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
Ministry.
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
decision.
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
Gypsies.
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
pneumonia.

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
Mnster 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
behavior."
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.
http://www.historyplace.com/worldwar2/holocaust/h-euthanasia.htm

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 pretexthospital 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
headquartered.
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 assessorsphysicians, 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 prisonat 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
victimsprototypes of the killing centers' facilities built in occupied Poland later in the
war.
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
relatives.
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 Mnster, 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 Bonhffer, 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 othersdoctors, 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
areas.
Between the middle of 1941 and the winter of 194445, 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 all, between 200,000 and 250,000 mentally and physically handicapped persons were
murdered from 1939 to 1945 under the T-4 and other euthanasia programs. The
magnitude of these crimes and the extent to which they prefigured the Final Solution
continue to be studied. Further, in an age of genetic engineering and renewed controversy
over mercy killings of the incurably ill, ethical and moral issues of concern to physicians,
scientists, and lay persons alike remain vital.
https://www.ushmm.org/learn/students/learning-materials-and-resources/mentally-andphysically-handicapped-victims-of-the-nazi-era/euthanasia-killings

Nazi Eugenics chart

The Shorter Oxford English Dictionary defines
euthanasia as the action of inducing a quiet and
easy death. This grant of a mercy death may
occur with the consent of the individual concerned,
is then termed voluntary euthanasia and was the
meaning originally given to the word. However,
euthanasia also came to be termed involuntary, as
for example when a patient is suffering from an
incurable and painful disease, or is in a coma and is
considered unlikely to regain consciousness. In such
circumstances, a third party or parties may determine
to put an end to the patients suffering.

The circumstances are, in general, 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 Nazi euthanasia was quite different in
conception and practice from the dictionary
definition, old or new. For it was derived, not from
humanitarian or compassionate reasoning, but from
pseudo-scientific theory and ruthless economic
policy. The Nazis destroyed life unworthy of life
(lebensunwertes Leben) as they termed it, not as an
act of mercy, but as part of a strategy to murder that
part of the population least able to defend itself.

Nazi Propaganda Drawing

That policy was directed not only at German
citizens, but at those of other eastern European
countries which fell under Nazi hegemony,
particularly Poland. The euthanasia programme
formed an essential part of the evolving Nazi policy
of extermination on a massive scale. That policy
reached its apogee with the murder of the Jews, but
had the programme arrived at its intended
conclusion, the eventual death toll would have been
immeasurably greater.

The Nazis did not create this twisted version of

euthanasia. Its roots lay in a selective reading of the
evolutionary theories of Charles Darwin, and the
distorted scientific thinking to which this gave
birth. The term "eugenics", a thesis which has no
scientific basis, was coined in 1881 by the British
naturalist and mathematician Francis Galton. It was
described as "the science of the improvement of the
human race by better breeding."
This took the concept of survival of the fittest, a
fundamental element of Nazi ideology, to its logical
conclusion. Eugenics developed within the larger
movement of Social Darwinism, which applied
Darwin's "struggle for survival" to human affairs.
The fundamental tenet of the eugenics movement
was that restricting the ability of inferior people to
procreate whilst maximizing that of superior
individuals, would benefit society. Attention was
focused on the feebleminded (an inaccurate term
covering everything from mental retardation to
alcoholism), labelled as idiots, imbeciles, or morons.
It was suggested that there existed a relationship
between low intelligence and both immorality and
crime.

