Democracy and citizen's participation are part of several aspects of life, and are required in health education, representing the necessary connection to the satisfaction of this practice. Discourse and practices of health education in health services are discussed in this article according to two main categories: 1) democracy and citizenship, and 2) participation of individuals as citizens. One of the strategies used by health professionals to provide the individuals autonomy as health promoters is strengthening the individuals' capacity to participate in decisions that affects them. In order to consolidate popular participation as a democratic ideal a critical professional attitude, based on the combination of full citizenship with liberty, participation, and equality, is required.