This chapter continues the effort to trace some aspects of the development of medical law by setting these within a wider explanatory framework. R. Dingwall and F. Hobson-West argue that the challenge to medicine can best be understood as part of a broader shift from medicalization to legalization – what they describe as a shift in the mode of governmentality. The chapter discusses the prevalence of ideas of individual choice and responsibility in contemporary Western societies. It focuses on the implications for democracy of 'progress' in medicine and the life sciences and what role, if any, the courts might play in enhancing the level of debate about such 'progress'. The chapter explains the interplay between individual choice, rights and self-assertion on the one hand, and individual responsibility, obligation and regulation on the other. Individuals are simultaneously empowered and responsibilized. They have the freedom to choose, but exercise that freedom responsibly.