Figure 1.--NAZI killing of targeted groups on a large scale did not begin with Jews and the SS, it began before the War by the German medical establishment and the targets were German children--handicapped children. German dictors were ordered to report handicapped children. these were doctors in private practice caring for families all over Germany. Children deemed to be seriously handicapped were removed from families, even if the families wanted to care for them. They were then killed in sanatorium that the NAZIS Weklfare Organization had taken over from medical groups. The SS was not involved, only German dicgtors and sanatoium support staff.

Unlike the sterilization program, the T4 euthanasia program was conducted in secrecy from the public by the German medical establishment. NAZI planners were concerned that a sterilization program would take not only generations, but centuries to eradicate hereditary disease and build a new Nordic Germanic race. Thus they adopted euthanasia, doctor-ordered killings, to support the sterilization program. The Euthanasia program was designed to eliminate any German assessed to be "incurably ill". Hitler signed secret orders authorizing the program on September 20, 1939 while staying in a resort hotel at Zoppot. It was called the T4 program because the headquarters was located at No. 4 Tiergartenstrasse in Berlin. This was not a NAZI program carried out behind barbed wire by the SS in secret. German doctors in large numbers participated in the program. [Aly, Chroust, and Pross] Census forms were immediately sent out requesting for "statistical purposes" to list patients who were senile, criminally inane, or of non-German blood. The T4 staff would determine which patients would be euthanized. NAZI officials wanted the program written into German law, but Hitler did not think this advisable. [Gilbert, pp. 273-274.] The categories of people subject to the program was gradually expanded. Dr. Karl Brandt, head of NAZI medicine and Hitler's physician, was deeply involved in the program. The NAZI program not only involved the mentally ill and retarded, but also the physically handicapped. This involved a program of killing the disabled--often children. Here the parents wishes were not considered. Parents would be told to being disabled children to residential homes. Many were then killed by the doctors. Estimates suggest that 0.1 million Germans, many children, were murdered in this program. The actual murders were conducted both individually and in groups. Truck exhaust, for example, was used to gas groups of patients. A handicapped child might be taken from is parents and "cared for" in a boarding facility. It did not matter that the parents wanted to care for the child. His parents would be told later that he died, but never that he was murdered by doctors. Hitler was, however becoming uneasy about the program. The Chancellery had received written protests. Some of the individuals protesting had been arrested. There were also clandestine protests. Himmler on December, 1940 called the architects of the program, Dr. Brack and Dr. Brandt, to his office to reprimand them--of course not about the program, but allowing information about the program to leak. He told them. "If Operation T4 had been entrusted to the SS, things would have have happened differently. When the Führer entrusts us with a job, we know how to deal with it correctly, without causing useless uproar among the people." After killing 50,000 Germans, including many children and babies, the euthanasia program was abandoned. [Gilbert, p. 354.] After the War, a "doctors trial" was held at Nuremberg for 23 NAZI doctors. Six of these doctors, including Brandt, were hanged and five given life sentences.

Sterilizations (1933)

The NAZI Cabinet on July 31, 1933, only a few months after seizing power, ordered compulsory sterilization for blind, deaf, and deformed people as well as individuals suffering from mental disorders. One of the first new laws passed by the NAZIs in 1933 was "The Law for the Prevention of Genetically Deformed Offspring". These laws were not aimed at Jews, but at Aryan children and adults. Institutionalized individuals were the most ready targets, but children still in their parents care were also affected by this order. Here the retarded were special targets. Hereditary Courts were set up all over Germany to considerate cases of individual reported, often by the family doctor. The NAZIs with the often enthusiastic assistance of German doctors and health-care wooers. Doctors were asked to help identify the carriers of hereditary disorders. NAZI laws gave doctors the right to order compulsory sterilization. Patients files were no longer confidential and could be used against a person in NAZI courts. German health care workers proceeded to sterilize both the physically disabled and mentally ill in an effort to eliminate hereditary diseases. One estimate suggests that by the beginning of World War II in 1939, about 320,000 Germans had been sterilized. There were not only compulsory sterilizations, but some NAZI officials also offered sterilization to Jewish mischling children as a way of leading normal lives in Germany. One example here is Steven Muller whose family managed to escape from Germany just before World War II broke out.

