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Nazi Euthanasia

In October of 1939 amid the turmoil of the outbreak of war Hitler ordered widespread
"mercy killing" of the sick and disabled.
Code named "Aktion T 4," the Nazi euthanasia program to eliminate "life unworthy of
life" at first focused on newborns and very young children. Midwives and doctors were
required to register children up to age three who showed symptoms of mental retardation,
physical deformity, or other symptoms included on a questionnaire from the Reich Health
A decision on whether to allow the child to live was then made by three medical experts
solely on the basis of the questionnaire, without any examination and without reading any
medical records.
Each expert placed a + mark in red pencil or - mark in blue pencil under the term
"treatment" on a special form. A red plus mark meant a decision to kill the child. A blue
minus sign meant a decision against killing. Three plus symbols resulted in a euthanasia
warrant being issued and the transfer of the child to a 'Children's Specialty Department'
for death by injection or gradual starvation.
The decision had to be unanimous. In cases where the decision was not unanimous the
child was kept under observation and another attempt would be made to get a unanimous
The Nazi euthanasia program quickly expanded to include older disabled children and
adults. Hitler's decree of October, 1939, typed on his personal stationary, enlarged "the
authority of certain physicians to be designated by name in such manner that persons
who, according to human judgment, are incurable can, upon a most careful diagnosis of
their condition of sickness, be accorded a mercy death."
Questionnaires were then distributed to mental institutions, hospitals and other
institutions caring for the chronically ill.
Patients had to be reported if they suffered from schizophrenia, epilepsy, senile disorders,
therapy resistant paralysis and syphilitic diseases, retardation, encephalitis, Huntington's
chorea and other neurological conditions, also those who had been continuously in
institutions for at least 5 years, or were criminally insane, or did not posses German
citizenship or were not of German or related blood, including Jews, Negroes, and
A total of six killing centers were established including the well known psychiatric clinic
at Hadamar. The euthanasia program was eventually headed by an SS man named
Christian Wirth, a notorious brute with the nickname 'the savage Christian.'
At Brandenburg, a former prison was converted into a killing center where the first Nazi
experimental gassings took place. The gas chambers were disguised as shower rooms, but
were actually hermetically sealed chambers connected by pipes to cylinders of carbon
monoxide. Patients were generally drugged before being led naked into the gas chamber.
Each killing center included a crematorium where the bodies were taken for disposal.
Families were then falsely told the cause of death was medical such as heart failure or

But the huge increase in the death rate for the disabled combined with the very obvious
plumes of odorous smoke over the killing centers aroused suspicion and fear. At

Hadamar, for example, local children even taunted arriving busloads of patients by saying
"here comes some more to be gassed."
On August 3, 1941, a Catholic Bishop, Clemens von Galen, delivered a sermon in
Münster Cathedral attacking the Nazi euthanasia program calling it "plain murder." The
sermon sent a shockwave through the Nazi leadership by publicly condemning the
program and urged German Catholics to "withdraw ourselves and our faithful from their
(Nazi) influence so that we may not be contaminated by their thinking and their ungodly
As a result, on August 23, Hitler suspended Aktion T4, which had accounted for nearly a
hundred thousand deaths by this time.
The Nazis retaliated against the Bishop by beheading three parish priests who had
distributed his sermon, but left the Bishop unharmed to avoid making him into a martyr.
However, the Nazi euthanasia program quietly continued, but without the widespread
gassings. Drugs and starvation were used instead and doctors were encouraged to decide
in favor of death whenever euthanasia was being considered.
The use of gas chambers at the euthanasia killing centers ultimately served as training
centers for the SS. They used the technical knowledge and experience gained during the
euthanasia program to construct huge killing centers at Auschwitz, Treblinka and other
concentration camps in an attempt to exterminate the entire Jewish population of Europe.
SS personnel from the euthanasia killing centers, notably Wirth, Franz Reichleitner and
Franz Stangl later commanded extermination camps.

Forced sterilization in Germany was the forerunner of the systematic killing of the
mentally ill and the handicapped. In October 1939, Hitler himself initiated a decree which
empowered physicians to grant a “mercy death” to “patients considered incurable
according to the best available human judgment of their state of health.” The intent of the
socalled “euthanasia” program, however, was not to relieve the suffering of the
chronically ill. The Nazi regime used the term as a euphemism: its aim was to
exterminate the mentally ill and the handicapped, thus “cleansing” the “Aryan” race of
persons considered genetically defective and a financial burden to society.
The idea of killing the incurably ill was posed well before 1939. In the 1920s, debate on
this issue centered on a book coauthored by Alfred Hoche, a noted psychiatrist, and Karl
Binding, a prominent scholar of criminal law. They argued that economic savings
justified the killing of “useless lives” (“idiots” and “congenitally crippled”). Economic
deprivation during World War I provided the context for this idea. During the war,
patients in asylums had ranked low on the list for rationing of food and medical supplies,
and as a result, many died from starvation or disease. More generally, the war
undermined the value attached to individual life and, combined with Germany's
humiliating defeat, led many nationalists to consider ways to regenerate the nation as a
whole at the expense of individual rights.

In 1935 Hitler stated privately that “in the event of war, [he] would take up the question
of euthanasia and enforce it” because “such a problem would be more easily solved”
during wartime. War would provide both a cover for killing and a pretext—hospital beds
and medical personnel would be freed up for the war effort. The upheaval of war and the
diminished value of human life during wartime would also, Hitler believed, mute
expected opposition. To make the connection to the war explicit, Hitler's decree was
backdated to September 1, 1939, the day Germany invaded Poland.
Fearful of public reaction, the Nazi regime never proposed a formal “euthanasia” law.
Unlike the forced sterilizations, the killing of patients in mental asylums and other
institutions was carried out in secrecy. The code name was “Operation T4,” a reference to
Tiergartenstrasse 4, the address of the Berlin Chancellery offices where the program was
Physicians, the most highly Nazified professional group in Germany, were key to the
success of “T-4,” since they organized and carried out nearly, all aspects of the operation.
One of Hitler's personal physicians, Dr. Karl Brandt, headed the program, along with
Hitler's Chancellery chief, Philip Bouhler. T-4 targeted adult patients in all government or
church-run sanatoria and nursing homes. These institutions were instructed by the Interior
Ministry to collect questionnaires about the state of health and capacity for work of all
their patients, ostensibly as part of a statistical survey.
The completed forms were, in turn, sent to expert “assessors”—physicians, usually
psychiatrists, who made up “review commissions.” They marked each name with a “+” in
red pencil, meaning death, or a “-” in blue pencil, meaning life, or “?” for cases needing
additional assessment. These medical experts rarely examined any of the patients and
made their decisions from the questionnaires alone. At every step, the medical authorities
involved were usually expected to quickly process large numbers of forms.
The doomed were bused to killing centers in Germany and Austria walled-in fortresses,
mostly former psychiatric hospitals, castles, and a former prison—at Hartheim,
Sonnenstein, Grafeneck, Bernburg, Hadamar, and Brandenburg. In the beginning, patients
were killed by lethal injectiostoD. But by 1940, Hitler, on the advice of Dr. Werner
Heyde, suggested that carbon monoxide gas be used as the preferred method of killing.
Experimental gassings had first been carried out at Brandenburg Prison in 1939. There,
gas chambers were disguised as showers complete with fake nozzles in order to deceive
victims—prototypes of the killing centers' facilities built in occupied Poland later in the
Again, following procedures that would later be instituted in the extermination camps,
workers removed the corpses from the chambers, extracted gold teeth, then burned large
numbers of bodies together in crematoria. Urns filled with ashes were prepared in the
event the family of the deceased requested the remains. Physicians using fake names
prepared death certificates falsifying the cause of death, and sent letters of condolences to
Meticulous records discovered after the war documented 70,273 deaths by gassing at the
six “euthanasia” centers between January 1940 and August 1941. (This total included up
to 5,000 Jews; all Jewish mental patients were killed regardless of their ability to work or
the seriousness of their illness.) A detailed report also recorded the estimated savings
from the killing of institutionalized patients.
The secrecy surrounding the T-4 program broke down quickly. Some staff members were

