HANDICAPPED
UNITED STATES
HOLOCAUST
MEMORIAL
MUSEUM
Soon after Hitler took power, the Nazis
formulated policy based on their vision
of a biologically “pure” population, to
create an “Aryan master race.” The
“Law for the Prevention of Progeny
with Hereditary Diseases,” proclaimed
July 14, 1933, forced the sterilization
of all persons who suffered from
diseases considered hereditary, such as
mental illness (schizophrenia and manic
depression), retardation (“congenital
feeble-mindedness”), physical deformity,
epilepsy, blindness, deafness, and severe
alcoholism.
THE MENTALLY AND PHYSICALLY HANDICAPPED:
VICTIMS OF THE NAZI ERA
FORCED STERILIZATIONS
strainedly while their sick
The “Sterilization Law”
and asocial offspring bur-
explained the importance
of weeding out so-called
den the community.
Some scientists and physi-
genetic defects from the
cians opposed the involun-
total German gene pool:
tary aspect of the law while
Since the National
others pointed to possible
Revolution public opinion
flaws. But the designation
has become increasingly
of specific conditions as
preoccupied with questions
inherited, and the desire to
of demographic policy and
eliminate such illnesses or
the continuing decline in
handicaps from the popula-
the birthrate. However, it is
tion, generally reflected the
not only the decline in pop-
scientific and medical think-
ulation which is a cause
ing of the day in Germany
for serious concern but
and elsewhere.
equally the increasingly
Nazi Germany was not
evident genetic composition
the first or only country to
of our people. Whereas the
sterilize people considered
hereditarily healthy fami-
“abnormal.” Before Hitler,
lies have for the most part
the United States led the
adopted a policy of having
world in forced sterilizations.
only one or two children,
Between 1907 and 1939,
countless numbers of infe-
more than 30,000 people in
riors and those suffering
twenty-nine states were
from hereditary conditions
sterilized, many of them
are reproducing unre-
unknowingly or against their
will, while they were incar-
sterilization was vasectomy
cerated in prisons or institu-
and ligation of ovarian tubes
tions for the mentally ill.
of women. Irradiation (x-
Nearly half the operations
rays or radium) was used in
were carried out in
a small number of cases.
California. Advocates of
Several thousand people
sterilization policies in both
died as a result of the opera-
Germany and the United
tions, women disproportion-
States were influenced by
ately because of the greater
eugenics. This socio-biologi-
risks of tubal ligation.
cal theory took Charles
Most of the persons target-
Darwin’s principle of natural
ed by the law were patients
selection and applied it to
in mental hospitals and
society. Eugenicists believed
other institutions. The
the human race could be
majority of those sterilized
improved by controlled
were between the ages of
breeding.
twenty and forty, about
Still, no nation carried
equally divided between men
sterilization as far as
and women. Most were
Hitler’s Germany. The forced
“Aryan” Germans. The
sterilizations began in
“Sterilization Law” did not
January 1934, and altogeth-
target so-called racial
er an estimated 300,000 to
groups, such as Jews and
400,000 people were steril-
Gypsies, although Gypsies
ized under the law. A diag-
were sterilized as deviant
nosis of “feeble-mindedness”
“asocials,” as were some
provided the grounds in the
homosexuals. Also, about
majority of cases, followed by
500 teenagers of mixed
schizophrenia and epilepsy.
African and German parent-
The usual method of
age (the offspring
In 1934 this 19-yearold shop clerk, identified only as “Gerda
D,” was diagnosed as
schizophrenic and
sterilized at the
Moabite Hospital. In
1939 she was repeatedly refused a marriage certificate because
of her sterilization.
Karl-Bonhoeffer-Nervenklinik, Berlin, Germany.
T-4 Medical Questionnaire
Questionnaire 1
Case no.............................................................................................................................
Name of Institution:.................................................in: .................................................
First and family name of patient...........................maiden name.............................
Date of birth: ................................City:..................................District:..........................
Last Residence: ......................................................................District:..........................
Unmarr., marr., wid., div.: Relig: .................Racea ...................Natlty: ..................
