The Dangerous Precedent of HB 254: A Risk to Vulnerable Communities
New Hampshire’s House Bill 254 (HB 254), also known as the “End of Life Freedom Act,” is a controversial piece of legislation that proposes to legalize physician-assisted suicide for individuals with terminal illnesses. While framed as a compassionate option, this bill introduces a host of ethical, medical, and social concerns that could have far-reaching consequences—particularly for the most vulnerable members of our community.
A Contradictory Message on Suicide
One of the most alarming aspects of HB 254 is the message it sends about suicide. Public health officials and mental health advocates have worked tirelessly to prevent suicides, especially among teenagers, veterans, and those struggling with mental health challenges. However, by legalizing physician-assisted suicide, the state would effectively be endorsing the idea that suicide is an acceptable option in certain cases.
As Derek Tremblay, Headmaster of Mount Royal Academy, highlighted in a letter to the House Education Committee, there has been a staggering increase in depression, self-harm, and suicide among adolescents in the past decade. Citing Jonathan Haidt’s The Anxious Generation, Tremblay pointed out:
Major depression in adolescent girls has increased by 145%, and in boys by 161% since 2010.
Emergency room visits for self-harm among adolescent girls have jumped 188%, and for boys 48%.
Suicide rates for adolescent girls have surged 167%, and for boys 91%.
If lawmakers are serious about addressing mental health and suicide prevention, normalizing physician-assisted suicide is a dangerous step in the wrong direction.
A Slippery Slope: Expanding Who Qualifies
Proponents of HB 254 argue that the law is strictly for terminally ill patients. However, experiences from other regions where assisted suicide has been legalized show that such laws often expand over time. In Canada, for example, its Medical Assistance in Dying (MAiD) law has gradually broadened its scope to include individuals with mental illness—a shift that has sparked global concern.
Once the door is opened, where does the expansion stop? Will patients with severe but non-terminal illnesses eventually be included? Will people with disabilities feel pressured to consider assisted suicide due to a lack of resources or support? These are not hypothetical concerns—they are real trends seen in other nations that have adopted similar policies.
Ethical Dilemmas for the Medical Community
Physicians take an oath to “do no harm.” HB 254 places them in an ethically troubling position, forcing them to consider whether their role is to heal or to facilitate death. The American Medical Association (AMA) has defined medical aid in dying as a form of suicide, reinforcing the idea that assisting in a patient’s death conflicts with the fundamental principles of medical ethics.
Additionally, there are concerns about coercion. For individuals who are elderly, disabled, or financially struggling, the option of physician-assisted suicide may become less of a “choice” and more of an expectation—especially in a healthcare system where treatment can be costly and burdensome.
A Better Way Forward
Rather than legalizing physician-assisted suicide, New Hampshire should focus on improving palliative care, expanding mental health resources, and ensuring that terminally ill patients have the compassionate, dignified care they deserve. Strengthening hospice services and investing in patient-centered care would provide a humane alternative without introducing the risks that HB 254 presents.
HB 254 is not just a policy debate—it is a question of how we, as a society, value life and care for our most vulnerable. Instead of opening a dangerous door, New Hampshire lawmakers should work to affirm life, dignity, and compassionate care for all.