Preparation

The NAZI state for several years prepared the groundwork for the T4 euthanasia program. It involved reshaping the focus of the medical establishment. Doctors in essence had to be convinced to kill. Various officials marshaled scientific or pseudo-scientific evidence to justify euthanasia, The Bavarian Minister of Health soon after his appointment proposed that psychopaths, the mentally retarded, and other "inferior" people be selected and killed. "This policy has already been initiated at our concentration camps," he pointed out. A year later, NAZI health authorities instructed mental institutions throughout the Reich to "neglect" their patients by withholding food and medical treatment. A variety of pseudo-scientific rationalizations for such killing were marshaled by NAZI officials. Eliminating the "unworthy" were promoted for economic considerations. Officials pointed out that funds expended to care for criminals and the insane could be used to provide loans to newly married couples. Euthanasia ad eugenics proponents saw incurably sick children as a burden on the healthy body of the Volk--the term used for the German people. For Hitler, "Wartime is the best time for the elimination of the incurably ill." [Bernbaum]

Time Factor

NAZI planners were concerned that a sterilization program would take not only generations, but centuries to eradicate hereditary disease and build a new Nordic Germanic race. Thus they adopted euthanasia, doctor-ordered killings, to support the sterilization program.

Authorization (September 1939)

German Führer Adolf Hitler personally issued a written order authorizing his personal physician and the chief of the Chancellery of to arrange for the elimination of designated individuals (September 20, 1939). He signed secret orders authorizing the program on while staying in a resort hotel at Zoppot. Hitler decided to backdate the order to September 1, 1939, the day World War II began. This provided the appearance of a wartime measure. He charged Dr. Karl Brandt and Chancellery chief Philipp Bouhler "with responsibility for expanding the authority of physicians…so that patients considered incurable, according to the best available human judgment of their state of health, can be granted a mercy killing."

Unpublicized

Unlike the sterilization program, the T4 euthanasia program was conducted in secrecy from the public by the German medical establishment, doctors who had taken the Hippocratic oath. This was, however, not a NAZI program carried out behind barbed wire by the SS in secret. The general public was not informed, but the medical establishment was. German doctors in large numbers participated in the program. [Aly, Chroust, and Pross]

Administration

Dr. Karl Brandt and Chancellery Chief Philipp Bouhler had the program functioning within only a few months. It was called the T4 program because the headquarters was located at No. 4 Tiergartenstrasse in Berlin. Just about all the German psychiatric community was quickly involved in the program. The mentally retarded and severely mental ill were major targets of the program. But medical doctors were also involved. Physicians active in the eugenics movement enthusiastically endorsed the T4 program. A major fisgure was Reich Health Direcor, Dr. Leonardo Conti, an anti-Semite and a strong believer in eugenics. He was important in brining the German medical establishment in line. What is not entirely clear to us is ho came up with this idea and promoted it. Gitler at the time was focused on the War. We find it difficult to believe that he would suddenly start thinking about handicapped people. e suspect that the people around him Brandt and Bouhler were the moving force. Conti was also important, but had less contact with Hitler.

The Targets

The program was framed to kill the incurably ill, physically or mentally disabled, emotionally distraught, and elderly people. In fact the program would go much further. The mandate was to kill anyone deemed to have a "life unworthy of living." The criteria for killing included both genetic (or perceived genetic because the science of genetics was in its infancy) and non-genetic disabilities and infirmities. An important criterion under the T4 program was economics--a judgment that doctors were not authorized to make under German law and which raised a range of ethical issues. The categories of people subject to the program was gradually expanded. The officials running the T4 program assigned people to the program on the basis of their economic productivity. The administrators referred to the program's victims as "burdensome lives" and "useless eaters." This was not just concepts used by the T4 administrators but appeared in school text books such as math books. Student would be asked to calculate the quantity of food consumed by the mentally retarded.

