Killing While Caring
Nursing in the Nazi “Euthanasia” Program
Susan Benedict, CRNA, DSN, FAAN
Medical University of South Carolina
First, the language of disability:
 People
with disabilities…
 People with developmental
disabilities…
 Many terms used are those
of the time and are not
acceptable today.
“A history of mental illness”…
as non-specific as “a
history of physical illness”.
 is
Anna G: Accused of killing 150
patients…
 “When
giving the [lethal]
medicine, I proceeded with a
lot of compassion. I took them
lovingly and stroked them
when I gave the medicine.
They were not to be tortured
more than necessary.”
Steps to the “Final Solution”
 Devaluation
and
generalization
 Sterilization
 Euthanasia
 Concentration camps
How could this happen?
 Eugenics
Passed in 1922, the US Model
Eugenical Sterilization Law
applied to



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



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Feeble-minded
Insane (including the psychopathic)
Criminalistic (including the delinquent and wayward)
Epileptic
Inebriate (including drug users)
Diseased (including the tuberculosis, the syphilitic, the
leprous, and others with chronic, infections, and legally
segregable diseases
Blind (including those with seriously impaired vision)
Deformed (including the crippled)
Dependent (including orphans, ne’er-do-wells, the homeless,
tramps and paupers.
Eugenics also popular in US
 Courses
taught at
 Columbia
University
 Brown University
 Northwestern University
 Harvard University
 Cornell University
 University of Wisconsin
In 1925, in “Mein Kampf” Hitler
wrote…
 “Those
who are physically
and mentally unhealthy and
unworthy must not
perpetuate their suffering in
the body of their children.”
July 1933: Germany’s
sterilization law passed
Hereditary epilepsy
 Schizophrenia
 Mental deficiency
 Huntington’s chorea
 Hereditary blindness and deafness
 Certain malformations
 Severe alcoholism

1934 - 1939
More
than 350,000
people were sterilized in
Germany
Education

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Examples in textbooks
Courses in nursing and medical schools
Racial hygiene a component of all
education
1935 Textbook

Problem 95
The construction of an insane asylum
requires 6 million RM. How many housing
units @ 15,000 RM could be built for the
amount spent on insane asylums?
Socialization


Posters depicting people with handicaps
Movies
Sterilizaton to “Euthanasia”

Binding and Hoche, 1920:
 The right to live must be earned.
 Destroying “lives not worth living”
would be humane.
 Elimination not a crime but
permissible and beneficial
Applied to



People with terminal illnesses
“Incurable lunatics”
Those who had sustained an illness or
injury and would awaken to a “nameless
misery”
Three phases of killing
 The
children’s “euthanasia”
program
 The T4 “euthanasia
program
 “Wild euthanasia”
The Children’s “euthanasia”
program
– 1945
 5,000 – 7,000 children killed
 1939
All children with the following
had to be reported:
 Idiocy
and Mongolism (particularly if
blindness or deafness were also present
 Microcephalie [sic]
 Hydrocephalus
 Deformities of every kind, in particular
the absence of limbs, spina bifida, etc.
 Paralysis including Little’s disease
(Spastics)
The midwife

Received a fee of 2 Reichsmark “in return
for her trouble”
3,000 – 5,000 children were
murdered
T-4 “Euthanasia” Program

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Grafeneck
Brandenburg
Hartheim

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Sonnenstein
Bernburg
Hadamar
T-4 “Euthanasia” Program

Began with this letter: 1 September 1939
Reichleiter Bouhler and
Dr. med Brandt
are charged with the responsibility to extend the
authorization of certain physicians designated by
name in order that patients who must be
considered incurable on the basis of human
judgment be granted the mercy death after a
critical evaluation of their illness.
Adolf Hitler
The plan
to kill 60,000 70,000

The victims of T-4

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Persons with developmental disabilities
Psychiatric patients
Epileptics
Persons with inherited diseases or
conditions
Persons with family histories of disease,
alcoholism, antisocial behaviors
Hadamar
14f13
T4 ended
 August
1941
 Killings had become public
knowledge
 Churches objected
 No objections from nursing
or medical organizations
70,273 adults were killed
in the T4 program
“Wild euthanasia”
Roles of nurses in the
“euthanasia” programs
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Reported newborns and children with
disabilities
Selected patients for killing
Accompanied the transports
Killed patients
Aktion Reinhard
Consequences for the nurses
Why did nurses participate?

Belief in National Socialism and its goals:
“I swear to Adolf Hitler, my Führer [leader],
unswerving loyalty and obedience. I
commit myself to every assignment that I
am placed in and to fulfill my task as a
National Socialistic nurse, loyal and
conscientious in the service for the people,
so help me God.”
Obedience
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To government
To administrators
To physicians
To superior ranking nurses
Lack of support

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From colleagues
From professional organizations
Duress?
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Some were sworn to secrecy.
Some were threatened verbally.
In over 50 years of post-war testimony, no
instance has been found of anyone being
shot, harmed, or sent to a concentration
camp for refusing.
Economics



Housing was tied to the job.
Jobs were hard to find.
Bonuses were paid for working in the
killing units.
In their words:
Helene W. (killed several hundred):
“I only did my duty, and I did everything on
the order of my superiors.

Luise E. (210)

“I would consider it a release if a physician
or a person acting on direction of a
physician would give me a dose releasing
me from my suffering…I didn’t do it with a
light heart but only after serious inner
fights I obeyed the orders.”
Anna G.: (150)

“I would never have committed a theft
because I know one isn’t allowed to.”
Martha W. (150):

“The only explanation I can give is that I
didn’t have enough time to think about it at
that time because the nurses were put
under a lot of stress.”
Erna D.:

“I can’t say why I didn’t refuse.”
Margarete T. (150):

“I saw the act of giving medicine, even in
order to kill mentally handicapped
persons, as an obligation I wasn’t allowed
to refuse. In case of refusal, I always
imagined my dismissal from the job of
nurse and civil servant, which is why I
didn’t refuse.”
Meta P.

“Among the nurses, there was strict
discipline and every subordinate nurse
was obliged to strictly execute the orders
of the superior.”
Edith B.:
 “I
didn’t see anything wrong
with it.”
Margarete Maria M.:

“If I had refused to execute her [another
nurse’s] orders, I would have been
dismissed. I could have quit the job, but at
that time I was obliged to support my
grandparents in Mesertiz.”
Gertrude F.:
 “I
was the youngest nurse
on our ward. Still today, I
haven’t completely become
aware of my wrongdoing.”
The killings of the
“euthanasia” programs led to
the murders in the
concentration camps.
Lessons for today:
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Remember the victims.
Be vigilant against marginalization.
Avoid generalizations about groups; i.e.,
the “mentally ill”, the “disabled”.
Consider the “slippery slope” of assisted
suicide and euthanasia.