected coach Jerry Sandusky abused young boys. It also was at play among Catholic Church officials in the years of official negligence in the face of child abuse.

Back when I wrote about that abuse crisis, I spoke with bishops of the Church who explained that officials had concentrated their attention on the priests, the fellow adults. They worried about the consequences for these other men and worked to resolve their issues.

It looks to have been the same phenomenon at Penn State, and for these doctors in the Boston study. Adults thinking of other adults.

Children are small. They don’t draw as much attention. The devastating detail in all these cases is that what makes children more easily overlooked, also makes them more vulnerable.