indiscreet while drinking in local pubs after work. Despite precautions, errors were made:
hairpins turned up in urns sent to relatives of male victims; the cause of death was listed
as appendicitis when the patient had the appendix removed years before. The town of
Hadamar school pupils called the gray transport buses “killing crates” and threatened
each other with the taunt, “You'll end up in the Hadamar ovens!” The thick smoke from
the incinerator was said to be visible every day over Hadamar (where, in midsummer
1941, the staff celebrated the cremation of their 10,000th patient with beer and wine
served in the crematorium).
A handful of church leaders, notably the Bishop of Münster, Clemens August Count von
Galen, local judges, and parents of victims protested the killings. One judge, Lothar
Kreyssig, instituted criminal proceedings against Bouhler for murder; Kreyssig was
prematurely retired. A few physicians protested. Karl Bonhöffer, a leading psychiatrist,
and his son Dietrich, a Protestant minister who actively opposed the regime, urged church
groups to pressure church-run institutions not to release their patients to T-4 authorities.
In response to such pressures, Hitler ordered a halt to Operation T-4 on August 24, 1941.
Gas chambers from some of the “euthanasia” killing centers were dismantled and shipped
to extermination camps in occupied Poland. In late 1941 and 1942, they were rebuilt and
used for the “final solution to the Jewish question.” Similarly redeployed from T-4 were
future extermination camp commandants Christian Wirth, Franz Stangl, Franz
Reichleitner, the doctor Irmfried Eberl, as well as about 100 others—doctors, male
nurses, and clerks, who applied their skills in Treblinka, Belzec, and Sobibor.
The “euthanasia” killings continued, however, under a different, decentralized form.
Hitler's regime continued to send to physicians and the general public the message that
mental patients were “useless eaters” and “life unworthy of life.” In 1941, the film Ich
klage an (I accuse) in which a professor kills his incurably ill wife, was viewed by 18
million people. Doctors were encouraged to decide on their own who should live or die.
Killing became part of hospital routine as infants, children, and adults were put to death
by starvation, poisoning, and injections. Killings even continued in some of Germany's
mental asylums, such as Kaufbeuren, weeks after Allied troops had occupied surrounding
Between the middle of 1941 and the winter of 1944–45, in a program known under code
“14f13,” experienced psychiatrists from the T-4 operation were sent to concentration
camps to weed out prisoners too ill to work. After superficial medical screenings,
designated inmates Jews, Gypsies, Russians, Poles, Germans, and others were sent to
those “euthanasia” centers where gas chambers still had not been dismantled, at Bernburg
and Hartheim, where they were gassed. At least 20,000 people are believed to have died
under the 14f13 program.
Outside of Germany, thousands of mental patients in the occupied territories of Poland,
Russia, and East Prussia were also killed by the Einsatzgruppen squads (SS and special
police units) that followed in the wake of the invading German army. Between September
29 and November 1, 1939, these units shot about 3,700 mental patients in asylums in the
region of Bromberg, Poland. In December 1939 and January 1940, SS units gassed 1,558
patients from Polish asylums in specially adapted gas vans, in order to make room for
military and SS barracks. Although regular army units did not officially participate in
such “cleansing” actions as general policy, some instances of their involvement have
been documented.

In such circumstances. https://www. in an age of genetic engineering and renewed controversy over mercy killings of the incurably ill. . However. Further. between 200. a third party or parties may determine to put an end to the patient’s suffering.000 and 250. scientists. as for example when a patient is suffering from an incurable and painful disease. and lay persons alike remain vital. euthanasia also came to be termed “involuntary”. The magnitude of these crimes and the extent to which they prefigured the “Final Solution” continue to be studied.In all.” This grant of a “mercy death” may occur with the consent of the individual Nazi Eugenics chart The Shorter Oxford English Dictionary defines euthanasia as “the action of inducing a quiet and easy death. or is in a coma and is considered unlikely to regain consciousness. ethical and moral issues of concern to physicians. is then termed “voluntary” “euthanasia” and was the meaning originally given to the word.000 mentally and physically handicapped persons were murdered from 1939 to 1945 under the T-4 and other “euthanasia” programs.ushmm.

particularly Poland. old or new. not from humanitarian or compassionate reasoning. the eventual death toll would have been immeasurably greater. but as part of a strategy to murder that part of the population least able to defend itself. in general. but at those of other eastern European countries which fell under Nazi hegemony. . but had the programme arrived at its intended conclusion. Nazi Propaganda Drawing That policy was directed not only at German citizens. not as an act of mercy.The circumstances are. That policy reached its apogee with the murder of the Jews. But Nazi ““euthanasia”” was quite different in conception and practice from the dictionary definition. that the person involved is no longer capable of making up his or her mind and/or to express his or her ultimate wish. but from pseudo-scientific theory and ruthless economic policy. The Nazis destroyed “life unworthy of life” (lebensunwertes Leben) as they termed it. For it was derived. The ““euthanasia”” programme formed an essential part of the evolving Nazi policy of extermination on a massive scale.

" Racism too. The term "eugenics". which applied Darwin's "struggle for survival" to human affairs. a thesis which has no scientific basis. labelled as idiots. would benefit society." This took the concept of “survival of the fittest”. It was suggested that there existed a relationship between low intelligence and both immorality and crime. It was concluded "Not all criminals are feebleminded. to its logical conclusion. That every feeble-minded woman is a potential prostitute would hardly be disputed by anyone. or morons. a fundamental element of Nazi ideology. was coined in 1881 by the British naturalist and mathematician Francis Galton.The Nazis did not create this twisted version of euthanasia. Pro-Eugenics' Propaganda The cause of the social problems of the time was deemed to be inherited feeblemindedness and the resulting poverty by hereditary degeneracy. Attention was focused on the feebleminded (an inaccurate term covering everything from mental retardation to alcoholism). The "darker peoples of southern Europe and the Slavs of eastern Europe are less . Eugenics developed within the larger movement of Social Darwinism. was not far from the minds of the eugenicists. imbeciles. It was described as "the science of the improvement of the human race by better breeding. but all feeble-minded persons are at least potential criminals. The fundamental tenet of the eugenics movement was that restricting the ability of “inferior” people to procreate whilst maximizing that of “superior” individuals. and the distorted “scientific” thinking to which this gave birth. Its roots lay in a selective reading of the evolutionary theories of Charles Darwin.

higher levels of antisocial behaviour. director of the Eugenics Record Office in the United States. Harry Hamilton Laughlin. as well as retarded and deformed children. such people appeared to have less intelligence. “The Right to Death” (Das Recht auf den Tod). where in his 1895 book. compared” human racial crossing with mongrelisation in the animal world" and argued that "immigrants from southern and eastern Europe. adding that the "Negro lies at the bottom of the scale" of intelligence." The eugenics movement was international. the current American population that any racial mixture would be deleterious. . Twenty five years later in a book entitled “The Permission to Destroy Life Unworthy of Life” (Die Freigabe der Vernichtung lebensunwerten Leben). but was particularly influential in Germany. the eugenicists themselves.” To the eugenicists. Karl Binding and Alfred Hoche proposed that “unworthy life” included not only the incurably sick. and genetically so inferior to. who were draining the state of its resources. useful act. Adolf Jost argued that if the state demanded the sacrifice of thousands of individuals in wartime. especially Jews. were racially so different from. such as. naturally. and. but many of the mentally ill and feebleminded. They were “burdensome existences” (Ballastexistenzen).intelligent than the fair peoples of western and northern Europe" wrote one. less human value than worthier individuals. accordingly. Killing such people was “an allowable. it had the same “right” in times of peace to demand the sacrifice of the impaired and nonproductive. (the world’s first professorial chair in eugenics was established in 1909 at University College London).

” In Germany the term "Race Hygiene" was in use long before the label of “eugenics” became common. Fritz Lenz. they continued: “Their life is absolutely pointless. heavy burden upon their relatives and society as a whole. two years before Hitler’s assumption of power. the right to live was not an entitlement but was to be earned.” The unimaginable had occurred. Their death would not create even the smallest gap--except perhaps in the feelings of their mothers or loyal nurses. and advocating “involuntary euthanasia”." And support it he did.Nazi encouragement of Genetically Health Families propaganda For Binding and Hoche. not to save life. and it was earned by being a useful economic contributor to society. physicians were being encouraged. Writing of those with disabilities. In 1931. Against such a background of pernicious nonsense masquerading as legitimate scholarly research. professor of race hygiene at the University of Munich. but they do not regard it as being unbearable. it is hardly surprising that Adolf Hitler became an early and enthusiastic supporter of this ““euthanasia”. psychiatrist and author of the 1933 Nazi sterilization . but to take it. declared: "Hitler is the first politician with truly wide influence who has recognized that the central mission of all politics is race hygiene and who will actively support this mission. In 1934 Ernst Rüdin. and the German Society for Race Hygiene (Deutsche Gesellschaft für Rassenhygiene) was to eventually represent all eugenicists. They are a terrible.