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. It was
concluded "Not all criminals are feebleminded, but
all feeble-minded persons are at least potential
criminals. That every feeble-minded woman is a
potential prostitute would hardly be disputed by
anyone." Racism too, was not far from the minds of
the eugenicists. The "darker peoples of southern
Europe and the Slavs of eastern Europe are less

intelligent than the fair peoples of western and

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

Nazi encouragement of Genetically Health

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

law stated: "The psychiatrist and the healthy person

are allies against the genetically defective. The
psychiatrist must render his service to the ultimate
aim of a hereditary pure, able and superior race." It
took Samuel Beckett to point out the irony in this
Nazi obsession with the creation of a race of
supermen. An `Aryan, he wrote, must be blonde
like Hitler, thin like Gring, handsome like
Goebbels, virile like Rhm and be named
Rosenberg.
At the 1929 party rally, 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 700-800,000 of the weakest
people, then the final result might even be an
increase in strength. 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. 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.
After attaining power in 1933, the Nazis began an
extensive propaganda campaign with the object of
acquainting the German people with the benefits of
euthanasia. Via newspapers and magazines,
radio and film, the suggestion was made that life
could be so much better for the productive many if
the non-productive few, who were such a burden to
the nation, were simply eliminated. Would it not be
better for them if an end was put to their misery and

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

Karl Brandt
By the end of 1938, 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). In
particular, a petition was received in respect of an
infant named Gerhard Herbert Kretschmar, the socalled `Knauer child, who had been born on 20
February 1939, blind, with one leg and part of one
arm missing, and who was described as an idiot.
Hitler ordered Karl Brandt, his personal physician, to
visit the child in a hospital at Leipzig. Brandt
testified at his post-war Nrnberg trial he had been
instructed that if the facts provided by the childs
father proved to be correct, he was to inform the
physicians in Hitlers name that euthanasia
could be carried out which it was, on 25 July 1939.
It is arguable that the `Knauer case was the catalyst
for all that followed, although it could equally be
argued that Hitlers dedication to euthanasia was
such that its introduction was inevitable at some
point in the mercifully brief history of National
Socialism.
On his return to Berlin, Brandt was authorized by

Hitler to proceed in the same fashion with similar

cases. Hitler did not wish to be publicly associated
with what even he considered to be a delicate matter,
and so Brandt was ordered to secretly organize a
programme with the aid of Philip Bouhler, head of
the Chancellery of the Fhrer (KdF: Kanzlei des
Fhrer der NSDAP), an agency created by Hitler in
1934, ostensibly to keep him in direct touch with the
concerns of the population, but acting in practice as
Hitlers private office. Under the direction of
Bouhler, the KdF was to acquire a more sinister
purpose, 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. Answerable to
nobody except Hitler, in 1939 Bouhler seized the
opportunity to acquire authorisation to administer the
euthanasia programme through his deputy,
Viktor Brack.

Phillip Bouhler
In May 1939, 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. By a decree dated 18 August 1939,
doctors and midwives were ordered to report all

cases of deformed newborn. Even before war

came in September 1939, the Nazis had thus
established a government sanctioned process for
murder. Two laymen made a preliminary selection of
cases, which was then reviewed by three medical
professors who determined the fate of the child. If
selected for euthanasia, the child was transferred
to one of a list of special hospital wards for killing.
As early as July 1939, Werner Heyde, who was to
play a prominent role in the euthanasia
programme, attended a meeting at which he learned
of the imminent killing of the adult mentally ill. As
with the `Final Solution, euthanasia provided a
perfect confluence of the two essential elements of
National Socialist ideology the biological and the
economic.
A hospital director, Ludwig Schaich reported:
When it became increasingly apparent, in the final
years before 1939, that war was imminent, 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
mentally deficient and epileptics on drastically
reduced rations in the event of war. When we
objected that this would mean condemning our
patients to a slow but certain death by starvation,
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, given that food supplies, once imports
dried up, would no longer suffice to feed the entire
population.

Tiergartenstrasse 4
In a report prepared for Hitler in the summer of
1939, another of his personal physicians, Dr
Theodore Morell, 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.e.,
euthanasia) and then told us that our child had
died from an illness. There is a lesson for us there.
We need not suppose that we cannot carry out any
salutary measure without the consent of the
sovereign people.
It was clear that the regime could expect no great
negative reaction to the programme from the general
populace. A survey conducted in April 1941 revealed
that 80% of the relatives of those murdered by the
programme were in agreement with the decision,
10% spoke out against it, and 10% were indifferent.