Address of nearest relative: .........................................................................................
Regular visits and by whom (address): .....................................................................
Guardian or Care-Giver (name, address): .................................................................
Cost-bearer:.....................................................How long in this inst.: .......................
In other Institutions, when and how long: .................................................................
How long sick:.....................From where and when transferred: .............................
Twin yes/no .........................Mentally ill blood relatives: .........................................
Diagnosis: ........................................................................................................................
Primary symptoms: ........................................................................................................
Mainly bedridden? yes/no.........Very restless yes/no ........Confined yes/no.......
Incurable phys. illness: yes/no..................War casualty: yes/no..............................
For schizophrenia: Recent case................Final stage .........good remission .........
For retardation: Debility: ..........................Imbecile:............Idiot:............................
For epilepsy: Psych. changes....................Average freq. of attacks ........................
For senile disorders: Very confused.....................................Soils self .....................
Therapy (Insulin, Cardiazol, Malaria, Salvarsan, etc.): Lasting effects: yes/no....
Referred on the basis of §51, §42b Crim. Code, etc. .................. By.......................
Crime:...................................Earlier criminal acts: .......................................................
Type of Occupation: (Most exact description of work and productivity, e.g.
Fieldwork, does not do much.—Locksmith’s shop, good skilled worker.—No
vague answers, such as housework, rather precise: cleaning room, etc..
Always indicate also, whether constantly, frequently or only occasionally
occupied).........................................................................................................................
Release expected soon:................................................................................................
Remarks: ..........................................................................................................................
Do not mark in this Space.
Place, Date...........................................
...........................................
...............................................................
...........................................
(Signature of medical director or his
...........................................
representative)
a
German or related blood (German-blooded), Jew, Jewish Mischling [halfbreed] 1st or 2nd degree, Negro (Mischling), Gypsy (Mischling), etc.
Translated in Robert J. Lifton, The Nazi Doctors: Medical Killing and the
Psychology of Genocide (New York, 1986), pp. 68–69.
Completed by
physicians, this
questionnaire (left)
was used by other
“assessor” physicians
to select patients who
were killed in the
“euthanasia” program.
of French colonial troops
Law of 1935, which required
stationed in the Rhineland
for all marriages proof that
in the early 1920s) were
any offspring from the union
sterilized because of their
would not be afflicted with a
race, by secret order, outside
disabling hereditary disease.
the provisions of the law.
Although the “Sterili-
Only the Roman Catholic
Church, for doctrinal rea-
zation Law” sometimes
sons, opposed the steriliza-
functioned arbitrarily, the
tion program consistently;
semblance of legality under-
most German Protestant
pinning it was important to
Churches accepted and
the Nazi regime. More than
often cooperated with the
200 Hereditary Health
policy. Popular films such as
Courts were set up across
Das Erbe (“Inheritance”)
Germany and later, annexed
helped build public support
territories. Each was made
for government policies by
up of two physicians and one
stigmatizing the mentally ill
district judge. Doctors were
and the handicapped and
required to register with
highlighting the costs of
these courts every known
care. School mathematics
case of hereditary illness.
books posed such questions
Appeals courts were also
as: “The construction of a
established, but few deci-
lunatic asylum costs 6
sions were ever reversed.
million marks. How many
Exemptions were sometimes
houses at 15,000 marks each
given artists or other talent-
could have been built for
ed persons afflicted with
that amount?”
mental illnesses. The
“EUTHANASIA” KILLINGS
“Sterilization Law” was
followed by the Marriage
Forced sterilization in
Germany was the forerunner
of the systematic killing of
Karl Binding, a prominent
the mentally ill and the
scholar of criminal law.
handicapped. In October
They argued that economic
1939, Hitler himself initialed
savings justified the killing
a decree which empowered
of “useless lives” (“idiots”
physicians to grant a “mercy
and “congenitally crippled”).
