This article discusses the social construction of the participation of civil society in the Unified Health System, and initially reflects on the progress in the legal area, against the daily obstacles in the construction of spaces to practice democracy; in other words, the distance between "the spirit and the letter of the law". It focuses on the analysis of the process of creation of health councils in Brazil, describing its importance for an effective participation of the civil society in decision-making in the health area, thinking over the shades of this utopia; it points out the challenges and possibilities for an effective social participation; it emphasizes the possibility of the active presence of subjects in the construction of the democratic process in the SUS and starts the discussion on the need to empower and to release the population. Finally it discusses the exclusion and marginalization of great part of the population, considering not only the construction of citizenship in Brazil, but also the concept of citizenship itself.
social participation; Health Council; citizenship