Finding the Individuals

The next step was to find the individuals. The most obvious were individuals institutionalized in mental hospitals or institutions for the disabled. The program's directors ordered a survey of all psychiatric institutions, hospitals, and homes for chronically ill patients. The T4 administrators wanted to go much farther than this. They wanted to find even individuals being cared for at home by families. Census forms were immediately sent out requesting for "statistical purposes" to list patients who were senile, criminally inane, or of non-German blood. Thus family doctors had to report on their patients.

Decisions to Eliminate

The T4 staff would determine which patients would be euthanized. Program medical staff reviewed forms sent by institutions and doctors throughout Germany. They did not examine individual patients or delve into their medical records. Nevertheless they made decisions on life or death.

Law

The T4 program was conducted without any authorization of law. NAZI officials wanted the program written into German law, but Hitler did not think this advisable. [Gilbert, pp. 273-274.] He thought that this would attract unwanted attention to the program. Dr. Karl Brandt, head of NAZI medicine and Hitler's physician, was deeply involved in the program.

Killing Process

The T4 involved a program of killing the disabled--often children. Here the parents or family members were not consulted. Family doctors followed government instructions and submitted the names of handicapped children, both physically and mentally handicapped. Parents were instructed to bring disabled children to residential homes. This was a legal order. The facilities used were often sanatorium in remote locations. Often beautiful facilities. There in idyllic settings, large numbers of children were then killed by the doctors. The actual murders were conducted both individually and in groups. At first the killings ordered were conducted on an individual basis, primarily by starvation and lethal injection. These were slow, labor intensive measures. The T4 Administrators aimed fir a much greater impact. They eventually chose asphyxiation by exhaust fumes as the preferred killing technique. German physicians not SS men actually oversaw the gassings. They were carried out in gas chambers disguised as showers. There were also gas vans. There were six killing centers in Germany and Austria: Bernburg, Brandenburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein. Crematoria were installed to dispose of the dead bodies. The SS was charged with the transport of groups to the killing centers. [Berenbaum] For this they donned (Nazi paramilitary corps) staff in charge of the transports donned white coats used b\y medical staff to maintain the appearance of a medical procedure. The program staff informed victims' families of the transfer to a new facility which of course were not identified as killing centers. Visits were not permitted at these centers. After the killing, the relatives received condolence letters, falsified death certificates (signed by real physicians), and urns containing the victim's ashes. The killing was not just those in institutions. Family doctors reported on their patients. And as a result, handicapped child might be taken from their parents and "cared for" in a boarding facility. It did not matter that the parents wanted to care for the child. Their parents would be told later that he died, but of course never that he was murdered by doctors.

Dissent

There were some in Germany that had the courage to speak out. The T4 program was never announced in the press. As part of the operation, however, doctors all over Germany were informed of the program. As a result, in became known outside the medical establishment. A few doctors protested. Not many, but a few did. Some refused to fill out the requisite census and forms. The strongest voice, however, was not the German medical establishment, but the Roman Catholic Church in Germany. The Church had signed an concordat with the the NAZIs, the provisions of which the NAZIs constantly ignored. The Church was tying to live with the NAZIs and declined to raise many issues. Euthanasia was, however, one step to far. The Church protested the supposed "mercy killings." Count Clemens August von Galen, the bishop of Münster, was the leading spokesman. He openly criticized the Government. asserting that it was the duty of Christians to oppose the taking of human life even at the cost of their own. [Bernbaum] There was also dissent from the even more docile Protestant churches. A Protestant pastor, Paul-Gerhard Braune, administered a Berlin medical facility. He wrote Hitler, protesting the euthanasia program which he described as a "large-scale plan to exterminate thousands of human beings" and was "unworthy" of institutions dedicated to healing. The head of the Reich Chancellery, Hans Lammers, replied that the program could not be stopped. SS-Gruppenführer Reinhard Heydrich, head of the Sicherheitsdienst (SD) (later SS-Obergruppenführer und General der Polizei), a month later issued an arrest warrant charging Braune with having "sabotaged measures of the regime in a irresponsible manner". It is notable that Heydrich got involved in this as T4 was not an SS operation. It is likely that the similarity between the T4 program and the Holocaust that he was orchestrating may have attracted the notice of the NAZI leadership. Braune was held 10 weeks in a Gestapo prison, but eventually released on the condition that he took no further actions criticizing the German Government or NAZI Party. [Gilbert, p. 327.] Many critics of the regime were sent to concentration camps. We are not sure why Braune was not. Perhaps because he did not make a public protest. Perhaps because his criticism was directed at the euthanasia program, a sensitive issue which the NAZIs were concerned that the public would not have support if it had been publicized.

