In order to gain allegiance, a transnational regulatory regime must be able to demonstrate its ‘regulatory legitimacy’ – it must persuade its members, and sometimes the global community in general, that it is addressing a true regulatory need. Most commonly, such regimes will appeal to one or more of the following conditions as being the basis for its regulatory legitimacy: transnational interdependency; global convergencies that are resulting in common regulatory needs that are more efficiently addressed at the transnational level; cosmopolitanism; the distinct concerns of particular transnational regional or professional populations; and the capacity of transnational law to facilitate emancipation from oppressive domestic regulatory structures. Establishing these various ‘bases of regulatory legitimacy’ often involve making empirical claims that can be subject to considerable contestation. As examined later in this volume, all this implicates the particular kinds of regulatory activities (see Chapter 3) and governance structures (see Chapter 4) the regime can support.

Taking a lead from Graeme Laurie’s willingness to ‘think outside the box’ – typified by his more recent work on ‘liminality’ – this chapter has as its thrust the idea that medical jurisprudence needs to speak to more than the leading cases and the nice doctrinal questions. It also needs to get the regulatory environment right for the upcoming technological developments – in genetics, robotics, additive manufacturing, nanotechnologies, artificial intelligence,, machine learning etc. – that promise to transform medical practice. Following this line of argument, medical lawyers should think outside the box of Law 1.0, where traditional legal principles, concepts and precedents are applied to new technologies and novel applications; engage with the regulatory challenges, including the challenges of regulatory connection and effectiveness but particularly that of regulatory legitimacy, that are the subject of Law 2.0 thinking; and join the embryonic Law 3.0 conversation, which contemplates not only smart technological solutions to regulatory problems but also humans being taken out of the loop (as both regulators and regulatees).