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.

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