" It took Samuel Beckett to point out the irony in this Nazi obsession with the creation of a race of “supermen. the suggestion was made that life could be so much better for the productive many if the non-productive few. Would it not be better for them if an end was put to their misery and . Hitler had suggested that countless lives could be eliminated by racial measures: Those designated as "useless eaters" “If Germany was to get a million children a year and was to remove 700-800. thin like Göring. The most dangerous thing is for us to cut off the natural process of selection and thereby rob ourselves of the possibility of acquiring able people.” Via newspapers and magazines.” After attaining power in 1933.000 of the weakest people.” An `Aryan’. virile like Röhm – and be named stated: "The psychiatrist and the healthy person are allies against the genetically defective. handsome like Goebbels. were simply eliminated. At the 1929 party rally. who were such a burden to the nation. The psychiatrist must render his service to the ultimate aim of a hereditary pure. able and superior race. the Nazis began an extensive propaganda campaign with the object of acquainting the German people with the benefits of ““euthanasia”. he wrote. The first born are not always the most talented or strongest people… As a result of our modern humanitarianism we are trying to maintain the weak at the expense of the healthy. radio and film. must be blonde like Hitler. then the final result might even be an increase in strength.

the “Marriage Health Law” prohibited marriage between two people if either party suffered from some form of mental disability.” It decreed compulsory sterilization for persons characterized by a wide variety of disabilities. officially castrated. he would take up the ““euthanasia”” question and implement it. Less than 6 months after his election in 1933. the Nazis thoroughly purged long-established ethical and administrative public supervisory bodies. many of whom subsequently became victims of the ““euthanasia”” programme. particularly tuberculosis or venereal disease. Hitler introduced the “Law for the Prevention of Genetically Diseased Offspring. had a "hereditary disease" as previously defined by law. which further blurred the distinction between actual criminal behaviour and the inappropriate social behaviour that characterized many people with disabilities. also regulated marriage among people with disabilities. held in indeterminate protective custody. 200. while directed primarily at Jews.000-350. These and other laws prepared the ground for the Nürnberg Laws of 1935. which. In the same year the Nazis enacted the “Law Against Dangerous Habitual Criminals”. By that time Hitler was already proposing that he would use the cover of war to murder psychiatric patients in fulfilment of a long-held belief that he had expressed in Mein Kampf. The war. If war should break out. and.000 persons had been sterilized. would provide both a distraction and an excuse for officially killing those deemed undesirable. Hitler reasoned. It has been estimated that by 1939. or suffered from a contagious disease. With the early introduction of legislation (the 'Law for the Restoration of the Professional Civil Service' of 7 April 1933).suffering? But the road to state sanctioned murder was to be a gradual one. in the case of sex offenders. . The law stipulated that these criminal asocials (asozialen) could be committed to state asylums. he informed Gerhard Wagner. For example.

the socalled `Knauer’ child.” Hitler ordered Karl Brandt. although it could equally be argued that Hitler’s dedication to ““euthanasia”” was such that its introduction was inevitable at some point in the mercifully brief history of National Socialism. Brandt testified at his post-war Nürnberg trial he had been instructed that if the facts provided by the child’s father proved to be correct. with one leg and part of one arm missing. On his return to Berlin. In particular. It is arguable that the `Knauer’ case was the catalyst for all that followed. blind. he was to inform the physicians in Hitler’s name that ““euthanasia”” could be carried out – which it was. Brandt was authorized by . and who was described as an “idiot. who had been born on 20 February 1939. the regime was receiving requests from the families of newborn or very young children with severe deformities and brain damage for the grant of a “mercy killing” (Gnadentod). a petition was received in respect of an infant named Gerhard Herbert Kretschmar. to visit the child in a hospital at Leipzig. his personal physician. on 25 July 1939.Karl Brandt By the end of 1938.

head of the Chancellery of the Führer (KdF: Kanzlei des Führer der NSDAP). Hitler did not wish to be publicly associated with what even he considered to be a delicate matter. Answerable to nobody except Hitler. for it was to be the conduit through which first the ““euthanasia”” programme and subsequently the planned mass extermination of Jews and others was to operate. By a decree dated 18 August 1939.Hitler to proceed in the same fashion with similar cases. and so Brandt was ordered to secretly organize a programme with the aid of Philip Bouhler. Hitler had instructed Brandt to pave the way for the killing of children by setting up a body entitled the `Reich Committee for the Scientific Registering of Serious Hereditary and Congenital Illnesses’. in 1939 Bouhler seized the opportunity to acquire authorisation to administer the ““euthanasia”” programme through his deputy. Under the direction of Bouhler. doctors and midwives were ordered to report all . Phillip Bouhler In May 1939. an agency created by Hitler in 1934. ostensibly to keep him in direct touch with the concerns of the population. the KdF was to acquire a more sinister purpose. but acting in practice as Hitler’s private office. Viktor Brack.

Two laymen made a preliminary selection of cases. the mentally deficient and epileptics on drastically reduced rations in the event of war. If selected for ““euthanasia””. the child was transferred to one of a list of special hospital wards for killing. would no longer suffice to feed the entire population. Werner Heyde. Even before war came in September 1939. As early as July 1939. who was to play a prominent role in the ““euthanasia”” programme. ““euthanasia”” provided a perfect confluence of the two essential elements of National Socialist ideology – the biological and the economic. in the final years before 1939. we learned that there had been discussion in the Reich Ministry of the Interior about putting the inmates of hospitals and nursing homes for the mentally ill. the Nazis had thus established a government sanctioned process for murder. attended a meeting at which he learned of the imminent killing of the adult mentally ill. When we objected that this would mean condemning our patients to a slow but certain death by starvation. Ludwig Schaich reported: “When it became increasingly apparent. that war was imminent. they carefully began to sound out how the Home Mission would react if the state were to contemplate the elimination of certain categories of sick person in wartime. As with the `Final Solution’.cases of “deformed” newborn. once imports dried up. A hospital director. which was then reviewed by three medical professors who determined the fate of the child.” . given that food supplies.

10% spoke out against it. Dr Theodore Morell..’ There is a lesson for us there.Tiergartenstrasse 4 In a report prepared for Hitler in the summer of 1939. having reviewed a survey carried out in the 1920s of the parents of severely handicapped children. wrote: “A number of parents expressed the view: `If only you had done it (i. ““euthanasia””) and then told us that our child had died from an illness. A survey conducted in April 1941 revealed that 80% of the relatives of those murdered by the programme were in agreement with the decision. another of his personal physicians.e. .” It was clear that the regime could expect no great negative reaction to the programme from the general populace. We need not suppose that we cannot carry out any salutary measure without the consent of the sovereign people. and 10% were indifferent.

they were hardly likely to do so when Jews.]) Those responsible for subsequent events later drew up several bills that would have made ““euthanasia”” legal. but these were rejected by .’ If people did not protest at the murder of their own relatives. In a dictatorship. to the end that patients considered incurable according to the best available human judgement of their state of health. and only a very few protested. where people knew while pretending not to know. However. dass nach menschlichen Ermessen unheilbar Kranken bei kritischster Beurteilung ihres Krankheitszustandes der Gnadentod gewährt werden kann. he was pressed to confirm his instructions. can be granted a mercy death. med. Although Hitler had already given verbal authorisation to the “euthanasia” enthusiasts. he wished to avoid the passing of an official law.It has been suggested that this policy of `official secrecy’. was an invitation to denial and moral indifference on the part of both the German establishment and the German nation as a whole. a brief decree was issued on Hitler’s private stationery and signed by him: Hitler's order to Bouhler authorizing the T4 program “Reich Leader Bouhler and Dr Brandt are charges with the responsibility for expanding the authority of physicians. die Befugnisse namentlich zu bestimmender Ärzte so zu erweitern. no debate was necessary. Gypsies. and even more infrequently in writing) for his wishes to attain the force of law. Brandt sind unter Verantwortung beauftragt. And so. It was enough for Hitler to simply issue a command (rarely explicit. to be designated by name. no act of government required. It laid the foundation for a similar reaction to the `Final Solution. [Reichsleiter Bouhler und Dr. in October 1939. and foreigners were slaughtered.

