Euthanasia Program

https://www.ushmm.org/wlc/en/article.php?ModuleId=10005200
The term "euthanasia" means literally "good death". It usually refers to the inducement of a
painless death for a chronically or terminally ill individual who would otherwise suffer. In the
Nazi context, however, "euthanasia" was a euphemistic term for a clandestine murder program.
The program targetedfor systematic killingmentally and physically disabled patients living
in institutional settings in Germany and German-annexed territories.
The "euthanasia" program was Nazi Germany's first program of mass murder. It predated the
genocide of European Jewry (the Holocaust) by approximately two years. The program was one
of many radical eugenic measures which aimed to restore the racial "integrity" of the German
nation. It endeavored to eliminate what eugenicists and their supporters considered "life
unworthy of life": those individuals whothey believedbecause of severe psychiatric,
neurological, or physical disabilities represented both a genetic and a financial burden on
German society and the state.
CHILD "EUTHANASIA" PROGRAM
In the spring and summer months of 1939, a number of planners began to organize a secret
killing operation targeting disabled children. They were led by Philipp Bouhler, the director of
Hitler's private chancellery, and Karl Brandt, Hitler's attending physician.
On August 18, 1939, the Reich Ministry of the Interior circulated a decree requiring all
physicians, nurses, and midwives to report newborn infants and children under the age of three
who showed signs of severe mental or physical disability.
Beginning in October 1939, public health authorities began to encourage parents of
children with disabilities to admit their young children to one of a number of specially
designated pediatric clinics throughout Germany and Austria. The clinics were in reality
children's killing wards. There, specially recruited medical staff murdered their young charges
by lethal overdoses of ,lmedication or by starvation.
At first, medical professionals and clinic administrators incorporated only infants and toddlers in
the operation. As the scope of the measure widened, they included youths up to 17 years of age.
Conservative estimates suggest that at least 5,000 physically and mentally disabled German
children perished as a result of the child "euthanasia" program during the war years.
EXTENDING THE "EUTHANASIA" PROGRAM
Euthanasia planners quickly envisioned extending the killing program to adult disabled patients
living in institutional settings. In the autumn of 1939, Adolf Hitler signed a secret authorization
in order to protect participating physicians, medical staff, and administrators from prosecution.

This authorization was backdated to September 1, 1939, to suggest that the effort was related to
wartime measures.
The Fhrer Chancellery was compact and separate from state, government, or Nazi Party
apparatuses. For these reasons, Hitler chose it to serve as the engine for the "euthanasia"
campaign. The program's functionaries called their secret enterprise "T4." This code-name came
from the street address of the program's coordinating office in Berlin: Tiergartenstrasse 4.
According to Hitler's directive, Fhrer Chancellery director Phillip Bouhler and physician Karl
Brandt undertook leadership of the killing operation. Under their auspices, T4 operatives
established six gassing installations for adults as part of the "euthanasia" action. These were:
Brandenburg, on the Havel River near Berlin; Grafeneck in southwestern Germany; Bernburg
and Sonnenstein, both in Saxony; Hartheim, near Linz on the Danube in Austria, and Hadamar in
Hessen.
Using a practice developed for the child "euthanasia" program, in the autumn of 1939 T4
planners began to distribute carefully formulated questionnaires to all public health officials,
public and private hospitals, mental institutions, and nursing homes for the chronically ill and
aged. The limited space and wording on the forms, as well as the instructions in the
accompanying cover letter, combined to give the impression that the survey was intended to
gather statistical data.
The form's sinister purpose was suggested only by the emphasis placed upon the patient's
capacity to work and by the categories of patients which the inquiry required health authorities to
identify. The categories of patients were:
-those suffering from schizophrenia, epilepsy, dementia, encephalitis, and other chronic
psychiatric or neurological disorders;
-those not of German or "related" blood;
-the criminally insane or those committed on criminal grounds; and
-those who had been confined to the institution in question for more than five years.
Secretly recruited "medical experts," physiciansmany of them of significant reputation
worked in teams of three to evaluate the forms. On the basis of their decisions beginning in
January 1940, T4 functionaries began to remove patients selected for the "euthanasia" program
from their home institutions. The patients were transported by bus or by rail to one of the central
gassing installations for killing.
Within hours of their arrival at such centers, the victims perished in gas chambers. The gas
chambers, disguised as shower facilities, used pure carbon monoxide gas. T4 functionaries
burned the bodies in crematoria attached to the gassing facilities. Other workers took the ashes of
cremated victims from a common pile and placed them in urns to send to the relatives of the
victims. The families or guardians of the victims received such an urn, along with a death
certificate and other documentation, listing a fictive cause and date of death.