It has been suggested that this policy of `official

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

Hitler. He believed (almost certainly correctly) that

this would present an unacceptable propaganda
opportunity to the enemy. It was necessary to wait
until final victory had been achieved before passing
such a law.
The decree was backdated to 1 September 1939 to
coincide with the date of commencement of the
Second World War. After operating from a number of
different addresses, a permanent headquarters for the
new
organization
was
established
at
Tiergartenstrasse 4 in Berlin. 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- und
Pflegeanstalten: RAG).
The organizations code name, T4, was taken from
this address. Other dummy organisations were set up
under seemingly innocuous titles the `Charitable
Foundation for Institutional Care (Gemeinntzige
Stiftung fr Anstaltspflege: Stiftung ), the `Charitable
Society for the Transportation of the Sick Limited
('Gemeinntziger
Krankentransport
GmbH':
Gekrat), the `Central Compensation Office for
Sanatoria
and
Nursing
Homes
(Zentralverrechnungsstelle
Heilund
Pflegeanstalten: ZVST). These names were all
intended to camouflage the true purpose of the
murderous plan.
The ultimate authority for the euthanasia
operation was Hauptamt II (Main Office II) of the
KdF, headed by Viktor Brack. 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, in
fact he had little to with it unless his authority was
needed in dealing with other government agencies.
Brandt dealt only with the medical aspect of the
operation, and continued to run his medical practice.
Heinrich Lammers was head of the Reich
Chancellery and constantly carped about the lack of
a legally proclaimed decree for euthanasia,
something Hitler absolutely refused to do. Martin
Bormann, head of the Party Chancellery, 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. He was

displeased at being excluded because his brother

Albert worked for the KdF and was also one of
Hitler's adjutants. Brack's deputy was Werner
Blankenburg; Hefelmann was the leading light at the
Kdf for children's euthanasia. All the KdF staff
involved in euthanasia took the job on in addition
to their normal functions, and all were completely
immersed in the business of murder.

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

January 1941, Allers was appointed managing

director of T4 by Brack. Find men with courage to
implement, and nerves to endure was mentioned
in a speech by Brack on 23 April 1941.
Judging from their backgrounds, the majority of
lower echelon staff recruited to the program were of
average intelligence with a basic standard of
education. They lacked the attributes or inclination
to become members of the SS or the police. 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, nor what they
would be doing. They were mostly employed at jobs
such as doormen, telephone operators, and general
handymen and were gradually inveigled into the
actual killing process. There were, of course,
exceptions to whom killing came naturally, but in
general the KdF, through their representative
Christian Wirth, bred a team of specialist murderers
who could kill without any qualms of conscience or,
if they were troubled, continued to kill anyway. The
later hands-on, practical killers of European Jewry
came predominantly from this euthanasia cadre of
`ordinary men: chefs, carpenters, drivers, plumbers,
photographers, and nurses.

Bus used to transport victims

Even before the issue of the edict, the killing of
Polish patients had begun in what were to become
the incorporated territories of Danzig-West Prussia
and the Warthegau, as well as that of German
patients in Pomerania and East Prussia. The units
involved
were
the
Eimann
commando,
Einsatzkommando 16 and the Selbstschutz (a
paramilitary organization of Volksdeutsche). The
Eimann commando, or Volksdeutsche SS-Sturmbann
E, was named after SS-Obersturmbannfhrer Kurt
Eimann, who was from Grlitz. In autumn 1939 the
Sturmbann was ordered to kill 1,400 patients from
Pomerania in the wood of Piasnitz near Neustadt in

