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Harm reduction is often defined as value- neutral with regard to drug use and drug users. In this paper Fry, Treloar & Maher argue that to its detriment, harm reduction research ( and practice), in its focus on technical skills, evidence and innovation, has failed to articulate an agreed moral framework. Using case examples from a recent forum on the topic, they make a case for a more ethically engaged harm reduction. Recent debate about ethical issues within harm reduction occurs against similar discussion in public health. The authors explain that crucial issues emerge at intersections between human rights, consumer engagement and applied communitarian ethics.