When A Patient Confesses

Prominent New York psychiatrist Dr. Douglas Ingram has been in practice for over 25 years but he was caught off guard when one patient, another doctor named Joseph DeMasi, made a disturbing confession during a therapy session, reports CBS News Legal Correspondent Kristin Jeannette-Meyers.

"He had interests in children, perhaps sexual interests." says Ingram. "I asked him if he had ever molested a child. No. If ever touched a child, no,"

Four months after the confession Dr. DeMasi molested a 10-year-old patient, Denny Almonte, while working in the emergency room.

"I felt terrible," says Ingram. "I felt amazed."

Dr. Ingram says he was struggling to protect children and his patient at the same time. He knew that the law requires a psychiatrist to break doctor/patient confidentiality if a patient is a substantial threat to others, but Ingram says he thought fantasies didn't add up to a credible threat. Lawyers for Denny Almonte disagreed.

"Dr. Ingram kept silent. He chose to protect the predator instead of the prey," says Karen Koskoff, attorney to Denny Almonte.

In a case that expands doctors' responsibilities further than ever, Almonte sued Dr. Ingram for negligence and won. A federal jury agreed Ingram had a legal duty to expose his patient as a potential pedophile.

Dr. Robert Michels, of New York's Cornell Medical Center, worries the verdict puts therapists in the impossible position of predicting when a patient will actually act out their fantasies.

"If psychiatrists are supposed to pick up the phone every time someone tells them such a fantasy, we're going to have a lot of patients who are going to decide not to talk to psychiatrists about troubling ideas," says Michels.

And Dr. Ingram fears it could cause psychiatrists to avoid patients like Dr. DeMasi -- the ones who need help the most.