Are users of health services "consumers" or "citizens"? What does citizen participation really mean? Why are citizenship and participation so strictly bond? This essay attempts to answer these questions. An effective participation guarantees the rights’ respect. There are several important and creative participation experiences in the health services. Participation, though, is not always "citizens activism". It is often ambiguous and useful to the aims of "management activism".
Keywords: Diritti di cittadinanza, partecipazione dei cittadini, salute collettiva, servizi sanitari, esperienze di partecipazione, attivismo dei cittadini