death” to “patients consid-
Economic deprivation during
ered incurable according to
World War I provided the
the best available human
context for this idea. During
judgment of their state of
the war, patients in asylums
health.” The intent of the
had ranked low on the list
so-called “euthanasia” pro-
for rationing of food and
gram, however, was not to
medical supplies, and as a
relieve the suffering of the
result, many died from
chronically ill. The Nazi
starvation or disease. More
regime used the term as a
generally, the war under-
euphemism: its aim was to
mined the value attached
exterminate the mentally ill
to individual life and,
and the handicapped, thus
combined with Germany’s
“cleansing” the Aryan race
humiliating defeat, led many
of persons considered
nationalists to consider ways
genetically defective and a
to regenerate the nation as a
financial burden to society.
whole at the expense of
The idea of killing the
incurably ill was posed well
individual rights.
In 1935 Hitler stated
before 1939. In the 1920s,
privately that “in the event
debate on this issue
of war, [he] would take up
centered on a book co-
the question of euthanasia
authored by Alfred Hoche,
and enforce it” because
a noted psychiatrist, and
“such a problem would be
Helene Lebel, T-4 Victim
This story (right) is
told on one of the
Museum ID cards
distributed to visitors
entering the permanent exhibition.
Helene Lebel, raised as a Catholic in Vienna, Austria, first
showed signs of mental illness when she was nineteen. Her
condition worsened until she had to give up her law studies and
her job as a legal secretary. In 1936 she was
diagnosed as a schizophrenic and was placed
in Vienna’s Steinhof Psychiatric Hospital. Two
years later, Germany annexed Austria. Helene’s
condition had improved at Steinhof, and her
parents were led to believe that she would soon
be moved to a hospital in a nearby town. In fact,
Helene was transferred to a former prison in
Brandenburg, Germany. There she was
undressed, subjected to a physical examination, and then led into
a “shower room,” where she was killed with a deadly gas.
H a n d i c a p p e d ~ V i c t i m s
o f
t h e
N a z i
E r a ~ 1 9 3 3 - 1 9 4 5
Buses operated by
the T4 transport
company Gekrat,
which conveyed victims
to the “euthanasia”
centers. Wiesbaden,
Germany, 1941.
War crimes investigators question a nurse
about the mass killings
at the Hadamar
“euthanasia” center.
Hadamar, Germany,
May 4, 1945.
The Hadamar
“euthanasia” center.
In all likelihood the
smoke is from the
crematoria. Hadamar,
Germany, 1941.
Hessisches Hauptstaatsarchiv, Wiesbaden, Germany.
(Top)Hessiches Hauptstaatsarchiv, Wiesbaden, Germany. (Bottom) National
Archives, Washington, D.C.
ESTIMATED SAVINGS FROM T-4 PROGRAM
more easily solved” during
wartime. War would provide
On the assumption that the level of nutrition of the inmates of
asylums will remain the same as at present even after the end of
the war, the savings in foodstuffs in the case of 70,273 disinfected
persons with an average life expectancy of ten years would be as
follows:
Type of foodstuff
Kg.
Potatoes
189,737,160
Meat and sausage products
13,492,440
Bread
59,029,320
Flour
12,649,200
Butter
4,216,440
Butter fat
421,680
Margarine
3,794,760
Bacon
531,240
Quark
1,054,080
Cheese
1,054,080
Special Foods
1,686,600
Pastry Products
1,475,766
Sago, etc.
421,608
Coffee substitute
3,373,080
Jam
5,902,920
Sugar
7,589,520
Eggs ––––––––––––––––33,731,040 items
Vegetables
88,544,040
Pulses
4,216,440
Salt and spice substitutes
1,054,080
Total 6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï6ï
400,244,520 kg
=141,775,573.80RM
On the basis of an average daily cost [per patient] of RM 3.50 there will be:
1. a daily saving of RM
245,955.50
2. a yearly saving of RM
88,543,980.00
3. with a life expectancy of ten years
885,439,800.00
in words: eight hundred and eighty-five million four hundred and thirty-five
thousand and eight hundred Reich marks
i.e. this sum will be or has been saved up to 1 September 1941 through the
disinfection of 70,273 persons carried out so far.
