Spain blasted the U.S. government on Wednesday for probing a high-profile euthanasia case in Barcelona, kicking off a diplomatic rift over human rights and end-of-life laws.
The dispute was spurred by a leaked U.S. diplomatic cable ordering the American Embassy in Madrid to open an investigation into Spain’s decision to allow sexual assault victim Noelia Castillo to undergo legal euthanasia last week.
After suffering repeated sexual assaults and surviving a suicide attempt that left her paralyzed and in constant pain, the 25-year-old woman applied to be permitted to undergo assisted suicide within the framework of Spain’s 2021 right-to-die law. Castillo’s family opposed the decision, and waged an ultimately unsuccessful, 18-month legal battle to block her from carrying out her wishes.
In the leaked cable, which has not been verified by POLITICO, State Department officials expressed concern over the application of Spain’s right-to-die law “in cases involving psychiatric conditions and non-terminal suffering” and instructed its diplomats to relay Washington’s “serious concerns” to their Spanish counterparts.
The dispute reflects a wider breakdown in U.S.-Spain relations, with persistent clashes over NATO defense spending and Madrid’s refusal to back the war on Iran.
News of the diplomatic probe irked officials including Spanish Health Minister Mónica García, who urged U.S. President Donald Trump to stop “sticking his nose” into Spain’s internal affairs.
“Spain is a serious country, with a solid healthcare system and a rights framework that protects and cares for all people, including those who choose to request help to die with dignity in legally regulated contexts, evaluated by clinical committees and endorsed by the courts,” she wrote on X.
García also blasted Washington for taking such interest in the death of a single Spaniard, when “thousands of uninsured people die in the United States each year and Trump supports and carries out human rights violations between Gaza and Iran.”
Catalan President Salvador Illa, from the region where the assisted suicide took place, similarly pushed back against the State Department’s suggestion that Spain hadn’t handled Castillo’s case well.
“We will defend with full force the professionals of our healthcare system against any malicious attacks that seek to undermine their work,” he wrote on X.
“We defend the right to a dignified death, after adopting one of the most advanced and exemplary legal frameworks in the world,” he added.
Spain legalized euthanasia and medically assisted suicide in 2021, making it one of a small group of European countries — including Belgium and the Netherlands — where assisted dying is permitted under strict conditions.
The practice has expanded rapidly where it is legal. In Belgium, euthanasia cases have increased more than tenfold over the past two decades, rising from a few hundred cases in the early 2000s to more than 4,400 in 2025, accounting for roughly 4 percent of all deaths.
EU law does not regulate euthanasia directly, leaving member countries to set their own frameworks — a patchwork that has fueled growing political and ethical debate across the bloc, particularly in cases involving psychiatric illness.
