With the ‘argumentative’ turn away from positivist epistemologies in the policy sciences, processes of (joint) meaning making in policy processes were placed center stage. The importance of language and discourse was emphasized, often accompanied by a normative call for participatory analysis. An often implicit assumption in this work in the argumentative tradition was that there a priori existed a multitude of actors willing to participate in policy debate, sharing frames and voicing narratives. Today, it seems as if we are witnessing a second shift towards the idea of a more material, biological citizenship: conceptions of what it entails to be a citizen are linked to beliefs about the biological existence of human beings, as individuals and as communities (Rose & Novas 2003). But these beliefs are in themselves far from self-evident. We will argue in this paper that the deliberation on sensitive health issues provides a discursive space for defining and reinforcing what it means to be a community, thus, for shaping the polis. We will show how in the cases of organ donation on the one hand and the right to die on the other hand, the public and the private intersect as the polis is instantiated in medical practices regarding highly private matters. We will show how in these practices different images emerge of the citizen and how he or she should relate to others, particularly in terms of giving and receiving: public spirit is to be found in the penetrating gaze of medical practice.