Nicolas Rio shared his expertise on participatory democracy during a symposium and workshop on health democracy at Unisanté in August 2024. This article returns to the three key questions discussed: Does social participation make it possible to (re)establish representation for all citizen-actors? What should be the purpose of participatory mechanisms? Isn't the crisis of democracy the result of a crisis of listening rather than one of speaking? Rio's analysis highlights the limits of current systems and suggests ways to improve their impact on public policy formulation and increasing the trust of citizen-actors in their institutions. Although this approach is not limited to health, its conclusions should help stimulate reflection in this arena.