From Choice to Coercion? The Troubling Implications of HB 254
A recent op-ed by Shannon McGinley, Executive Director of Cornerstone Action and Cornerstone Policy Research, in NH Journal highlights a growing debate in New Hampshire: the potential consequences of House Bill 254, also known as the “New Hampshire End of Life Freedom Act” (McGinley, NH Journal). While supporters claim the bill provides autonomy for those facing terminal illness, McGinley warns that it could lead to coercion, placing government and insurance companies in control over life-and-death decisions.
The Shift from Choice to Pressure
HB 254 aims to legalize physician-assisted suicide (PAS) in New Hampshire, allowing terminally ill individuals to obtain life-ending medication. However, McGinley argues that such policies, which often begin under the guise of compassionate care, can rapidly evolve into dangerous precedents. He points to other jurisdictions, such as Canada and Oregon, where initial safeguards around PAS have eroded, and eligibility has expanded beyond those with terminal illnesses.
In Canada, for example, the Medical Assistance in Dying (MAID) law was originally intended for those with a prognosis of six months or less to live. Now, eligibility is being considered for individuals with mental health conditions and non-terminal disabilities. McGinley cautions that HB 254 could set New Hampshire on a similar trajectory, where those facing complex health conditions may feel societal pressure to end their lives rather than seek extended care.
A System Ripe for Abuse?
One of the most concerning aspects of HB 254 is its potential impact on the most vulnerable populations. McGinley underscores the risks for individuals with disabilities, low-income patients, and the elderly—groups that often face systemic barriers to healthcare. If PAS becomes an accepted medical practice, some fear that insurance companies may prioritize cost-saving measures over life-extending treatments. Instead of covering expensive long-term care or palliative services, insurers could subtly (or explicitly) steer patients toward the more “economical” option of assisted suicide.
Furthermore, McGinley warns that state-run healthcare programs, which already struggle with funding shortfalls, could see PAS as a practical solution to alleviate financial strain. If enacted, HB 254 could create a situation where vulnerable individuals are influenced—if not outright coerced—into making decisions that benefit bureaucracies rather than their own well-being.
The Psychological Toll on Suicide Prevention Efforts
New Hampshire has long invested in suicide prevention programs, recognizing the alarming rise in mental health crises. HB 254 raises a contradiction: How can the state simultaneously work to reduce suicides while legalizing physician-assisted suicide? McGinley suggests that normalizing PAS could undermine these prevention efforts, sending a message that some lives are not worth saving.
Where Does New Hampshire Go from Here?
As the debate over HB 254 unfolds, it is critical to weigh the risks of such legislation beyond its immediate intent. McGinley’s op-ed challenges lawmakers and the public to consider whether legalizing PAS will truly enhance personal freedom—or if it will create a framework where economic and bureaucratic pressures subtly dictate who lives and who dies.
While supporters argue that HB 254 is about choice, opponents fear it could become a tool for coercion. New Hampshire must ask itself: Are we prepared to take that risk?
Read McGinley’s full op-ed in NH Journal here.