T4. Other dummy organisations were set up under seemingly innocuous titles – the `Charitable Foundation for Institutional Care’ (Gemeinnützige Stiftung für Anstaltspflege: Stiftung ). The premises were rented by the KdF in early 1940 under the name of the`Reich Work Group of Sanatoria and Nursing Homes’ (Reichsarbeitsgemeinschaft Heil. something Hitler absolutely refused to do. headed by Viktor Brack. The organization’s code name. head of the Party Chancellery. It was the decisionmaking agency for all aspects of the “euthanasia” and subsequent Aktion Reinhard policies. Although Bouhler was titular head of the whole operation. the `Central Compensation Office for Sanatoria and Nursing Homes (Zentralverrechnungsstelle Heilund Pflegeanstalten: ZVST). a permanent headquarters for the new organization was established at Tiergartenstrasse 4 in Berlin. in fact he had little to with it unless his authority was needed in dealing with other government agencies. The decree was backdated to 1 September 1939 to coincide with the date of commencement of the Second World War.’ These names were all intended to camouflage the true purpose of the murderous plan.und Pflegeanstalten: RAG). Martin Bormann. After operating from a number of different addresses.” He was .Hitler. the `Charitable Society for the Transportation of the Sick Limited’ ('Gemeinnütziger Krankentransport GmbH': Gekrat). The ultimate authority for the ““euthanasia”” operation was Hauptamt II (Main Office II) of the KdF. Brandt dealt only with the medical aspect of the operation. and continued to run his medical practice. was kept well away from “euthanasia” matters because it was well-known at the KdF that in his hands “euthanasia would not stop at mental patients. Heinrich Lammers was head of the Reich Chancellery and constantly carped about the lack of a legally proclaimed decree for “euthanasia”. was taken from this address. It was necessary to wait until final victory had been achieved before passing such a law. He believed (almost certainly correctly) that this would present an unacceptable propaganda opportunity to the enemy.

by one means or another.displeased at being excluded because his brother Albert worked for the KdF and was also one of Hitler's adjutants. None were coerced. a young lawyer. Allers. was sent to Poland as an army training sergeant. or to end one’s participation. Some were told that a ““euthanasia”” law existed. “even down to the tea-ladies. In . Brack's deputy was Werner Blankenburg. his mother met Blankenburg in the street and when she told him that her son was in the army. Hefelmann was the leading light at the Kdf for children's “euthanasia”. In 1939. However. Few of those approached declined an invitation to become involved. So far as is known.” The recruitment of Dieter Allers may be regarded as typical. all participants were required to confirm. nobody was executed or sent to a concentration camp for doing so. All the T4 staff were initially interviewed by Brack or Blankenburg. All the KdF staff involved in “euthanasia” took the job on in addition to their normal functions. It was possible to refuse to participate in killing. as some did. Werner Blankenburg Viktor Brack Individuals recruited for the project were asked if they were prepared to participate. their understanding of the necessity to maintain absolute secrecy. but could not be shown to them for the same reason of secrecy. In November 1940. and all were completely immersed in the business of murder. Doctors were never ordered to kill psychiatric patients and handicapped children. Blankenburg offered to give him a job at the KdF and arranged for his discharge from the military.

if they were troubled. The later hands-on. of course. There were.January 1941. and nurses. through their representative Christian Wirth. was named after SS-Obersturmbannführer Kurt Eimann. bred a team of specialist murderers who could kill without any qualms of conscience or. “Find men with courage to implement”. continued to kill anyway. and general handymen and were gradually inveigled into the actual killing process. The Eimann commando. carpenters. The overall impression obtained from their personnel backgrounds was that they were initially surprised at being selected as none had applied to join T4. they were summoned and had no idea why. as well as that of German patients in Pomerania and East Prussia. plumbers. drivers. They lacked the attributes or inclination to become members of the SS or the police. The units involved were the Eimann commando. practical killers of European Jewry came predominantly from this “euthanasia” cadre of `ordinary men’: chefs. exceptions to whom killing came naturally. They were mostly employed at jobs such as doormen. Judging from their backgrounds. but in general the KdF.400 patients from Pomerania in the wood of Piasnitz near Neustadt in . In autumn 1939 the Sturmbann was ordered to kill 1. Bus used to transport victims Even before the issue of the edict. Einsatzkommando 16 and the Selbstschutz (a paramilitary organization of Volksdeutsche). telephone operators. Allers was appointed managing director of T4 by Brack. photographers. who was from Görlitz. or Volksdeutsche SS-Sturmbann E. nor what they would be doing. the majority of lower echelon staff recruited to the program were of average intelligence with a basic standard of education. and “nerves to endure” was mentioned in a speech by Brack on 23 April 1941. the killing of Polish patients had begun in what were to become the incorporated territories of Danzig-West Prussia and the Warthegau.

The commando also journeyed to East Prussia. formerly the chief of staff of Naumann’s Einsatzgruppe VI. By that time gassing experiments on mental patients utilizing both carbon monoxide and an agent similar to Zyklon B had already taken place at Fort VII in Posen (Poznan. south of Danzig (Gdansk. chief chemist of the Kripo (Criminal Police) suggested the use of bottled carbon monoxide as a killing agent. near Wejherowo). The first of these vans was operated by a commando headed by Herbert Lange.West-Prussia (today. where in a period of less than three weeks more than 1.800 German and Polish patients were gassed. Kiev. but in mobile gas vans. not in stationary gas chambers. The first gas chambers were being constructed at Grafeneck and Brandenburg in late November. bottled carbon monoxide was introduced into a sealed compartment at the rear of the vehicle.000 Polish patients in the mental hospital at Konradstein (today Kocborowo).) In the following months. It has been estimated that a total of 7. and so on. Dvinsk. By January 1940. Dr Albert Widmann. . experimental killing phase. Throughout the first months of that year. Initially executions were by shooting. Lange’s commando travelled around the Warthegau in a van bearing a sign advertising `Kaiser’s Kaffeegeschäft’ (Kaiser’s Coffee Company). Polish patients were being gassed. Aglona. Mogilev.700 sick and handicapped patients fell victim to this early. woods close to the Piasnica River. Poltava. thousands of Polish mental patients were killed. Following the invasion of the former Soviet Union in 1941. many more mentally ill patients were murdered in places such as Riga.) Eimann was sent to the SSStandortkommandantur at Lublin on 20 November 1941. the Eimann commando began killing 2. but in October. On 22 September 1939.

the ““euthanasia”” programme in the Reich entered four distinctive but overlapping phases. Dr Hermann Pfannmüller.000 children had been killed. “No Jews are allowed in my institution!” Pfannmüller proudly declared. 22 -28 special wards were established in hospitals throughout the country for the murder of children. The strategy for adult “euthanasia” was much more comprehensive. openly admitting that among the children to be murdered were some who were not mentally ill.Smoking Chimney at Hadamar During the first two years of the war. this programme was extended from infants to older children. whether or not an individual was . They were simply the children of Jewish parents. and in some cases even to teenagers. A visitor to the Reich Committee institution at Eglfing-Haar described the cynicism with which the director. institutionalised Jews and concentration camp prisoners. approximately 5. or (b) had been institutionalized for more than five years. adults. or (c) had been committed as criminally insane: or (d) were non-`Aryan’. The Interior Ministry had issued another decree on 21 September 1939. requiring medical facilities to complete a questionnaire in respect of all patients who (a) suffered from an extensive list of medical conditions and were unable to work. relating sequentially to the killing of infants. As with children. By the end of the war. In time. boasted of his methods.

the regional health departments and administrators of the psychiatric institutions had been completely taken over by Party officials who . Dr Rudolph Boeckh. and to complete my education [Ausbildung].800 concerned… They merely questioned the nursing staff. and another to carry them out oneself in their final consequences. That was by no means always the case. Dr Friedrich Hölzel declined.condemned to die was supposedly decided by a panel of physicians. protested at the manner in which the medical commission had behaved at his establishment: “… The commission did not examine one single patient out of the 1. When approached to become head of the children’s “euthanasia” programme at Eglfing-Haar by the aforementioned Pfannmüller. whose opinions were recorded on the forms… Cases were observed in which the opposite of the staff member’s true statement was recorded on the questionnaire…” Not all doctors were prepared to become part of the nefarious plan." T-4 Euthanasia program personnel at a social gathering By the late 1930s. although there was often a disquieting acceptance of the principle involved. head physician of the asylum at Neuendettelsau. the medical establishment was deeply implicated in the “euthanasia” programme. Heinrich Bunke gave the following explanation for accepting the invitation to join T4 as a physician : "It provided the opportunity to collaborate with experienced professors. writing: “… It is one thing to approve of measures of the state with full conviction. to do scientific work. I am reminded of the difference which exists between a judge and an executioner…” But in general.

