I suppose this shouldn't really be a surprise, but it's useful to have it documented. In Flanders, where active euthanasia is legal, doctors are killing nearly as many people without their request as with it. The study (based on the doctors' own answers to a questionnaire) found that the people killed without their own request were primarily 80 years old or more and were usually unable to be part of the "decision" because of dementia or coma.
While the authors of the study make some feeble gestures in the direction of wishing to reduce the number of terminations without request, their preferred solution is...ta-dum!--end-of-life planning. In other words, if we can just get the old people to say ahead of time that they want to be killed if they become demented, then when we kill them later, that will be with their consent. Problem solved.
Call me cynical, but I can't help wondering how happy the study authors (or the Flemish doctors) would be if the end-of-life planning with lucid elderly people resulted in unequivocal statements that they did not want to be actively terminated under any circumstances. And, a more chilling question: Would that really result in fewer terminations without consent?
Then there's the matter of drug advice. The study authors found that a number of the doctors who stated that they used drugs with the intention of actively terminating the patient were using opioids, and the study authors are of the opinion that the opioids used may, despite the express intent of killing, have not actually hastened death. (Darn!) And then there's the other problem, that patients may "regain consciousness" and that the procedure may "take longer than expected." They recommend educating doctors better about the nature and action of opioids. It's difficult to read this in any way other than the way that Wesley J. Smith reads it--namely, that doctors should be taught to use quicker, more effective drugs for killing their patients.
It's worth remembering that, under Flemish guidelines, doctors are legally required to have explicit requests in order to kill their patients. Why, then, do we find only such mild concern in the study that finds the reality so different from the theory? And why is the recommended action not prosecution of the doctors for breaking the law but rather increased pressure on patients to make living wills sooner?
I'm afraid the answer to these questions is only too depressingly obvious. The advocates of choice aren't really all that het up about the negation of all choice by direct murder without consent.