West-Prussia (today, woods close to the Piasnica

River, near Wejherowo). On 22 September 1939, the
Eimann commando began killing 2,000 Polish
patients in the mental hospital at Konradstein (today
Kocborowo), south of Danzig (Gdansk.)
In the following months, thousands of Polish mental
patients were killed. Initially executions were by
shooting, but in October, Dr Albert Widmann, chief
chemist of the Kripo (Criminal Police) suggested the
use of bottled carbon monoxide as a killing agent.
The first gas chambers were being constructed at
Grafeneck and Brandenburg in late November. 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.) Eimann was sent to the SSStandortkommandantur at Lublin on 20 November
1941.
By January 1940, Polish patients were being gassed,
not in stationary gas chambers, but in mobile gas
vans; bottled carbon monoxide was introduced into a
sealed compartment at the rear of the vehicle. The
first of these vans was operated by a commando
headed by Herbert Lange, formerly the chief of staff
of Naumanns Einsatzgruppe VI. Throughout the
first months of that year, Langes commando
travelled around the Warthegau in a van bearing a
sign advertising `Kaisers Kaffeegeschft (Kaisers
Coffee Company).
The commando also journeyed to East Prussia,
where in a period of less than three weeks more than
1,800 German and Polish patients were gassed. It has
been estimated that a total of 7,700 sick and
handicapped patients fell victim to this early,
experimental killing phase. Following the invasion
of the former Soviet Union in 1941, many more
mentally ill patients were murdered in places such as
Riga, Dvinsk, Aglona, Poltava, Mogilev, Kiev, and
so on.

Smoking Chimney at Hadamar

During the first two years of the war, the
euthanasia programme in the Reich entered four
distinctive but overlapping phases, relating
sequentially to the killing of infants, adults,
institutionalised Jews and concentration camp
prisoners. 22 -28 special wards were established in
hospitals throughout the country for the murder of
children. In time, this programme was extended from
infants to older children, and in some cases even to
teenagers. By the end of the war, approximately
5,000 children had been killed. A visitor to the Reich
Committee institution at Eglfing-Haar described the
cynicism with which the director, Dr Hermann
Pfannmller, boasted of his methods, openly
admitting that among the children to be murdered
were some who were not mentally ill. They were
simply the children of Jewish parents. No Jews are
allowed in my institution! Pfannmller proudly
declared.
The strategy for adult euthanasia was much more
comprehensive. 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; or (b) had been institutionalized for more
than five years; or (c) had been committed as
criminally insane: or (d) were non-`Aryan. As with
children, whether or not an individual was

condemned to die was supposedly decided by a

panel of physicians. That was by no means always
the case. Dr Rudolph Boeckh, head physician of the
asylum at Neuendettelsau, 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 1,800 concerned They
merely questioned the nursing staff, whose opinions
were recorded on the forms Cases were observed
in which the opposite of the staff members true
statement was recorded on the questionnaire
Not all doctors were prepared to become part of the
nefarious plan, although there was often a
disquieting acceptance of the principle involved.
When approached to become head of the childrens
euthanasia programme at Eglfing-Haar by the
aforementioned Pfannmller, Dr Friedrich Hlzel
declined, writing: It is one thing to approve of
measures of the state with full conviction, and
another to carry them out oneself in their final
consequences. I am reminded of the difference which
exists between a judge and an executioner But in
general, 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, to do scientific work, and to complete my
education [Ausbildung]."

T-4 Euthanasia program personnel at a social

gathering
By the late 1930s, the regional health departments
and administrators of the psychiatric institutions had
been completely taken over by Party officials who

used their political affiliation to browbeat those who

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

injections, but when the poison had little immediate

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

Kaufbeuren euthanasia center

A similar killing method applied in all of the centres.

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

academic credit for their efforts.

As in the death camps which were to follow, the
logistical problems of burning the bodies far
outweighed the relatively simple killing method.
Between two and eight bodies were cremated at a
time. After cremation, residual bone was crushed in
mills or by mallets on specially constructed
worktables. Each killing centre had a so-called
special registry office, from where a standard
falsified death certificate and letter of condolence
were sent to victims next-of-kin.

