Reply to Letters to CMAJ Commentary ‘Secure care: more harm than good’

We thank Clark and colleagues for their presentation of an ethical perspective on secure care in response to our previously published commentary on this topic (1, 2). We fully agree that the ethical criteria presented in their letter (3, 4) are critical considerations in this important discussion. In our assessment outlined below, we conclude that secure care fails many of these fundamental ethical tests and is therefore ethically problematic on numerous fronts. Consistent with our original commentary (2), this leads us to call for increased investments in voluntary treatment services and other supports as opposed to secure care policies.