Euthanasia in Nazi Germany - The T4 Programme

The ideological ground for the Nazi euthanasia programme had been thoroughly prepared years before, with the acceptance that some lives were not worthy of living.

Karl Binding, a law professor and Alfred Hoche, a doctor, published their seminal work: "Permission to Destroy Life Unworthy of Life".

Two cultural factors, social Darwinism and eugenics, ensured that the book had immediate influence in the medical establishment and the social sciences.

The benefits for German society was racial purity, and re-directing medical resources and funds to those "worthy" of support.

Propaganda and a compliant media were used to persuade Germans that euthanasia was a humane social policy.

Mentally ill and disabled "subhumans" in a series of powerful and popular films, were used to reinforce the message.

Link to the United States Holocaust Memorial Museum

The German experiment with euthanasia provides salutary lessons for the debate in the early 21st century.

During the Nazi's T-4 programme, an estimated 250,000-350,000 Germans were put to death. It is not commonly known that the gas chamber technology used by the Nazi's in 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.