From J. Noakes and G. Pridham, Nazism: A History in Documents and
Eyewitness Accounts, 1919–1945 (New York, 1988), Vol. 2, pp. 1042–43.
Physicians, the most
both a cover for killing and
highly Nazified professional
a pretext—hospital beds
group in Germany, were
and medical personnel
key to the success of “T-4,”
would be freed up for the
since they organized and
war effort. The upheaval
carried out nearly all aspects
of war and the diminished
of the operation. One of
value of human life during
Hitler’s personal physicians,
wartime would also, Hitler
Dr. Karl Brandt, headed the
believed, mute expected
program, along with Hitler’s
opposition. To make the
Chancellery chief, Philip
connection to the war
Bouhler. T4 targeted adult
explicit, Hitler’s decree
patients in all government-
was backdated to September
or church-run sanatoria and
1, 1939, the day Germany
nursing homes. These insti-
invaded Poland.
tutions were instructed
Fearful of public reaction,
Dr. Eduard Brandt,
a T-4 statistician,
worked out the savings
in foodstuffs and
money realized from
the “disinfection”
(murder) of 70,273
“useless mouths”
(persons) in the T-4
program (left).
gram was headquartered.
by the Interior Ministry to
the Nazi regime never
complete questionnaires
proposed a formal “euthana-
about the state of health
sia” law. Unlike the forced
and capacity for work of all
sterilizations, the killing of
their patients, ostensibly as
patients in mental asylums
part of a statistical survey.
and other institutions
The completed forms
was carried out in secrecy.
were, in turn, sent to expert
The code name was
“assessors” — physicians,
“Operation T4,” a reference
usually psychiatrists, who
to Tiergartenstrasse 4, the
made up “review commis-
address of the Berlin Chan-
sions.” They marked each
cellery offices where the pro-
name with a “+,” in red
pencil, meaning death, or a
gassings had first been
“–” in blue pencil, meaning
carried out at Brandenburg
life, or “?” for cases needing
Prison in 1939. There, gas
additional assessment.
chambers were disguised as
These medical experts rarely
showers complete with fake
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
nozzles in order to deceive
victims — prototypes of the
killing centers’ facilities
built in occupied Poland
later in the war.
Again, following procedures that would later be
instituted in the extermina-
killing centers in Germany
tion camps, workers
and Austria — walled-in
removed the corpses from
fortresses, mostly former
the chambers, extracted
psychiatric hospitals, castles
gold teeth, then burned
and a former prison —
large numbers of bodies
at Hartheim, Sonnenstein,
Grafeneck, Bernburg,
Hadamar, and Brandenburg.
In the beginning, patients
were killed by lethal injection. But by 1940, Hitler, on
together in crematoria.
Urns filled with ashes were
prepared in the event the
family of the deceased
requested the remains.
the advice of Dr. Werner
Physicians using fake names
Heyde, suggested that
prepared death certificates
carbon monoxide gas be used
falsifying the cause of death,
as the preferred method
and sent letters of condo-
of killing. Experimental
lences to relatives.
Bishop of Münster,
Clemens August
Count von Galen,
protested the T-4
killings in a sermon
August 13, 1941
(right). Thousands of
copies were printed and
circulated. Galen was
not punished because
Hitler did
not want to clash
openly with the
Catholic Church.
Bishop of MÜnster Protests Killings
Never under any circumstances may a human being kill an innocent person apart from war and legitimate self-defense. If you
establish and apply the principle that you can kill ‘unproductive’
fellow human beings then woe betide us all when we become old
and frail!...woe betide loyal soldiers who return to the homeland
seriously disabled, as cripples, as invalids. If it is once accepted
that people have the right to kill ‘unproductive’ fellow humans—
and even if it only initially affects the poor defenseless mentally
ill—then as a matter of principle murder is permitted for all
unproductive people....