Dr Walter Schmidt. Among those present were Drs Horst Schumann (later director of Grafeneck and then Sonnenstein.which also provided victims for the Hadamar killing centre . Hartheim and Pirna-Sonnenstein (only four of which were in operation at any given time.) Each killing centre was assigned a code that was to be used in all telephone conversations and written communications with the T4 central offices: "A" was assigned to Grafeneck. Schmidt. they were the arbiters of life and death. strutted around in SS uniform with pistol at his side supervising the daily murder of patients. Brandenburg. described by one male nurse as a “hothead and psychopath. "D" to Sonnenstein. often recruited from the police. it was decided to use bottled carbon monoxide in stationary gas chambers situated in six killing centres .used their political affiliation to browbeat those who remained non-political. who had been murdered in the main by lethal doses of medication or starvation.Grafeneck. The nonmedical middle managers. Hadamar. An experimental gassing was carried out at the former Brandenburg-Havel prison in either December 1939 or at the beginning of January 1940. Bernburg. Following Dr Widmann’s expert advice and the experience gained at Posen. a fanatical Nazi bureaucrat. 4-6 further inmates were administered lethal .” gave orders to his nurses to shoot dead any patient who attempted to escape. Unlike the children. During the T4 “euthanasia” phase at the Eichberg Institution .) 18-20 asylum inmates were herded into a rudimentary gas chamber which had been constructed under the supervision of Christian Wirth. and Irmfried Eberl (later director of Brandenburg and subsequently first Commandant of Treblinka. a name which was to loom large in events to come. "Be" to Bernburg and "E" to Hadamar. the much greater number of adults to be liquidated demanded a more efficient killing system. "C" to Hartheim. "B" to Brandenburg. subsequently notorious for his medical experiments on prisoners at Auschwitz). were motivated by personal considerations of advancement and ideological commitment. The onlookers watched closely as the inmates died from carbon monoxide poisoning.

Kaufbeuren euthanasia center . The gas was supplied by the Ludwigshafen plant of I G Farben (today Badische Anilinund Sodafabriken: BASF) to the KdF. the victims were given a stamped postcard on which to report to relatives a safe arrival at their destination. From the autumn of 1940.injections. who traded under the name “Jennerwein” (Brack) and “Brenner” (Blankenburg). at Hadamar. Gekrat. A fleet of buses (usually three at each killing centre) was hired from the Reich Post Office. only minutes before they were taken to the gas chamber. For example. in order to maintain secrecy. but when the poison had little immediate effect. The Gekrat bus drivers were all SS-NCOs recruited from the concentration camps. Most of the deceptive practices that were later used in the death camps in Poland were first in evidence in the ““euthanasia”” programme. The experiment was considered a success. but were first taken to transit institutions. was created to ship the victims by bus to the killing centres. these inmates were also gassed. patients were no longer transferred direct to the killing centres.

the patients were told they were to enter this "inhalation room" for therapeutic reasons. Usually in batches of 40-60 at a time. and within 10 to 15 minutes.. Prior to cremation.. A room suitable in the planning of the hospital was used. a deception that was to become a common feature of Nazi killing centres. with the necessary apparatus. Organs. the gassing apparatus was operated by the medical director at each ““euthanasia”” institution.A similar killing method applied in all of the centres. who often received . At his trial at Nürnberg." Apparently. That was made into a gas chamber. it was Bouhler who suggested that the gas chamber at Brandenburg should be disguised as a shower room. who became known as the Vergasungsarzt ('gassing doctor'. a compressed bottle. Not all bodies of children had been immediately cremated. Outside of this room there was a bottle. It was sealed. the bodies were plundered. in accordance with orders from the KdF.) Within 5 minutes. Gold-filled teeth and dental bridges were broken from the corpses' mouths for smelting. some kind of pipe with holes in it. it was given special doors and windows. and then a few metres of gas pipe were laid. hiding a 3cm perforated pipe that encircled the chamber. a pressure gauge. The brains were processed by the Kaiser-Wilhelm-Institute of Neurological Research in Berlin and the KaiserWilhelm-Institute of Psychiatry in Munich (today the Max-Planck-Institutes). however. Troublesome or resistant patients were sedated or manhandled into the chamber by brute force. Viktor Brack had described the simple design of the gas chambers : "No special gas chambers were built. all were dead. Autopsies were conducted on some in the interests of "science" by doctors attempting to find causes for the child's disability. were collected at autopsies. the chamber was ventilated and the bodies were transferred either to the autopsy room or to the crematorium for incineration. the victims were unconscious. necessary instruments. Autopsy activities of this kind provided experience for novice surgeons. a room attached to the reception ward. Initially.The gas chambers were approximately 3m x 5m x 3m high. etc.. Benches lined the walls. After a wait of approximately 1 hour. especially fresh brains.

academic credit for their efforts. a Euthanasia Program physician who was responsible for sending many patients to be gassed. Each killing centre had a so-called special registry office. sometimes known as the book of . the logistical problems of burning the bodies far outweighed the relatively simple killing method. Nazi functionaries and German bureaucrats were stereotypically precise and efficient when it came to keeping records about mass murder. Between two and eight bodies were cremated at a time. correspondence with outsiders. After cremation. Originals or copies of all paperwork generated by the killing program were retained. including record books and lists for internal T4 use. As in the death camps which were to follow. A list of causes that could explain a sudden natural death was available. the ashes of the deceased were available upon request. Relatives were informed that it had been necessary to cremate the body for public health reasons. each killing centre kept a death book (Sterbebuch). from where a standard falsified death certificate and letter of condolence were sent to victim’s next-of-kin. and the medical records of the killed patients. residual bone was crushed in mills or by mallets on specially constructed worktables. To organize the paperwork. Friedrich Mennecke.

one in every 1. at which a formula was presented by which the number of future potential Reich “euthanasia” victims could be calculated. Of those requiring treatment. Given that we need to make provision now for keeping healthy people alive. The main speaker at this gathering was Viktor Brack. and in many cases they need twice or three times as much nursing care. ten would require psychiatric treatment. incurring endless costs for their maintenance. civilian hospitals and auxiliary hospitals. This figure proved to be an under-estimate. They sit and vegetate like animals. the statistician Edmund Brandt (one of many bureaucrats to find employment with the post-war . According to the notes of one of those present at the meeting. The basis of the calculation was the ratio 1. they are social misfits undeserving of life – and yet physically they are perfectly healthy human beings who may well live on for many more years. people who are of no use at all to the rest of humanity.” Applying this ratio to the population of the Reich as a whole resulted in an aggregate figure of 65. local authority representatives convened on 3 April 1940.patients (Krankenbuch).000 -70. it is all the more necessary to get rid of these creatures first. five would receive this as in-patients.” On 9 October 1939. In the midst of this carnage. In 1942. That is to say. a meeting of the organisers of the programme had been held. who are only a burden on society.000 of the population would be subject to ““euthanasia”. meaning that for every 1. even if only to take better care for now of the curable patients in our hospitals and nursing homes. Brack was explicit about the social and economic benefits of “euthanasia”: “In many hospitals and nursing homes of the Reich there are countless people with incurable diseases of every kind. and there is absolutely no prospect of these people ever recovering and becoming useful members of society again. The space thus freed up is needed for all kinds of things essential to the war effort: military hospitals. The rest of society needs to be protected against these people. and one of those in-patients would fall within the scope of the programme.000 of the population.000 potential victims. They eat the food that could be given to others.000:10:5:1.

incapable of labour – “useless mouths” in Nazi terminology – would yield precisely 885.) “Disinfection” was a code word for murder. In fact. chief nurse at Hadamar At least 20.800 Reichsmarks in savings by 1951.West German government) prepared an analysis entitled “What has so far been accomplished by the various institutions in terms of disinfection?” The “institutions” were the six principle killing centres (it has been estimated that there were more than 100 such establishments overall.000 further victims had been killed by that time by means of lethal injection. So far as children were concerned. despite a pause.439. the total number of .” Irmgard Huber. It has been calculated that as many as 33% of the beds occupied by the mentally sick in the pre-war period had been made available through “euthanasia. Some sources suggest that the taken together. it never stopped at all. clothing and accommodation on the assumption that those murdered had been allowed to survive for a further ten years.273 patients had been murdered by gassing. between January 1940 and August 1941. he estimated that the killing of these sick persons. Based on the average daily needs for an institutional inmate. By Brandt’s calculations. precisely 70. when the killings were officially suspended. Brandt went on to calculate the savings made in food. the killing in various guises continued until the end of the war.

a figure as high as 200. Ludwig "Israel" Alexander was the first person and the only Jew listed on the Eglfing-Haar transport list of twenty-five men destined for Grafeneck on 18 January 1940. But in April 1940 local health authorities were required to provide details of all Jewish patients within their jurisdictions. The name "Israel. but also their hospital fees. which continued to be received for some months after the actual date of death. Beginning in January 1940. Aktion Cholm. Selected members of the staff of T4 began killing Jews on a gigantic scale at the Nazi death camps in Poland solely because . or were considered undesirable. as it was known. indicates that Alexander was considered Jewish under the Nürnberg racial laws. By this stage. in the Lublin District of Poland." which all male Jews were forced to take on after 1 January 1939. They were killed simply because they were both Jewish and a patient. for whatever reason. since it was not only possible to collect the gold teeth and jewellery of the deceased. proved particularly lucrative for T4. From 1941 Jewish patients were sent to the Generalgouvernement. Indeed. In reply to enquiries from the families of the murdered. one of those qualifications also disappeared. concluded with the killing of those who. In short.victims of the ““euthanasia”” programme may have reached 160. and there either shot or killed in gas vans. these Jewish patients were transferred to the killing centres and gassed. were either unable to contribute to the economic well being of the Reich. Gekrat stated that the victims gassed in Brandenburg or liquidated in Poland had been sent to an asylum in Chelm (sometimes referred to as “Cholm”). politically or racially. Alexander was thus probably the first handicapped Jewish patient murdered in the gas chamber of a ““euthanasia”” killing centre. and even mailed death notices from Chelm containing fictitious dates of death in order to add to the deception.000 has been quoted by some historians. Initially no distinction was made between Jewish and non-Jewish adult patients. what had been conceived by the eugenicists as the extermination of the medically 'incurable'.000. the medical condition of Jewish patients had become irrelevant. Very shortly.

