Nazi euthanasia program

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Within the broad scope of the Holocaust, the Nazi euthanasia program encompassed several programs, such as the Action T4, which had medical personnel evaluate hundreds of thousands of people to see if they met Nazi criteria that categorized them as "life unworthy of life". If so, the people were killed, either by direct lethal means or starvation. Other aspects of the program included Nazi euthanasia experiments, as well as direct medical killing in concentration camp hospitals, distinct from the gas chambers.


In Mein Kampf (1924), Hitler wrote

He who is bodily and mentally not sound and deserving may not perpetuate this misfortune in the bodies of his children. The völkische [racial] state has to perform the most gigantic rearing-task here. One day, however, it will appear as a deed greater than the most victorious wars of our present bourgeois era[1]

Robert Jay Lifton wrote that the Nazi version of "euthanasia" was based on the work of Adolf Jost, who published The Right to Death (Das Recht auf den Tod) in 1895.

Jost argued that control over the death of the individual must ultimately belong to the social organism, the state. This is in direct opposition to the contemporary concept of euthanasia, which emphasizes the individual’s “right to die” or “right to death” or “right to his or her own death,” as the ultimate human claim. In contrast, Jost was pointing to the state’s right to kill"[2]

It may be noted that racial hygienist ideas were far from unique to the Nazi movement, although Hitler expressed them in an extreme form. The ideas of social Darwinism were widespread in all western countries in the early 20th century, and the eugenics movement had many followers among educated people, being particularly strong in the United States of America. The idea of sterilising those carrying hereditary defects or exhibiting what was thought to be hereditary anti-social behaviour was widely accepted, and was put into law in the United States of America, Sweden, Switzerland and other countries. Between 1935 and 1975, for example, 63,000 people were sterilised on eugenicist grounds in Sweden.[3]

Precursor: sterilization

See also: Nazi sterilization experiments

The Nazi regime began to implement racial hygienist policies as soon as it came to power. The July 1933 Law for the Prevention of Hereditarily Diseased Offspring prescribed compulsory sterilization for people with a range of hereditary conditions such as schizophrenia, epilepsy, Huntington's chorea and “imbecility.” Sterilisation was also mandated for chronic alcoholism and other forms of social deviance. This law was administered by the Reich Interior Ministry under Wilhelm Frick through special Hereditary Health Courts (Erbgesundheitsgerichten), which examined the inmates of nursing homes, asylums, prisons, aged care homes and special schools to select those to be sterilised. >ref>Evans, p. 507</ref>

It is estimated that 360,000 people were sterilised under this law between 1933 and 1939. The law was used punitively in some cases, against women convicted of prostitution, for example. Some people with non-hereditary disabilities were also affected, despite the lack of logic this entailed. There were some suggestions that the program should be extended to people with physical disabilities, but such ideas had to be expressed carefully given that one of the most powerful figures of the regime, Joseph Goebbels, suffered from congenital club foot. Philip Bouhler himself was very lame as a result of war wounds to his legs. After 1937 the acute shortage of labour in Germany arising from the crash rearmament program meant that anyone capable of work was deemed to be “useful” and was exempted from the law, and the rate of sterilisation declined.[4]

Action T4

The T4 program is commonly described as one of “euthanasia,” and this expression was in fact used at the time by some of the officials responsible for executing the program. Action T4 had little in common with contemporary ideas of euthanasia. The program was not motivated by concern for the welfare of the individuals involved, nor by a desire to release them from suffering—most killed were not suffering. It was carried out primarily according to the dictates of “racial hygiene” ideology; secondarily, to reduce the cost to the state of maintaining people with disabilities at a time when the overwhelming financial priority of the regime was rearmament. The program, moreover, was nearly always carried out without the consent of the people concerned or their families.

Action T4 personnel socializing

Beginning in August 1939, operations under the code name T4, and killed an estimated 75,000 to 250,000 people with intellectual or physical disabilities. The codename T4 was an abbreviation of “Tiergartenstrasse 4”, the address of a villa in the Berlin borough of Tiergarten which was the headquarters of the General Foundation for Welfare and Institutional Care (Gemeinnnützige Stiftung für Heil und Anstaltspflege)[5] The villa no longer exists, but a plaque set in the pavement on Tiergartenstrasse marks its location.. This body operated under the direction of Philipp Bouhler, the head of Hitler’s Chancellery of the Fuehrer or private chancellery. This was the Kanzlei des Führer der NSDAP, not to be confused with the Reich Chancellery or Reichskanzlei, and Dr Karl Brandt, Hitler’s personal physician.

