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Comparative studies on health and social welfare issues have led to the development of models pertaining to the socio-political organization of the welfare state, especially ones that take into account the cost of caring for vulnerable people. Few, however, have focused on the place of civil and political rights in their comparisons.Beyond the increase in the number of legal constraints in many Western countries, recognizing legal (in)capacity raises the question of the repercussions that situations of disability, dependency or illness can have on vulnerable people’s ability to exercise their rights. More broadly, it reveals the very real tensions resulting from the coexistence of ideals that are difficult to articulate to one another, such as autonomy and protection, or solidarity and freedom.This article draws a socio-historical comparison of the evolution of modes of recognition of legal (in)capacity in France and in Quebec. It sheds light on the role of “expert” actors and knowledge in the process of clinically assessing (in)capacity, as well as on that of international human rights experts, by highlighting the salient elements of three modes of recognition of (in)capacity. It puts into perspective contemporary connections and tensions between clinical concern for vulnerable people and respect for their rights.