Then, it is only necessary for some secret edict to order that the
method developed for the mentally ill should be extended to
other ‘unproductive’ people, that it should be applied to those
suffering from incurable lung disease, to the elderly who are frail
or invalids, to the severely disabled soldiers. Then none of our
lives will be safe any more. Some commission can put us on the
list of the ‘unproductive’, who in their opinion have become
worthless life. And no police force will protect us and no court will
investigate our murder and give the murderer the punishment he
deserves. Who will be able to trust his physician any more? He
may report his patient as ‘unproductive’ and receive instructions
to kill him. It is impossible to imagine the degree of moral
depravity, of general mistrust that would then spread even
through families if this dreadful doctrine is tolerated, accepted
and followed. Woe to mankind, woe to our German nation if
God’s holy commandment ‘Thou shalt not kill’, which God proclaimed on Mount Sinai amidst thunder and lightning, which God
our Creator inscribed in the conscience of mankind from the very
beginning, is not only broken, but if this transgression is actually
tolerated and permitted to go unpunished.
From Burleigh and Wipperman, The Racial State: Germany, 1933–1945
(New York, 1991), pp. 152–53.
A physician displaying a patient at the
Karl-Bonhoeffer
psychiatric clinic.
Berlin, Germany.
Meticulous records
called the gray transport
discovered after the war
buses “killing crates” and
documented 70,273
threatened each other with
deaths by gassing at the
the taunt, “You’ll end up in
six “euthanasia” centers
the Hadamar ovens!” The
between January 1940 and
thick smoke from the incin-
August 1941. (This total
erator was said to be visible
included up to 5,000 Jews;
every day over Hadamar
all Jewish mental patients
(where, in mid-summer
were killed regardless of
1941, the staff celebrated the
their ability to work or the
cremation of their 10,000th
seriousness of their illness.)
patient with beer and wine
A detailed report also
served in the crematorium).
recorded the estimated
Karl-Bonhoeffer-Nervenklinik, Berlin, Germany.
A handful of church
savings from the killing of
leaders, notably the Bishop
institutionalized patients.
of Münster, Clemens August
The secrecy surrounding
Count von Galen, local
the T-4 program broke down
judges, and parents of
quickly. Some staff members
victims protested the
were indiscreet while drink-
killings. One judge, Lothar
ing in local pubs after work.
Kreyssig, instituted criminal
Despite precautions, errors
proceedings against Bouhler
were made: hairpins turned
for murder; Kreyssig was
up in urns sent to relatives
prematurely retired. A few
of male victims; the cause
physicians protested. Karl
of death was listed as appen-
Bonhöffer, a leading psychia-
dicitis when the patient
trist, and his son Dietrich,
had the appendix removed
a Protestant minister who
years before. The town of
actively opposed the regime,
Hadamar school pupils
urged church groups to pres-
sure church-run institutions
send to physicians and the
out prisoners too ill to work.
gassed 1,558 patients from
not to release their patients
general public the message
After superficial medical
Polish asylums in specially
to T-4 authorities.
that mental patients were
screenings, designated
adapted gas vans, in order
“useless eaters” and “life
inmates — Jews, Gypsies,
to make room for military
sures, Hitler ordered a halt
unworthy of life.” In 1941,
Russians, Poles, Germans,
and SS barracks. Although
to Operation T4 on August
the film Ich klage an (“I
and others — were sent to
regular army units did not
24, 1941. Gas chambers from
accuse”) in which a professor
those euthanasia centers
officially participate in such
some of the euthanasia
kills his incurably ill wife,
where gas chambers still
“cleansing” actions as gener-
killing centers were disman-
was viewed by 18 million
had not been dismantled,
al policy, some instances
tled and shipped to extermi-
people. Doctors were
at Bernburg and Hartheim,
of their involvement have
nation camps in occupied
encouraged to decide on
where they were gassed.
been documented.