The T4 program developed from the Nazi Party’s policy of “racial hygiene,” the belief that the German people had to be “cleansed” of “racially unsound” elements, which included people with disabilities. The program set important precedents for the later Holocaust of the Jews and other minorities of Europe: the noted British historian of the Nazi era, Ian Kershaw, has characterised Action T4 as “a vital step in the descent into modern barbarism”[6].

Killing of children

In May 1939, when Hitler had already determined to attack Poland in the summer or autumn of that year, the parents of a severely deformed child born near Leipzig wrote to Hitler seeking his permission for their child to be put to death.[7] Hitler approved this, and authorised the creation of the Reich Committee for the Scientific Registering of Serious Hereditary and Congenital Illnesses (Reichsausschuss zur wissenschaftlichen Erfassung erb- und anlagebedingter schwerer Leiden), headed by Karl Brandt, his personal physician, and administered by Herbert Linden of the Interior Ministry and an SS officer, Viktor Brack. Brandt and Bouhler were authorised to approve applications to put children in similar circumstances to death[8].

This precedent was used to establish a program of killing children with severe disabilities from which the voluntary element soon disappeared. From August the Interior Ministry required doctors and midwives to report all cases of newborns with severe disabilities. Those to be killed were "all children under three years of age in whom any of the following 'serious hereditary diseases' were 'suspected': idiocy and mongolism (especially when associated with blindness and deafness); microcephaly; hydrocephaly; malformations of all kinds, especially of limbs, head, and spinal column; and paralysis, including spastic conditions"[9]. The reports were assessed by a panel of medical experts, of whom three were required to give their approval before a child could be killed.[10].

Various methods of deception were used to gain consent, particularly in Catholic areas where parents were generally uncooperative. Parents were told that their children were being sent to “Special Sections” for children where they would receive improved care.[11] The children sent to these centres were kept for "assessment" for a few weeks and then killed by lethal injection, their deaths recorded as "pneumonia". Autopsies were usually performed, and brain samples were taken to be used for medical research. This apparently helped to ease the consciences of many of those involved, since it gave them the feeling that the children had not died in vain and that the whole program had a genuine medical purpose.[12].

Once war broke out in September 1939, the program became less rigorous in its process of assessment and approval. It expanded to include older children and adolescents. The conditions covered also expanded and came to include "various borderline or limited impairments in children of different ages, culminating in the killing of those designated as juvenile delinquents. Jewish children could be placed in the net primarily because they were Jewish; and at one of the institutions, a special department was set up for 'minor Jewish-Aryan half-breeds'"[13]. At the same time increased pressure was placed on parents to agree to their children being sent away. Many parents suspected what was really happening, especially when it became apparent that institutions for children with disabilities were being systematically cleared out, and refused consent. They were threatened that they would lose custody of all their children, and if that did not suffice the parents themselves could be threatened with call-up for "labour duty."[14] By 1941 over 5,000 children had been killed[15].

Killing of adults

Brandt and Bouhler soon developed plans to expand the program to adults. In July 1939 they had held a meeting attended by Dr Leonardo Conti, Reich Health Leader and State Secretary for Health in the Interior Ministry, and Professor Werner Heyde, head of the SS medical department. This meeting had made preliminary arrangements for a national register of all institutionalised people with mental illnesses or physical disabilities.

The first adults with disabilities to be systematically killed by the Nazi regime were not, however, Germans, but rather Poles, as the SS men of Einsatzkommando 16 cleared the hospitals and mental asylums of the “Wartheland”, a region of western Poland which was earmarked for rapid incorporation into Greater Germany and resettlement by ethnic Germans following the German conquest of Poland. In the Danzig (now Gdańsk) area, some 7,000 Polish inmates of various institutions were shot, while 10,000 were killed in the Gdynia area. Similar measures were taken in other areas of Poland destined for incorporation into Germany[16]. At Posen (now Poznań), hundreds of patients were killed by means of carbon monoxide gas in an improvised gas chamber developed by Dr Albert Widmann, chief chemist of the German Criminal Police (Kripo). In December 1939 the SS head Heinrich Himmler witnessed one of these gassings, ensuring that this invention would later be put to much wider uses[17].

