In this essay some elements of analysis are presented in order to ponder on democracy and participation, moving beyond traditional dichotomies, and beyond the health field. An overview of present day forms of participation, and changes in the relation of citizens with politics is proposed, observing its potential and weak points. We advocate that, in order to further people's participation in the administration of public policies, there must be a complementarity between the institutional channels and other forms of involving the citizen with public affairs, more fluid and sporadic, recognizing each single element that is a part of, and qualifies, living and participating in a democracy.
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