Because the program was secret, T-4 planners and functionaries took elaborate measures to
conceal its deadly designs. Even though physicians and institutional administrators falsified
official records in every case to indicate that the victims died of natural causes, the "euthanasia"
program quickly become an open secret.
In view of widespread public knowledge of the measure and in the wake of private and public
protests concerning the killings, especially from members of the German clergy, Hitler ordered a
halt to the euthanasia program in late August 1941.
According to T4's own internal calculations, the "euthanasia" effort claimed the lives of 70,273
institutionalized mentally and physically disabled persons at the six gassing facilities between
January 1940 and August 1941.
SECOND PHASE
Hitler's call for a halt to the T4 action did not mean an end to the "euthanasia" killing operation.
The child "euthanasia" program continued as before. Moreover, in August 1942, German medical
professionals and healthcare workers resumed the killings, although in a more carefully
concealed manner than before. More decentralized than the initial gassing phase, the renewed
effort relied closely upon regional exigencies, with local authorities determining the pace of the
killing.
Using drug overdose and lethal injectionalready successfully used in child euthanasiain this
second phase as a more covert means of killing, the "euthanasia" campaign resumed at a broad
range of institutions throughout the Reich.
Many of these institutions also systematically starved adult and child victims.
The "euthanasia" program continued until the last days of World War II, expanding to include an
ever wider range of victims, including geriatric patients, bombing victims, and foreign forced
laborers. Historians estimate that the "Euthanasia" Program, in all its phases, claimed the lives of
200,000 individuals.
GERMAN-OCCUPIED EAST
Persons with disabilities also fell victim to German violence in the German-occupied east. The
Germans confined the "euthanasia" program, which began as a racial hygiene measure, to the
Reich properthat is, to Germany and to the annexed territories of Austria, Alsace-Lorraine, the
Protectorate of Bohemia and Moravia, and the Warthegau in former Poland. However, the Nazi
ideological conviction which labeled these persons "life unworthy of life" also made
institutionalized patients the targets of shooting actions in Poland and the Soviet Union. There,
the killings of disabled patients were the work of SS and police forces, not of the physicians,
caretakers, and T4 administrators who implemented the "Euthanasia" Program itself.

In areas of Pomerania, West Prussia, and occupied Poland, SS and police units murdered some
30,000 patients by the autumn of 1941 in order to accommodate ethnic German settlers
(Volksdeutsche) transferred there from the Baltic countries and other areas.
SS and police units also murdered disabled patients in mass shootings and gas vans in occupied
Soviet territories. Thousands more died, murdered in their beds and wards by SS and auxiliary
police units in Poland and the Soviet Union. These murders lacked the ideological component
attributed to the centralized "euthanasia" program. The SS was apparently motivated primarily
by economic and material concerns in killing institutionalized patients in occupied Poland and
the Soviet Union.
The SS and the Wehrmacht quickly made use of the hospitals emptied in these killing operations
as barracks, reserve hospitals, and munitions storage depots. In rare cases, the SS used the empty
facilities as a formal T4 killing site. An example is the "euthanasia" facility Tiegenhof, near
Gnesen (today Gniezno, in west-central Poland).
SIGNIFICANCE OF THE "EUTHANASIA" PROGRAM
The "euthanasia" program represented in many ways a rehearsal for Nazi Germany's subsequent
genocidal policies. The Nazi leadership extended the ideological justification conceived by
medical perpetrators for the destruction of the "unfit" to other categories of perceived biological
enemies, most notably to Jews and Roma (Gypsies).
Planners of the Final Solution later borrowed the gas chamber and accompanying crematoria,
specifically designed for the T4 campaign, to murder Jews in German-occupied Europe. T4
personnel who had shown themselves reliable in this first mass murder program figured
prominently among the German staff stationed at the Operation Reinhard killing centers of
Belzec, Sobibor and Treblinka.
Like those who planned the physical annihilation of the European Jews, the planners of the
"euthanasia" program imagined a racially pure and productive society. They embraced radical
strategies to eliminate those who did not fit within their vision.
Resources
Friedlander, Henry. The Origins of Nazi Genocide: From Euthanasia to the Final Solution.
Chapel Hill: University of North Carolina Press, 1995.
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Aly, Gtz, Peter Chroust, and Christian Pross. Cleansing the Fatherland: Nazi Medicine and
Racial Hygiene. Baltimore, MD: Johns Hopkins University Press, 1994.
Bryant, Michael S. Confronting the "Good Death": Nazi Euthanasia on Trial, 1945-1953.
Boulder: University Press of Colorado, 2005.

Burleigh, Michael. Death and Deliverance: "Euthanasia" in Germany c. 1900-1945. Cambridge:

Cambridge University Press, 1994.
Gallagher, Hugh Gregory. By Trust Betrayed: Patients, Physicians, and the License to Kill in the
Third Reich. Arlington, VA: Vandamere Press, 1995.