The idea of killing “useless” mental patients soon spread from occupied Poland to adjoining areas of Germany itself, probably because Nazi Party and SS officers in these areas were most familiar with what was happening in Poland. These were also the areas where German wounded from the Polish campaign were expected to be accommodated, creating a demand for hospital space. The Gauleiter of Pomerania, Franz Schwede-Coburg, dispatched 1,400 patients from five Pomeranian hospitals to Poland, where they were shot. The Gauliter of East Prussia, Erich Koch, likewise had 1,600 patients killed. In all, more than 8,000 Germans were killed in this initial wave of killings. These were carried out on the initiative of local officials, although Himmler certainly knew and approved of them[18].

The program for killing adults with mental or physical disabilities began with a letter from Hitler issued in October 1939. The decree charged Bouhler and Brack with “enlarging the authority of certain physicians, to be designated by name, in such a manner that persons who, according to human judgement, are incurable, can, upon a most careful diagnosis of their condition of sickness, be accorded a mercy death”[19]. The letter was backdated to 1 September to provide “legality” to those killings already carried out[20], and to link the program more definitely to the war, giving it a rationale of wartime necessity[21]. It is important to note that this letter—which provided the sole legal basis for the program—was not a formal "Führer decree," which in Nazi Germany possessed the force of law. For this reason Hitler deliberately bypassed Health Minister Leonardo Conti and his department, who were held to be not sufficiently imbued with National Socialist ruthlessness and who might have raised awkward questions about the legality of the program, entrusting it to his personal agents Bouhler and Brandt. Several drafts of a formal "euthanasia" law were prepared, but Hitler refused to authorise them. Thus the senior participants in the program always knew that it was illegal even by the loose definition of legality prevailing in Nazi Germany.[22].

The program was administered by Brack’s staff from the villa at Tiergartenstrasse 4, under the guise of the General Foundation for Welfare and Institutional Care, supervised by Bouhler and Brandt. Others closely involved included Dr Herbert Linden, who had been heavily involved in the children's program, and Dr Ernst Grawitz, chief physician of the SS. These officials chose the doctors who were to carry out the "operational" part of the program. They were chosen for their political reliability, professional reputation, and known sympathy for radical eugenics. They included several who had proved their worth in the child-killing program, such as Unger, Heinze, and Hermann Pfannmüller. The new recruits were mostly psychiatrists, notably Professor Carl Schneider of Heidelberg, Professor Max de Crinis of Berlin and Professor Paul Nitsche from the Sonnenstein state institution. Heyde became the operational leader of the program, succeeded later by Nitsche[23].

In early October all hospitals, nursing homes, old people's homes and sanatoria were required to report all patients who had been institutionalised for five years or more, who had been committed as “criminally insane,” who were of “non-Aryan race,” or who had been diagnosed with any of a list of specified conditions. These included schizophrenia, epilepsy, Huntington’s chorea, advanced syphilis, senile dementia, paralysis, encephalitis and “terminal neurological conditions generally”. Many doctors and administrators assumed that the purpose of the reports was to identify inmates who were capable of being drafted for "labour service". They therefore tended to overstate the degree of incapacity of their patients, to protect them from labour conscription - with fatal consequences[24]. When some institutions, mainly in Catholic areas, refused to co-operate, teams of T4 doctors (or in some cases Nazi medical students) visited them and compiled their own lists, sometimes in a very haphazard and ideologically motived manner[25]. At the same time, all Jewish patients were removed from institutions and were killed during 1940[26].

As with child inmates, adults had their cases assessed by a panel of "experts" working at the Tiergartenstrasse offices. The experts were required to make their judgments solely on the basis of the reports, rather than on detailed medical histories, let alone examinations. Sometimes they dealt with hundreds of reports at a time. On each they marked a + (meaning death), a - (meaning life), or occasionally a ? meaning that they were unable to decide. Three "death" verdicts condemned the person concerned. As with the children, over time these processes became less rigorous, the range of conditions considered unsustainable grew broader, and zealous Nazis further down the chain of command increasingly made decisions on their own initiative[27].