Friedrich Mennecke, a Euthanasia

Program physician who was responsible
for sending many patients to be gassed.
A list of causes that could explain a sudden natural
death was available. Relatives were informed that it
had been necessary to cremate the body for public
health reasons; the ashes of the deceased were
available upon request. Nazi functionaries and
German bureaucrats were stereotypically precise and
efficient when it came to keeping records about mass
murder. Originals or copies of all paperwork
generated by the killing program were retained,
including record books and lists for internal T4 use,
correspondence with outsiders, and the medical
records of the killed patients. To organize the
paperwork, each killing centre kept a death book
(Sterbebuch), sometimes known as the book of

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

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.)
Disinfection was a code word for murder. By
Brandts calculations, between January 1940 and
August 1941, when the killings were officially
suspended, precisely 70,273 patients had been
murdered by gassing. Brandt went on to calculate the
savings made in food, clothing and accommodation
on the assumption that those murdered had been
allowed to survive for a further ten years. Based on
the average daily needs for an institutional inmate,
he estimated that the killing of these sick persons,
incapable of labour useless mouths in Nazi
terminology would yield precisely 885,439,800
Reichsmarks in savings by 1951. 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.

Irmgard Huber, chief nurse at Hadamar

At least 20,000 further victims had been killed by
that time by means of lethal injection. In fact, despite
a pause, the killing in various guises continued until
the end of the war. So far as children were
concerned, it never stopped at all. Some sources
suggest that the taken together, the total number of

victims of the euthanasia programme may have

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

they were Jews.

A starved survivor sits up in bed at

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

euthanasia programme had become widespread,

in part because the killings were taking place on
German soil. The Nazis were quick to learn the
lesson. Future killing centres would be established
far away, where possible in isolated areas. Aware of
growing public disquiet, and in the wake of explicit
sermons preached by a number of churchmen, in
particular Bishop Clemens August Graf von Galen of
Mnster, on 24 August 1941, Hitler ordered the
suspension of adult euthanasia. But childrens
euthanasia, Aktion 14f13, and the so-called
wild euthanasia of adults in hospitals
continued. The suspension should more accurately
be called a pause for reorganization.
Indeed, 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. Thereafter, gas chambers at the killing
centres functioned on a greatly reduced scale, but
thousands of patients were murdered by means of
lethal drugs or starvation at mental hospitals like
Eichberg, Meserlitz-Oberwald, Kaufbeuren and
many others. The extermination of the incurably ill,
according to T4 psychiatrist Friedrich Panse, put all
perpetrators in a state of being "drunk with elation".
In 1973, The University Clinic of Psychiatry,
Dsseldorf, published an obituary of Panse, who
"expertly guided" patients into the gas chambers.
Their paean culminated with the sentence. "A life in
the service of the suffering people...is completed."
Paul Nitsche, psychiatric head of mass murder, once
commented: "Isnt it wonderful to get rid of all the
ballast collecting in the asylums? Now we can
perform some real therapy."

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 Nrnberg trial. Valentin Faltlhauser
insisted that, for him, the decisive motive was
compassion. Paediatrician Ernst Wentzler stated, I
had the feeling that my activity was something
positive, and that I had made a small contribution to
human progress. 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. I worried about every sick child as if
it had been my own...I fully realize the problem; it is
as old as mankind, but it is not a crime against man

nor humanity. It is pity for the incurable, literally.

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

police.

Staff from the Hadamar euthanasia center during

their trial. Wiesbaden, Germany, October 8-15, 1945
All quickly became desensitized killers, rapidly
descending into a criminal nightmare of sadistic
brutality and death. Almost 100 of them were made
available to Odilo Globocnik in Lublin to operate the
gas chambers of Belzec, Sobibor and Treblinka.
When the time arrived and the final decision had
been made to implement the Jewish genocide, 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, the symbiosis between euthanasia and the
`Final Solution went beyond these obvious
connections. Killing the handicapped and the Jews
were two sides of the same coin. The former action
was intended to remove from the German race its
imperfections; the latter was designed to destroy
Nazisms greatest perceived enemy.
The dual functions were inseparable, two essential
aspects of what Hitler liked to call his
Weltanschauung, his world view. Where that
world view was to lead will be examined in the
following pages.
http://www.holocaustresearchproject.org/euthan/
The German experiment with euthanasia provides salutary lessons for the debate in the
early 21st century.
During the Nazi's T-4 programme, an estimated 250,000-350,000 Germans were put to
death. It is not commonly known that the gas chamber technology used by the Nazi's in