Prisoners were ostensibly assessed by similar criteria to those applied to the handicapped. Sonnenstein. those who had artificial limbs. By the war’s end the victims of Aktion 14f13 probably numbered about 20.” This was the code name given to the extension of T4 operations to the concentration camps. A starved survivor sits up in bed at Hadamar The fourth manifestation of ““euthanasia”” was the so-called “Aktion 14f13.they were Jews. were routinely selected for extermination. Doctors visited the camps. Those prisoners selected were transported to either Hartheim.000. but did not conduct medical examinations. Again. By the summer of 1941. simply being Jewish was enough to incur a death sentence. or Bernburg for gassing. knowledge of the . In practice. wore spectacles or had “unsatisfactory” personal histories.

Düsseldorf. But children’s ““euthanasia””. Aware of growing public disquiet." Paul Nitsche. according to T4 psychiatrist Friedrich Panse. once commented: "Isn’t it wonderful to get rid of all the ballast collecting in the asylums? Now we can perform some real therapy. The University Clinic of Psychiatry.. Indeed. but thousands of patients were murdered by means of lethal drugs or starvation at mental hospitals like Eichberg. and in the wake of explicit sermons preached by a number of churchmen. Aktion 14f13. one expert has expressed the opinion that more victims of ““euthanasia”” perished after the official order to cease than had been killed before it was issued. "A life in the service of the suffering people. in part because the killings were taking place on German soil. on 24 August 1941. put all perpetrators in a state of being "drunk with elation". in particular Bishop Clemens August Graf von Galen of Mü completed. Thereafter.““euthanasia”” programme had become widespread. Future killing centres would be established far away. Their paean culminated with the sentence. Hitler ordered the suspension of adult ““euthanasia””. and the so-called “wild” ““euthanasia”” of adults in hospitals continued. Meserlitz-Oberwald. gas chambers at the killing centres functioned on a greatly reduced scale. Kaufbeuren and many others. where possible in isolated areas. psychiatric head of mass murder. The Nazis were quick to learn the lesson. published an obituary of Panse. The suspension should more accurately be called a pause for reorganization. The extermination of the incurably ill. who "expertly guided" patients into the gas chambers.." . In 1973.

it is as old as mankind. but it is not a crime against man . Valentin Faltlhauser insisted that.. “I had the feeling that my activity was something positive. and that I had made a small contribution to human progress.I fully realize the problem.The last child killed by the head nurse at the Kaufbeuren-Irsee euthanasia facility The extent to which the medical profession had rationalised their homicidal behaviour is perhaps best illustrated by the testimony of defendants at their post-war Nürnberg trial.” Karl Brandt affirmed the following: “Do you think it was a pleasure for me to receive the order to permit “euthanasia”? For fifteen years I had toiled at the sickbed and every patient was to me like a brother.. “the decisive motive was compassion. I worried about every sick child as if it had been my own.” Paediatrician Ernst Wentzler stated. for him.

Death can mean deliverance. nor for personal enrichment.” The courts were not fooled by this apparent display of contrition.nor humanity. It was never meant to be murder. The perverse thoughts and distorted concepts which brought about these savageries are not dead. chief of counsel for the prosecution at Nürnberg.. They are not ignorant men. Death is life .. Telford Taylor. Not the least significant aspect of the “euthanasia” programme was the indication it provided. That is why I am a doctor!. They must not become a spreading cancer in the breast of humanity. as well as to government and Party leaders. Most of them are trained physicians and some of them are distinguished scientists. and so it is in my conscience. T4 supplied the kernel of professional killers who were to undertake Aktion Reinhard in Poland..just as much as birth. They must be cut out and exposed.[They] did not kill in hot blood.. Some had been recruited because they were considered ideologically reliable.. I am a doctor. Polish killing centres succeeded their German and Austrian counterparts.” “Euthanasia” was vital to the development of Nazi genocidal policy. or were recommended by a relative or friend. Here I cannot believe like a clergyman or think as a jurist. of just how much could be achieved behind the mask of `official secrecy’. tortures and other atrocities committed in the name of medical science. Others began their careers in the concentration camps or the . In my heart there is a love of mankind. literally. both to Hitler. It paved the way both in method and personnel.are charged with murder. described the prominent physicians who were tried and convicted of murder in the following terms: “The defendants. And most importantly. and I see the law of nature as being the law of reason. It is pity for the incurable. They cannot be killed by force of arms. These men were long term exponents of the physical process of murder and the disposal of corpses.. Victims were delivered from every part of occupied Europe instead of merely from the Reich.. Bottled carbon monoxide was replaced by petroleum engine exhaust fumes and hydrocyanic acid..they are not all perverts.

the KdF was able to draw upon the experience and technical support of T4 personnel to carry their plans through to completion But as a number of eminent historians have pointed out. an estimated 250. the symbiosis between ““euthanasia”” and the `Final Solution’ went beyond these obvious connections. The dual functions were inseparable.police. It is not commonly known that the gas chamber technology used by the Nazi's in . http://www. Wiesbaden. rapidly descending into a criminal nightmare of sadistic brutality and death. two essential aspects of what Hitler liked to call his Weltanschauung.000-350. The former action was intended to remove from the German race its “imperfections”. When the time arrived and the final decision had been made to implement the Jewish genocide. Killing the handicapped and the Jews were two sides of the same coin. Germany. Sobibor and Treblinka. During the Nazi's T-4 programme. 1945 All quickly became desensitized killers. Staff from the Hadamar euthanasia center during their trial.” Where that “world view” was to lead will be examined in the following pages.000 Germans were put to death. October The German experiment with euthanasia provides salutary lessons for the debate in the early 21st century.holocaustresearchproject. his “world view. Almost 100 of them were made available to Odilo Globocnik in Lublin to operate the gas chambers of Belzec. the latter was designed to destroy Nazism’s greatest perceived enemy.

and second that in effect. in many cases. "Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive. This means proving to the agency that one's life was worthwhile). constructed on hospital grounds. This attitude in its early stages concerned itself merely with the severely and chronically sick. "It started with the acceptance of the attitude. Years before in 1920. 1949. a doctor." "The small beginnings" By the end of the nineteenth century in Germany. . the ideological ground had been thoroughly prepared. and finally all non-Germans.the war years was developed when the large number of adult and child euthanasia cases required more efficient means than narcotics and starvation. The beginnings at first were merely a subtle shift in emphasis in the basic attitudes of physicians. Before Adolf Hitler came to power and issued the executive order for the T-4 programme to be implemented. July. The extraordinarily high death rate from mass starvation in German mental hospitals during World War I. basic to the euthanasia movement. scattered voices could be heard calling for euthanasia in the name of personal choice and mercy. Gas chambers were. an American psychiatrist. the ideologically unwanted. using arguments identical to those heard today. In his "Medical Science under Dictatorship". the racially unwanted. that there is such a thing as a life not worthy to be lived. The killing ended with the surrender in May. was a consultant to the Secretary of War and serving with the office of the Chief Counsel for War Crimes in Nuremberg during 1946 and 1947. it became evident to all who investigated them. 1945 and the leading doctors were put on trial at the Nuremberg War Crimes Trials. published in the New England Journal of Medicine. two eminent German academics: Karl Binding. Dr Alexander observed: "Whatever proportions these crimes finally assumed. was an early warning signs of the deadly shift official attitudes could take toward the mentally ill when resources were strained. a law professor and Alfred Hoche. published their seminal work: "Permission to Destroy Life Unworthy of Life". an individual had to justify his existence according to criteria imposed from outside. Leo Alexander. that they started from small beginnings. They argued that first it was acceptable for an outside agency to define what individual life was worthless.