At first patients were killed by lethal injection, the method established for killing children, but the slowness and inefficiency of this method for killing adults, who needed larger doses of increasingly scarce and expensive drugs and who were more likely to need restraint, soon became apparent. Hitler himself recommended to Brandt that carbon monoxide gas be used[28]. At his trial, Brandt later described this as a "major advance in medical history"[29]. The first gassings took place at Brandenburg in January 1940, under the supervision of Widmann and Christian Wirth, a Kripo (criminal police) officer who was later to play a prominent role in the “final solution” extermination of the Jews. Once the efficacy of this method was established, it became standardised and was instituted at a number of centres across Germany. As well as Brandenburg, these included Grafeneck in Baden-Württemberg, Hartheim near Linz in Austria, Sonnenstein in Saxony, Bernburg in Saxony-Anhalt and Hadamar in Hesse. As well as killing patients from mental homes, nursing homes and sanatoria, these centres were also used to kill prisoners transferred from concentration camps in Germany and Austria.

Patients were transferred from their institutions to the killing centres in buses operated by teams of SS men wearing white coats to give an air of medical authenticity. To prevent the families and the doctors of the patients tracing them, they were often sent to "transit" centres in major hospitals where they were allegedly "assessed" before being moved again to "special treatment" centres. (The expression "special treatment", Sonderbehandlung, was later widely employed as a euphemism for killing during the extermination of the Jews). Families were sent letters explaining that owing to wartime regulations it would not be possible to visit relatives in these centres. In fact most of these patients were killed within 24 hours of arriving at the centres, and their bodies cremated[30]. For every person killed, a death certificate was prepared, giving a false but plausible cause of death, and sent to the family along with an urn of ashes (random ashes, since the victims were cremated en masse). The preparation of thousands of falsified death certificates in fact took up most of the working day of the doctors who operated the centres[31].

During 1940, the centres at Brandenburg, Grafeneck and Hartheim killed nearly 10,000 people each, while another 6,000 were killed at Sonnenstein. In all about 35,000 people were killed in T4 operations that year. Operations at Brandenburg and Grafeneck were wound up at the end of the year, partly because the areas they served had been “cleared” and partly because of public opposition. In 1941, however, the centres at Bernberg and Sonnenstein increased their operations, while Hartheim (where Wirth and Franz Stangl were successively commandants) continued as before. As a result, another 35,000 people were killed before August 1941, when the T4 program was shut down. Even after that date, however, the centres continued to be used to kill concentration camp inmates: eventually some 20,000 people in this category were killed.[32]

In 1971 the Hungarian-born journalist Gitta Sereny conducted a series of interviews with Franz Stangl, who was in prison in Düsseldorf after having been convicted of co-responsibility for killing 900,000 people as commandant of the Sobibor and Treblinka extermination camps in Poland. Stangl gave Sereny a detailed account of the operations of the T4 program based on his time as commandant of the killing facility at the Hartheim “institute”[33]. He described how the inmates of various asylums were removed and transported by bus to Hartheim. Some were in no mental state to know what was happening to them, but many were perfectly sane and for them various forms of deception were used. They were told they were at a special clinic where they would receive improved treatment, and were given a brief medical examination on arrival. They were then induced to enter what appeared to be a shower block, where they were gassed with carbon monoxide (this ruse was later used on a much larger scale at the extermination camps).


Hitler and his colleagues were aware from the start that a program of killing large numbers of Germans with disabilities would be unpopular with the German public. Although Hitler had a fixed policy of not issuing written instructions, he made an exception when he provided Bouhler and Brack with written authority for the T4 program in his confidential October 1939 letter. This was apparently to overcome opposition within the German state bureaucracy – the Justice Minister, Franz Gürtner, needed to be shown Hitler’s letter in August 1940 to gain his co-operation[34].

Hitler told Bouhler at the outset that “the Führer’s Chancellery must under no circumstances be seen to be active in this matter”[35]. There was a particular need for caution in Catholic areas, which after the annexations of Austria and the Sudetenland in 1938 included nearly half the population of Greater Germany, and where public opinion could be expected to be hostile. In March 1940 a confidential report from the SD in Austria warned that the killing program must be implemented with stealth “in order to avoid a probable backlash of public opinion during the war”[36].

Opposition persisted within the bureaucracy. A district judge, Lothar Kreyssig, wrote to Gürtner protesting (correctly) that the T4 program was illegal (since no law or formal decree from Hitler had authorised it), Gürtner replied “If you cannot recognise the will of the Führer as a source of law, then you cannot remain a judge,” and had Kreyssig dismissed[37].