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

Two cultural factors unique to Germany at the time, ensured that the book had immediate
influence in the medical establishment and the social sciences. These factors were the
ethos of social Darwinism and eugenics.
Social Darwinists applied Charles Darwin's theories of natural selection to human society.
Social progress depended on the fittest and most powerful surviving and the weakest
elements being culled to prevent infecting their betters.
Eugenics envisaged a hierarchy of human beings, the lower levels being the mentally
handicapped and the disabled.

Binding and Hoche set out to undermine the Hippocratic Oath tradition. They argued that
the criteria for medical practice should be utilitarian. People were valuable in terms of
their contribution to society. Their "quality of life" should be the determining factor in
medical treatment.
In contrast, the Hippocratic Oath assumed that an individual did not have to prove their
worth. The sanctity and value of each individual human person was sacrosanct.
Binding and Hoche placed people in categories and deemed that certain individuals were
"unworthy" of life: those with terminal illnesses, the disabled (including children) and the
mentally ill.
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.
Such sentiments were readily accepted by influential doctors, the intelligentsia and soon
wider German society. Ten years after the publication of Mein Kampf, 45 percent of
German doctors had joined the Nazi party. Thus when the Nazis came to power in 1933,
determined to create a new Aryan Master Race, many Germans were ready to be
persuaded on the merits of "merciful" euthanasia.
The legalisation of voluntary euthanasia was a Nazi priority and the public were
supposed to be reassured by a raft of safeguards. However the proposals were vigorously
opposed by the churches and the Nazis retreated to wait for a more opportune time.
Within six months, "Heredity Health Courts" were established to sterilize those in the
targeted categories. An estimated 350,000 Germans were sterilised under this programme,
until May, 1945.
Propaganda used to persuade
Propaganda minister Joseph Goebbels, marshalled the resources of the state-controlled
media to persuade Germans that euthanasia was a humane social policy, the foundation

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

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

(political) group, were carried out under the guise of sickness."

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

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

Parental authorisation fraud

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

the expected resistance.

The Euthanasia continues
The T4 programme officially closed down. But euthanasia continued from November
1941 to 1945, under the code name "14 f 13", which was the title of the forms used to
establish "eligibility". The victims were concentration camp prisoners, politicals,
"habitual" criminals and Jews, who were all classified as incurably insane and gassed.
The centres that remained open for "14 f 13", were Bernburg and Hartheim.
Nuremburg
57 percent of Nazis who faced trials for crimes against people with mental disabilities
were acquitted, compared with just 24 percent of those accused of crimes against Jews.
Of those found guilty, less than two percent received life sentences, compared with 11
percent for killing Jews.
The mentally handicapped were seen as a burden on society and so judges, and especially
lay judges, did not consider their murders to be as great a crime. None of those who were
given life sentences for murdering people with mental disabilities were actually made to
serve their time.
http://www.life.org.nz/euthanasia/abouteuthanasia/history-euthanasia6

T4 Program, also called T4 Euthanasia Program,

Nazi German effortframed as a euthanasia programto kill incurably ill, physically or

mentally disabled, emotionally distraught, and elderly people. Adolf Hitler initiated this
program in 1939, and, while it was officially discontinued in 1941, killings continued
covertly until the military defeat of Nazi Germany in 1945.
[MEDIA-STRIP][END-1ST-PARA]
In October 1939, Adolf Hitler empowered his personal physician and the chief of the
Chancellery of the Fhrer to kill people considered unsuited to live. He backdated his
order to September 1, 1939, the day World War II began, to give it the appearance of a

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

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