Eugenics envisaged a hierarchy of human beings. Their "quality of life" should be the determining factor in medical treatment. the intelligentsia and soon wider German society. many Germans were ready to be persuaded on the merits of "merciful" euthanasia. People were valuable in terms of their contribution to society. Propaganda used to persuade Propaganda minister Joseph Goebbels. until May. the lower levels being the mentally handicapped and the disabled. "Heredity Health Courts" were established to sterilize those in the targeted categories. Social Darwinists applied Charles Darwin's theories of natural selection to human society. The sanctity and value of each individual human person was sacrosanct. the disabled (including children) and the mentally ill. Such sentiments were readily accepted by influential doctors. These factors were the ethos of social Darwinism and eugenics. 45 percent of German doctors had joined the Nazi party. An estimated 350. Binding and Hoche set out to undermine the Hippocratic Oath tradition. determined to create a new Aryan Master Race. Ten years after the publication of Mein Kampf. marshalled the resources of the state-controlled media to persuade Germans that euthanasia was a humane social policy. They argued that the criteria for medical practice should be utilitarian. the foundation . However the proposals were vigorously opposed by the churches and the Nazis retreated to wait for a more opportune time. Thus when the Nazis came to power in 1933. In contrast. There were two benefits for German society if these categories could be eliminated: racial purity and re-directing medical resources and funds to those "worthy" of support. the Hippocratic Oath assumed that an individual did not have to prove their worth.Two cultural factors unique to Germany at the time. The legalisation of voluntary euthanasia was a Nazi priority and the public were supposed to be reassured by a raft of safeguards.000 Germans were sterilised under this programme. Binding and Hoche placed people in categories and deemed that certain individuals were "unworthy" of life: those with terminal illnesses. 1945. Within six months. ensured that the book had immediate influence in the medical establishment and the social sciences. Social progress depended on the fittest and most powerful surviving and the weakest elements being culled to prevent infecting their betters.

German Religious Groups Oppose Move -Associated Press BERLIN. Oct. The next step was infanticide. From infants." After killing the child (with the usual 'cause of death' listed as pneumonia). an oath to the health of the Nazi state. jam.supposedly for treatment.for building the Master Race. Some of the victims were non-mentally ill children whose behavior was deemed abnormal or anti-social. New York Times reports Nazi plans for euthanasia Headline: Nazis Plan to Kill Incurables to End Pain. minus the brain. the body was delivered to the family." The Hippocratic Oath replaced Before 1933. German school children studied maths problems and calculated how many services. The Oath required that a doctor's first duty is to his patient. In the popular film "I Accuse".who were a "drain on society. Infanticide: the first legal killings Once German doctors accepted social eugenics. the categories were extended to those between three and seventeen years old. A brief report on the child was then sent to Berlin where three doctors judged the child. and other necessities of life could be saved by killing people . Thus a German doctor's first duty was now to promote the interests of the Reich.7. The Nazis replaced the Hippocratic Oath with the Gesundheit. Thousands were killed at psychiatric institutions and paediatric clinics by being spoonfed lethal medicines and drugs. with its famous "do no harm" clause. following a secret directive issued in 1939. an attractive woman suffering from multiple sclerosis was gently killed by her loving husband. who reported every birth of a child with disabilities to the authorities. The child was sent to an institution . Graphic pictures portrayed mentally ill and disabled "subhumans" in a series of powerful and popular films. today announced its intention to authorize physicians to end the sufferings of incurable patients.the chronically sick and crippled . . how much bread. in almost every case to be "unworthy of life. which required the willing cooperation of doctors and midwives. the forcible sterilisation of the "unfit" became widespread. Hitler appointed Dr Karl Brandt (later hanged following the Nuremberg War Crimes Trials) to head the bureaucracy and implement the infanticide programme. every German doctor took the Hippocratic Oath. to reinforce the message. 1933: The Ministry of Justice in a detailed memorandum explaining the Nazi aims regarding the German penal code.

hastened to observe: "The Catholic faith binds the conscience of its followers not to accept this method of shortening the suffering of incurables who are tormented by pain. so request.The memorandum. it was expected in some interested circles. his nearer relatives. October 8. still lacking the force of law. The legal question of who may request the application of euthanasia has not been definitely solved. might ignore the provisions for euthanasia. It was for that reason the that the first exterminations of the later . In insisting that euthanasia shall be permissible only if the accredited attending physician is backed by two experts who so advise. which overnight has become a widely-discussed word in the Reich. proposed that "it shall be made possible for physicians to end the tortures of incurable patients upon request. were openly advocated in an article published in an official German medical journal. The Catholic newspaper Germania. By 1936. the Ministry believes a guarantee is given that no life still valuable to the State. incurability would be determined not only by the attending physician. than those for political reasons. more ready to accept the extermination of the sick. ideas for exterminating the physically or socially unfit. In medical circles the main question was raised as to just when a man is incurable and when his life should be ended." In Lutheran circles." (Source . will be wantonly destroyed. acting from motives that do not contravene morals. According to the present plans of the Ministry of Justice. 1933) The T-4 Euthanasia programme implemented According to Leo Alexander MD. Alexander commented: "It is rather significant that the German people were considered by their Nazi leaders." This proposed legal recognition of euthanasia ? the act of providing a painless and peaceful death ? raised a number of fundamental problems of a religious. too. in the interests of true humanity. life is regarded as something that God alone can take. or "in case the patient no longer is able to express his desire. but also by two official doctors who would carefully trace the history of the case and personally examine the patient. A large section of the German people. Sunday.New York Times. the sterilisation and euthanasia of persons with chronic mental illness was discussed at a meeting of Bavarian psychiatrists in 1931. The Ministry merely has proposed that either the patient himself shall "expressly and earnestly" ask it. scientific and legal nature.

As the war progressed. The outraged soldiers were only just prevented from shooting them on the spot. a teacher at Southland Boys School. using mainly lethal injections in the so-called hospitals. were carried out under the guise of sickness. Read more . On August 24th." "The worst thing about this business was that it produced a certain brutalisation of the nursing personnel. They delegated the selection to the nurses and the attendants. 1941. Caughey met one of the leading Nazi doctors in 1934. Despite the official ban. A neuropathologist. The killings took place at converted hospitals when the victims entered the "showers". repeatedly and openly condemned the T-4 programme from his pulpit. A New Zealand doctor." German citizens grew increasingly uneasy about the secret T-4 programme. There was a case of American infantry discovering a euthanasia hospital in Bavaria. were either too busy or did not care. and simply put their names on the list. Dr Hallenvorden.E. German doctors carried on much as before. People could hardly avoid drawing their own conclusions when columns of smoke would later issue from the hospital chimney. the categories of those to be killed were scrupulously defined.(political) group. The vans known as "ravens" inspired dread. with the proviso that infanticide be continued. by Nyall Paris. it was halted only by the Allied Occupation. It was included in a later article "Euthanasia and the Growth of a Death Culture". J. but as time went on human nature prevailed. Hitler and Heinrich Himmler were enraged when the popular Archbishop von Galen. gave Dr Alexander a first-hand account of how the selection process evolved: "Most institutions did not have enough physicians and what physicians there were. and the doctors had so many patients that they did not know them. Invercargill. seriously wounded Wermacht soldiers were routinely euthanised. The programme was designated a state secret. July 10. Public concern was monitored by the Gestapo. Hitler gave verbal instructions to Dr Karl Brandt to stop the euthanasia programme. 1985. He wrote an article "How Mercy Killing Expanded". still fully functioning with the medical staff at their posts. published in The Southland Times. or was otherwise a problem was put on a list and transported to the killing centre (to be gassed with Zyclon B in the 'showers'). In the beginning." Hitler issued the secret directive to begin T-4 in late October 1939. Rumours quickly spread about the black vans transporting the victims to the six specially designated "hospitals". They got to simply picking out those whom they did not like. Termed "wild euthanasia". with the families of the deceased receiving falsified death certificates. Whoever looked sick.

it became the administrative hub for the "Final Solution": the extermination of the Jews. "Into that Darkness: from mercy killing to mass murder" by journalist Gitta Sereny. It was the nerve centre for the most secret operation in Nazi Germany. was built around seventy interviews with Franz Stangl. absolute secrecy was necessary. Franz Stangl His story is that of a decent man. the "mercy killing" of the mentally and physically handicapped in Germany and Austria. The only patients affected were those who after the most careful examination ? a series of four tests carried out by at least two physicians ? were considered incurable. but to protect the sensibilities of the population. which administered Hitler's private affairs and enabled T4 to function in secrecy. The Reality Careful medical examinations in mental institutions by travelling doctors were rare. T4 staff simply sent out a questionnaire to all institutions (under the pretext of economic planning). But meantime. In 1970. he was assigned to Berlin in November 1940. The planning and orders came from the Fuhrer Chancellery. Germany was going to pass a similar law in the near "Into that Darkness: from mercy killing to mass murder" A unique insight into the Nazi euthanasia programme was published in Britain in 1974. overseeing security and ensuring that the safeguards for the patients were strictly adhered to. An Austrian detective happily married to a devout Catholic and strongly anti-Nazi wife. asking for details of those retarded and suffering various categories of disability. Arriving at T4. former commandant of the Treblinka extermination camp in eastern Poland. many of the key figures in the programme were still alive and consented to be interviewed by Sereny. who gradually becomes morally corrupted. Stangl had earlier worked at one of the "institutes" in Hitler's Euthanasia programme. The Safeguards explained Stangl was told that for many years Russia and America had legalised euthanasia on the severely insane and deformed. leaving for posterity first-hand accounts of what really happened. The responses were then graded by T4 staff who marked each case with a plus or minus sign: life or death. Enjoying steady promotion in Linz. T4's administration The headquarters of T4 was a villa at Tiergartenstrasse 4 in an exclusive Berlin suburb. . A painless death would be a merciful release from an intolerable existence. the mercy killing was going to be carried out slowly and after much psychological preparation. Later. he was informed that his new role was to be police superintendent in a special institute.