The Catholic Church had agreed to withdraw from all political activity in the Concordat of 1933 between Germany and the Holy See, but the prospect of state-sanctioned mass killing of German citizens and such a challenge to fundamental Catholic belief in the sanctity of human life posed a serious dilemma for German Catholics. In 1935 the Church had protested in a private memorandum against proposals to pass a law legalising euthanasia (in the true sense of the word): this was one reason the law was not proceeded with.

In January 1939, however, Brack commissioned a paper from Dr Joseph Mayer, Professor of Moral Theology at the University of Paderborn, on the likely reactions of the churches in the event of a state euthanasia program being instituted. Mayer – a longstanding euthanasia advocate – reported that the churches would not oppose such a program if it was seen to be in the national interest. Brack showed this paper to Hitler in July, and it may have increased his confidence that a “euthanasia” program would be acceptable to German public opinion.[38] (When Gitta Sereny interviewed Mayer shortly before his death in 1967, he denied that he had approved of killing people with disabilities, but since no copies of this paper are known to survive, this cannot be determined.)[39] This turned out to be the case. In fact the T4 program was the sole example of an action by the Nazi regime which provoked large-scale public protests.

It was impossible to keep the T4 program secret, given that thousands of doctors, nurses and administrators were involved in it, and given that the majority of those killed had families who were actively concerned about their welfare. Despite the strictest orders to maintain secrecy, some of the staff at the killing centres talked - sometimes when drunk in bars - about what went on there. In some cases families could tell that the causes of death notified were false, as when a patient was said to have died of appendicitis when he had no appendix. In other cases several families in the same town would receive death certificates on the same day. In the towns where the killing centres were located, many people saw the inmates arrive in buses, saw the smoke from the crematoria chimneys, and drew the correct conclusion. In Hadamar ashes containing human hair rained down on the town.[40] In May 1941 the Frankfurt County Court wrote to Gürtner describing scenes in Hadamar where children shouted in the streets that people were being taken away in buses to be gassed.[41]

During 1940 rumours of what was taking place spread, and many Germans withdrew their relatives from asylums and sanatoria to care for them at home – often with great expense and difficulty. In some places doctors and psychiatrists co-operated with families to have patients discharged, or, if the families could afford it, had them transferred to private clinics where the reach of T4 did not extend. (The class aspect of T4 should be noted: it was mainly working-class families whose relatives were in state institutions. Wealthy families could protect their disabled relatives by keeping them at home or in private clinics.) Other doctors agreed to "re-diagnose" some patients so that they no longer met the T4 criteria, although this ran the risk of exposure when the Nazi zealots from Berlin conducted inspections. In Kiel, Professor Hans Gerhard Creutzfeldt managed to save nearly all of his patients.[42] For the most part, however, doctors co-operated with the program, either out of ignorance as to its true nature or out of agreement with Nazi eugenicist policies.[43]

During 1940 protest letters began to arrive at the Reich Chancellery and the Ministry of Justice, some of them from Nazi Party members. The first open protest against the removal of people from asylums took place at Absberg in Franconia in February 1941, and others followed. The SD report on the incident at Absberg noted that "the removal of residents from the Ottilien Home has caused a great deal of unpleasantness," and described large crowds of Catholic townspeople, among them Party members, protesting at the removal.[44] Opposition to the T4 policy sharpened after the German attack on the Soviet Union in June 1941, because the war in the east produced for the first time large-scale German casualties, and the hospitals and asylums began to fill up with maimed and disabled young German soldiers. Rumours began to circulate that these men would also be subject to “euthanasia,” although in fact no such plans existed.