Cancellation (August 1941)

Hitler became increasingly uneasy about the program, especially as he has signed an actual document--a mistake he would not repeat. The Chancellery had received written protests. Some of the individuals protesting had been arrested. There were also clandestine protests. Himmler called the architects of the program, Dr. Brack and Dr. Brandt, to his office (December 1940). He reprimanded them--of course not about the program, but allowing information about the program to leak. He told them. "If Operation T4 had been entrusted to the SS, things would have have happened differently. When the Führer entrusts us with a job, we know how to deal with it correctly, without causing useless uproar among the people." [Gilbert, p. 354.] After killing 50,000-100,000 Germans, including many children and babies, the euthanasia program was officially abandoned (August 24, 1941). Some authors believe that more people were actually killed after the program was officially canceled. [Berbaum]

Victims

Estimates suggest that as many as 0.1 million Germans, many of them children, were murdered during the 2 years the T4 program operated (1939-41). Some believe that another 0.1 million were killed after the program was reportedly closed down. In fact there was even killing after the NAZI surrender (May 1945).

Prosecutions

After the War, a "Doctors Trial" was held at Nuremberg for 23 NAZI doctors. Six of these doctors, including Brandt, were hanged and five given life sentences. NAZI Health Director, Dr. Lonardo Conti, would have been a defendent at the trial. And he was involved in much more than just the T-4 program. Rather than face a trial and the record of his actions as Reich Health Director, he decided to hang himself (October 1945). Actually, the great proportion of the German medical establishment had been involved in one way or another in the program. Very few German doctors registered any objection to the program.

The Holocaust

Any assessment of the T4 program has obvious connections with the Holocaust. The Holocaust especially targeted the children and elderly at first because they were "non producers". And after the T4 program was supposedly closed, the industrial killing of Jews began in the German death camps built in Poland. The SS drew from the experience of the T4 program as to how to efficiently kill large numbers of people. And some of the staff working on the T4 program became involved in the SS killing operations.

Post-War Discussions

'Amen' is a German film, about a not very well know NAZI killing program that pre-dated the Holocaust, the infamous T-4 euthenasian program. The first large scale NAZI program targetred German children, handicapped children, both mentally and phhsically. Adults were also killed, but the primary target was handicapped children. Many of the personel involved in T-4 and the killing procedures palyed a major role in the Holocaust. The film is based on a 1963 play by Rolf Hochhuth, 'The Deputy, a Christian Tragedy'. There are scenes with the Hitler Youth and German children. The plot focuses on a SS officer, Kurt Gerstein, who was an engineer and designed a mobile water purificaion system. He had a retarded daughter who he cares for deeply. His daughter is reported by the family dictor and taken from him and euthenised in the T-4 program. The film is about Gerstein who opposed the program and his SS career. He attempted to alert the world to the extermination camps. His role in life is depicted in the film.

Sources

Aly, Gotz, Peter Chroust, and Christian Pross. Cleansing the Fatherland: Nazi Medicine and Racial Hygiene (Johns Hopkins University Press: Baltimore, 2004).

Berenbaum, Michael. "T4 Euthanasia Program", Holocaust Survivors and Remembrance Network.

Gilbert, Martin. A History of the Twentieth Century Vol. 2 1933-54 (William Morrow and Company, Inc.: New York, 1998), 1050p.

Rogow, Sally. Hitler's Unwanted Children".

Created: 5:29 AM 7/12/2009
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