Nazi Euthanasia
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.
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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
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
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
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.
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
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
police.
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
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.
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.
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