During 1940 and 1941 some Protestant churchmen protested privately against T4, but none made any public comment. Theophil Wurm, the Lutheran Bishop of Württemberg, wrote a strong letter to Interior Minister Frick in March 1940. Others who privately protested were the Lutheran theologian Friedrich von Bodelschwingh, who was director of the Bethel Institution for epileptics at Bielefeld, and Pastor Paul-Gerhard Braune, director of the Hoffnungstal Institution in Berlin. Both used their connections with the regime to negotiate exemptions for their institutions: Bodelschwingh negotiated directly with Brandt and indirectly with Hermann Göring, whose cousin was a prominent psychiatrist. Braune had meetings with Justice Minister Gürtner, who was always dubious about the legality of the program, and later wrote a strongly worded letter to Hitler protesting against it: Hitler did not read it, but was told about it by Lammers.[45] In general, however, the Protestant church was deeply enmeshed with the Nazi regime and was unwilling to criticise its actions.[46]

The Catholic Church, which since 1933 had pursued a policy of avoiding confrontation with the Nazi regime in the hope of preserving its core institutions intact, became increasingly unable to keep silent in the face of mounting evidence about the killing of inmates of hospitals and asylums. Leading Catholic churchmen, led by Michael Cardinal von Faulhaber of Munich, wrote privately to the government protesting against the policy. In July 1941 the Church broke its silence when a pastoral letter from the bishops was read out in all churches, declaring that it was wrong to kill (except in self-defence or in a morally justified war).[47] This emboldened Catholics to make more outspoken protests.

A few weeks after the pastoral letter was read out, the Catholic Bishop of Münster in Westphalia, Clemens August Graf von Galen, publicly denounced the T4 program in a sermon, and telegrammed his text to Hitler, calling on “the Führer to defend the people against the Gestapo.” "It is a terrible, unjust and catastrophic thing when man opposes his will to the will of God," Galen said. "We are talking about men and women, our compatriots, our brothers and sisters. Poor unproductive people if you wish, but does this mean that they have lost their right to live?"[48] Robert Lifton says of this sermon: "This powerful, populist sermon was immediately reproduced and distributed throughout Germany - indeed, it was dropped among German troops by British Royal Air Force flyers. Galen’s sermon probably had a greater impact than any other one statement in consolidating anti-“euthanasia” sentiment."[49] Another Bishop, Franz Bornewasser of Trier, also sent protests to Hitler, though not in public. In August Galen was even more outspoken, broadening his attack to include the Nazi persecution of religious orders and the closing of Catholic institutions. He attributed the heavy allied bombing of Westphalian towns to the wrath of God against Germany for breaking His laws. Galen’s sermons were of course not reported in the German press, but they were widely circulated in the form of illegally printed leaflets.[50] Local Nazis asked for Galen to be arrested, but Goebbels told Hitler that if this happened there would be an open revolt in Westphalia.[51]

By August the protests had spread to Bavaria. According to Gitta Sereny, Hitler himself was jeered by an angry crowd at Hof – the only time he was opposed to his face in public during his 12 years of rule.[52] Despite his private fury, Hitler knew that he could not afford a confrontation with the Church at a time when Germany was engaged in a life-and-death two-front war, a belief which was reinforced by the advice of Goebbels, Martin Bormann, head of the Party Chancellery, and Heinrich Himmler, head of the SS. Robert Lifton writes: "Nazi leaders faced the prospect of either having to imprison prominent, highly admired clergymen and other protesters — a course with consequences in terms of adverse public reaction they greatly feared — or else end the program."[53] Himmler said: "If operation T4 had been entrusted to the SS, things would have happened differently,” because “when the Führer entrusts us with a job, we know how to deal with it correctly, without causing useless uproar among the people.”[54]

On 24 August 1941 Hitler ordered the cancellation of the T4 program, and also issued strict instructions to the Gauleiters that there were to be no further provocations of the churches for the duration of the war. The invasion of the Soviet Union in June had opened up new opportunities for the T4 personnel, who were soon transferred to the east to begin work on a vastly greater program of killing: the “final solution of the Jewish question.” But the winding up of the T4 program did not in fact bring the killing of people with disabilities to an end, although from the end of 1941 the killing became less systematic. Lifton documents that the killing of both adults and children continued to the end of the war, on the local initiative of institute directors and party leaders. The methods reverted to those employed before the gas chambers were employed: lethal injection, or simple starvation.[55] Kershaw estimates that by the end of 1941 75,000 to 100,000 people had been killed as a result of the program, but that further tens of thousands of concentration camp inmates, and people judged incapable of work, were killed in Germany between 1942 and 1945 (this figure does not include the Jews who were deported to their deaths in 1942 and 1943). Hartheim, for example, continued to kill people sent to it from all over Germany until 1945.

