Sometimes, not always, not never: a response to Pickard and Pearce

This paper provides a response to Hanna Pickard and Stephen Pearce's paper Balancing costs and benefits: a clinical perspective does not support a harm minimisation approach for self-injury outside of community settings.' This paper responded to my article Should healthcare professionals sometimes allow harm? The case of self-injury.' There is much in the paper that I would agree with, but I feel it is important to respond to a number of the criticisms of my paper in order to clarify my position and to facilitate ongoing debate in relation to this important issue.