Poland. In late 1941 and
their own who should live
At least 20,000 people are
1942, they were rebuilt and
or die. Killing became part
believed to have died under
and 250,000 mentally and
used for the “final solution
of hospital routine as
the 14f13 program.
physically handicapped
to the Jewish question.”
infants, children, and
Similarly redeployed from
adults were put to death by
sands of mental patients in
from 1939 to 1945 under the
T-4 were future extermina-
starvation, poisoning, and
the occupied territories of
T-4 and other “euthanasia”
tion camp commandants
injections. Killings even
Poland, Russia, and East
programs. The magnitude
Christian Wirth, Franz
continued in some of
Prussia were also killed by
of these crimes and the
Stangl, Franz Reichleitner,
Germany’s mental asylums,
the Einsatzgruppen squads
extent to which they prefig-
the doctor Irmfried Eberl, as
such as Kaufbeuren, weeks
(SS and special police units)
ured the “final solution”
well as about 100 others —
after Allied troops had
that followed in the wake of
continue to be studied.
doctors, male nurses, and
occupied surrounding areas.
the invading German army.
Further, in an age of genetic
In response to such pres-
Outside of Germany, thou-
In all, between 200,000
persons were murdered
Between September 29 and
engineering and renewed
/˙
skills in Treblinka, Belzec,
and the winter of 1944–45,
November 1, 1939, these
controversy over mercy
and Sobibor.
clerks, who applied their
Between the middle of 1941
in a program known under
units shot about 3,700 men-
killings of the incurably ill,
The “euthanasia” killings
code “14f13,” experienced
tal patients in asylums in
ethical and moral issues
continued, however, under a
psychiatrists from the T-4
the region of Bromberg,
of concern to physicians,
different, decentralized form.
operation were sent to con-
Poland. In December 1939
scientists, and lay persons
Hitler’s regime continued to
centration camps to weed
and January 1940, SS units
alike remain vital.
FOR FURTHER INFORMATION
MUSEUM HOLDINGS
VISIT THE PERMANENT EXHIBITION
LIBRARY
The “Science” of Race (4th floor): eleven eugenics books; slides used
to depict racial types and physical deformities; anthropologists’
tools for measuring skulls and noses from Ulm, Germany
Many scholarly works published in the last ten years on race
hygiene, forced sterilization, and the euthanasia program.
The Murder of the Handicapped (4th floor): body, hand, and wrist
restraints and leather gloves used in the Bernburg Psychiatric
Hospital in Germany; a hospital bed and blanket, doctor’s coat,
syringes, and other medical instruments used in the Psychiatric
Asylum and Hospital in Schwerin, Germany
A number of documents related to forced sterilizations.
The Killers (2nd floor): photos of medical trials on video monitor
VISIT THE WEXNER LEARNING CENTER (2nd floor)
From the MENU choose TOPIC LIST. From the alphabetical list of
topics choose “Racism: The Use of Nazi Racial Theory.” Touch
“Nazi Euthanasia Program” to learn more about the euthanasia
program.
From the MENU choose ID CARD. Type in the following numbers
to read stories of victims of the euthanasia program: 6187, 1823.
COLLECTIONS
Audiotape of the sister of a euthanasia victim.
Videotape of an individual rescued by his mother.
Photographs depicting the handicapped in medical custody and
of some of the euthanasia institutes and T-4 staff.
RECOMMENDED READING
Burleigh, Michael, and Wolfgang Wipperman. The Racial State:
Germany, 1933–1945 (London, 1991).
Gallagher, Hugh G. By Trust Betrayed: Patients, Physicians, and the
License to Kill in the Third Reich (New York, 1990).
Lifton, Robert J. The Nazi Doctors: Medical Killing and the Psychology
of Genocide (New York, 1986).
Müller-Hill, Benno. Murderous Science: Elimination by Scientific Selection
of Jews, Gypsies and Others; Germany 1933–1945 (Oxford, 1988).
Proctor, Robert. Racial Hygiene: Medicine under the Nazis
(Cambridge, MA, 1988).
Pross, Christian, and Götz Aly. The Value of the Human Being: Medicine
in Germany, 1918–1945 (Berlin, 1991).
Weindling, Paul. Health, Race and German Politics between National
Unification and Nazism 1870–1945 (Cambridge, England, 1989).
United States Holocaust Memorial Museum
100 Raoul Wallenberg Place, SW Washington, D.C. 20024-2150