" Usually. advised the Minister of Justice that the "institute" at Hadamar was public knowledge.Parental authorisation fraud It has been claimed that parents gave such authority. there were public protests by some Protestant and Catholic pastors and bishops. Corpses enter the furnace on a conveyor belt and the smoke from the crematorium is visible for miles. a lawyer. later testified at Nuremberg that in 1935. Parents signed the authorisations in good faith. They had killed all those who they intended to kill. An outraged crowd had gathered and on sighting Hitler. Hitler's intentions Dr Karl Brandt. They have to feel at ease. Patients arrived in vans and were immediately given a cursory examination. jeered him. Parents were informed that eleven Special Sections were being established throughout Germany. The process was explained to Stangl: "The people must not be allowed to realise that they are going to die. along with the urn of ashes to be sent to the families. Bishop von Galen preached his famous sermon in Munster on August 3rd 1941. Stangl arranged the paperwork and for their personal effects. because it would be easier to do in wartime when the Church would not be able to put up . Reichskommissar for Health and Hitler's personal doctor (condemned to death in August. shouting "Here's more coming to be gassed!". He confided that his superiors had specifically stated that the programme was expected to be completed by late July 1941. The medical staff drink to oblivion in the nearby Gasthof and the regular customers take care to avoid them. Gitta Sereny interviewed Dieter Allers. 1947). Public knowledge An official letter from Frankfurt in May 1941. by mental patients being loaded onto trucks. On August 24th. was appointed chief administrative officer of T4. who in December1940. Hitler verbally advised Dr Karl Brandt to stop the euthanasia programme. Nothing must be done to frighten them. Children followed the blacked-out buses and vans. unaware that their children would be killed by lethal injection. where the children could receive advanced treatment to assist their recovery. but they were victims of a ruse. he would resolve this question. Hitler told the then Minister of Health. within an hour. This infers that the protests had negligible effect. as the programme had effectively met its targets. Gerhard Wagner. A bogus cause of death was put on the death certificate. Stangl at Schloss Hartheim The former small hospital was now a special institute. Bishop von Galen's sermon was printed on flyers which were dropped over Germany by RAF planes. Throughout 1940 and early 1941. 1941. the patients were gassed. that if war came. Hitler's train was held up near Nuremberg.

and. The centres that remained open for "14 f 13". and especially lay judges. killings continued covertly until the military defeat of Nazi Germany in 1945. also called T4 Euthanasia Program. politicals. compared with just 24 percent of those accused of crimes against Jews. "habitual" criminals and Jews. Of those found guilty. The mentally handicapped were seen as a burden on society and so judges. Nuremburg 57 percent of Nazis who faced trials for crimes against people with mental disabilities were acquitted. the day World War II began. [MEDIA-STRIP][END-1ST-PARA] In October 1939. He backdated his order to September 1. compared with 11 percent for killing Jews. But euthanasia continued from November 1941 to T4 Program. http://www. 1939. to give it the appearance of a . who were all classified as incurably insane and gassed.the expected resistance. None of those who were given life sentences for murdering people with mental disabilities were actually made to serve their time. which was the title of the forms used to establish "eligibility". less than two percent received life sentences. Adolf Hitler initiated this program in 1939. were Bernburg and Hartheim. Nazi German effort—framed as a euthanasia program—to kill incurably ill. physically or mentally disabled. under the code name "14 f 13". emotionally distraught. did not consider their murders to be as great a crime. The Euthanasia continues The T4 programme officially closed The victims were concentration camp Adolf Hitler empowered his personal physician and the chief of the Chancellery of the Führer to kill people considered unsuited to live. and elderly people. while it was officially discontinued in 1941.

” he noted. While the program’s personnel killed people at first by starvation and lethal injection. the German people.” Some physicians active in the study of eugenics. medical experts reviewed forms sent by institutions throughout Germany but did not examine patients or read their medical records. The relatives then received condolence letters. were not possible.wartime measure. openly challenged the regime. authorities instructed mental institutions throughout the Reich to “neglect” their patients by withholding food and medical treatment. “Wartime is the best time for the elimination of the incurably ill. The Roman Catholic church. who saw Nazism as “applied biology. they later chose asphyxiation by poison gas as the preferred killing technique.” The program’s directors ordered a survey of all psychiatric institutions. Program administrators established gas chambers at six killing centres in Germany and Austria: Hartheim. the Bavarian minister of health proposed that psychopaths. Karl Brandt and Chancellery chief Philipp Bouhler were “charged with responsibility for expanding the authority of physicians…so that patients considered incurable. the bishop of Münster. Sonnenstein.” protested the “mercy killings.” Count Clemens August von Galen. Some refused to fill out the requisite forms. the mentally retarded. “This policy has already been initiated at our concentration camps. Visits. can be granted a mercy killing. An important criterion was economic. Program staff informed victims’ families of the transfer to the killing centres. The Nazis referred to the program’s victims as “burdensome lives” and “useless eaters. At Tiergartenstrasse 4. Nazi officials assigned people to this program largely based on their economic productivity. they had the power to decide life or death. The murder of the handicapped was a precursor to the Holocaust. Pseudoscientific rationalizations for the killing of the “unworthy” were bolstered by economic considerations. headed by physicians. falsified death certificates signed by physicians. A new bureaucracy. Dr. Hadamar. the T4 Program—named for the Chancellery offices that directed it from the Berlin address Tiergartenstrasse 4—involved virtually the entire German psychiatric community. arguing that it was the duty of Christians to oppose the taking of human life even if this cost them their own lives. and homes for chronically ill patients. Soon after the Nazis came to power.” enthusiastically endorsed this program. Grafeneck. According to bureaucratic calculations. and urns containing ashes. Proponents for the program saw incurably sick children as a burden on the healthy body of the Volk. according to the best available human judgment of their state of health. The killing centres to . and Brandenburg. Bernburg. and other “inferior” people be isolated and killed. In this directive. nor were they necessarily based on infirmity. which had not taken a stand on the “Jewish question. A few doctors protested.” Within a few months. was established with a mandate to kill anyone deemed to have a “life unworthy of living. however. the criteria for inclusion in this program were not exclusively genetic. Nevertheless. The SS (Nazi paramilitary corps) staff in charge of the transports donned white coats to keep up the charade of a medical procedure. The transformation of physicians into killers took time and required the appearance of scientific justification. Physicians oversaw gassings in chambers disguised as showers. A year later. the state could put funds that went to the care of criminals and the insane to better use—for example. hospitals. However.” Hitler said. using lethal gas provided by chemists. in loans to newly married couples.

but only if they cooperated in sending others to their death. Some of the physicians who became specialists in the technology of cold-blooded murder in the late 1930s later staffed the death camps.000 or more. professional. the handicapped killing centres installed ovens to dispose of dead bodies. On August 24. The official conclusion of the T4 Program in 1941 also coincided with the escalation of the Holocaust.000 victims during its two years of open operation. In . and their organized transportation foreshadowed mass deportation. almost two years after the T4 Program was initiated. may have reached 200. While the program claimed over 70. The death camps that followed took the technology to a new level. it appeared to cease. They had long since lost all their moral.britannica. The total number killed under the T4 Program. at least temporarily. including this covert phase. and ethical inhibitions. As the extermination camps did later.” http://www. Like the Judenrat (“Jewish Council”) leaders during the Holocaust. it had gone underground and continued covertly during the war years. the killing centres murdered even more victims between the official conclusion of the program and the fall of the Nazi regime in 1945. The handicapped killing centres developed gas chambers like those later used at extermination camps. psychiatrists were able to save some patients during the T4 Program. the culmination of Nazi programs to eliminate those deemed an embarrassment to the “master race. 1941. The extermination camps could kill thousands at one time and burn their bodies within hours.which the handicapped were transported were the antecedents of the extermination camps.