WWII period

The Nuremberg Military Tribunal medical case indictment,dealt with actions between September 1939 and April 1945, which was under Allied jurisdiction. The indictment described as "the systematic and secret execution of the aged, insane, incurably ill, of deformed children, and other persons, by gas, lethal injections, and diverse other means in nursing homes, hospitals, and asylums. Such persons were regarded as "useless eaters" and a burden to the German war machine. The relatives of these victims were informed that they died from natural causes, such as heart failure. German doctors involved in the "euthanasia" program were also sent to Eastern occupied countries to assist in the mass extermination of Jews."[56] Charges were placed against Kurt Blomer, Viktor Brack, Karl Brandt, and Waldemar Hoven. Blomer was acquitted; Brack, Karl Brandt, and Hoven]] were convicted.


  1. Hitler, Mein Kampf p., 447 (cited by Peter Padfield, Himmler, Macmillan 1990, 260).
  2. Robert Jay Lifton, The Nazi Doctors, Basic Books, 46
  3. Richard J. Evans, The Third Reich in Power, Allen Lane 2005, p. 514
  4. Evans, 508
  5. Gitta Sereny, Into That Darkness, Pimlico 1974, 48
  6. Ian Kershaw (2000), Hitler', vol. II, p. 252
  7. Lifton is of the view that this request was "encouraged," although the existence of the child and the agreement of the parents to its killing were apparently genuine (Lifton, 50)
  8. Kershaw, II, 259.
  9. Lifton, 52.
  10. These were Professor Werner Catel (a Leipzig psychiatrist), Professor Hans Heinze, head of a state institution for children with intellectual disabilities at Görden near Brandenburg, Ernst Wentzler a Berlin pediatric psychiatrist, and the author Dr Helmut Unger (Lifton, 52).
  11. Sereny, 55
  12. Lifton, p. 60
  13. Lifton, 56.
  14. Lifton, 55
  15. Browning, 190. Lifton concurs with this figure, but notes that the killing of children continued even after the T4 program was formally ended in 1941.
  16. Browning, 186-87.
  17. Browning, 188.
  18. Browning, 190, Kershaw, II, 261.
  19. Padfield, 261.
  20. Kershaw, II, 253
  21. Lifton, 63.
  22. Lifton, 64.
  23. Lifton, 64.
  24. Lifton, 66.
  25. Lifton, 67.
  26. Browning, 191, Padfield, 261, 303, Lifton 77. According to Lifton, most Jewish inmates of German mental institutions were dispatched to Lublin in Poland in 1940 and killed there.
  27. Lifton, 67.
  28. Lifton, 71.
  29. Lifton, 72.
  30. Lifton, 71.
  31. Lifton, 74.
  32. These figures come from Ernst Klee, "Euthanasie" im SS-stadt: Die “Vernichtung lebensunwerten Leben” (“Euthanasia” in the SS-state: The extermination of “life unworthy of life”), Frankfurt 1983
  33. Sereny, 41-90.
  34. Kershaw, II, 253.
  35. Padfield, 261.
  36. Padfield, 304.
  37. Kershaw, II, 254.
  38. Kershaw, II, 259
  39. Sereny, 71
  40. Lifton, 75
  41. Sereny, 58
  42. Lifton, 82. Creutzfeldt is also remembered as the co-discoverer of Creutzfeldt-Jakob disease
  43. Lifton, 80. Lifton lists a handful of psychiatrists and administrators who actively resisted the T4 program.
  44. Lifton, 90
  45. Lifton, 90-92
  46. Sereny, 69, 74
  47. Kershaw, II, 427
  48. Lifton, 93
  49. 94
  50. Kershaw, II, 427
  51. Kershaw, II, 429
  52. Sereny, 59. Sereny did not claim firsthand knowledge of this event. It is apparently based on testimony given by Dr Friedrich Mennecke during a postwar trial. According to Mennecke, Hitler was traveling between Munich and Berlin when his train suddenly stopped at a station. A crowd was watching a group of "retarded patients" being loaded into a train. Seeing Hitler at the window, the crowd became threatening. Mennecke apparently told this as an "anecdote" rather than something he knew to be true. (Lifton, 95 footnote 1)
  53. Lifton, 95
  54. Lifton, 95
  55. Lifton 96-102
  56. , The Medical Case of the Subsequent Nuremberg Proceedings, Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10. October 1946–April 1949.