Citizen participation and patient rights are the collective and the individual expression of an active partnership orientation of the relations between those acting in the medical and health care system. Citizen participation is the complement and continuation of existing individual patient rights through collective rights of citizens, the insured and patients to take part in communication and decision-making processes on information, quality, effectiveness and efficiency. In Germany and Europe individual patient participation is accepted as an objective and guaranteed by law („Charter of Patient Rights”). The participation of citizens as a collective involvement in decision-making processes going beyond the individual case is neither as an objective nor in practice generally established. The article presents the situation of individual and collective rights in Germany and Europe, legitimates collective citizens' rights to participate in derision-making processes on the levels of the medical and the health care system and discusses different forms and examples of participation in national, regional and local institutions. Citizen participation is a „discovery procedure“ and, from a legal point of view, not an outcome-determined but a procedure-oriented concept of organisation of the medical and health care system.