ABSTRACTThere is a growing acceptance of user rights models with regard to dependent populations such as nursing home residents, but classic theories of rights presuppose levels of human rationality and human agency often lacking in the case of highly dependent populations. While user rights models have strong advantages at a rhetorical level, the reduced capacity for dependent groups to assert their rights constitutes a significant structural limitation. Policies, practices and regulatory strategies developed on the assumption that very dependent groups can indeed assert such rights thus proceed on a premise which is fatally flawed.