Nazi Euthanasia Program

Since ancient times, when sickly children were left outside to die from exposure, euthanasia has been practiced, debated or condemned by various societies. In the late 19th and early 20th centuries the debate over euthanasia took a new turn when it gained popularity among some doctors and lawyers. These advocates proposed that medicine play a role in offering "dying help: to the suffering. Proponents of such an ethic unwittingly laid the philosophical groundwork for the massive euthanasia program that would take place in the late 1930s and early 1940s in Germany.

Although much of the same language and many of the same ideas used by early euthanasia advocates have regained popularity today, contemporary "right to die" activists shun any comparisons to Nazi Germany. Derek Humphry, author of Final Exit, maintains that the Nazi era is too "singular and unusual" to merit comparisons. Such statements fail to take into account the decades leading up to Nazi Germany or the emotional arguments and propaganda that were used to justify the euthanasia program.

Works such as Jost's Das Recht auf den Tod (The Right to Death) and Binding and Hoche's Die Freigabe der Vernichtung Lebensunwerten Lebens (The Permission to Destroy Life Unworthy of Life) greatly influenced the German medical profession of the 1920s and 30s. In his book, The Nazi Doctors, historian Robert Lifton describes the latter work as "crucial" in creating acceptance among medical professionals for euthanasia and physician-assisted suicide. Published 13 years before Hitler took power, The Permission to Destroy Life Unworthy of Life proposed that "sterbehilfe," the German word for "dying help," be offered to the "incurably ill" and "lives in a condition of total helplessness, requiring care by another."

Professor Binding was one of Germany's leading experts in constitutional law and criminal jurisprudence. Dr. Hoche was a well-respected psychiatrist. The book explicitly stated the "sterbehilfe" must be voluntary. But the line between voluntary and involuntary quickly blurred in Hitler's Germany.

Arguments by early opponents of euthanasia mirror the arguments of euthanasia opponents today. Dr. M. Beer wrote in his 1914 book, Ein Schoner Tod: Ein Wort zur Euthanasiefrage (A Beautiful Death: A Word About the Question of Euthanasia):

"Once respect for the sanctity of human life has been diminished by introducing voluntary mercy-killing for the mentally healthy incurably ill...who is going to ensure that matters stop there?"

The pro-euthanasia movement of that time was not limited to Germany. As Robert Proctor documents in Racial Hygiene: Medicine Under the Nazis, support for legalized euthanasia was building throughout Europe and the United States. In 1935, a number of British physicians formed the Voluntary Euthanasia Legalization Society, headed by the president of the Royal College of Surgeons. That same year, French-American Nobel Prize winner Alex Carrel suggested in his book Man the Unknown that the criminally insane should be "humanely and economically disposed of in small euthanasia institutions supplied with proper gas." W.G. Lennox, in a speech at Harvard University, advocated "the privilege of death for the congenitally mindless and for the incurable sick who wish to die." A 1937 Gallup poll found that 45 percent of Americans favored euthanasia for "defective infants." In fact, Nazi physicians cited American support for euthanasia in their defense at Nuremberg. American support for euthanasia sharply declined after the war.

Nazi propaganda films portrayed euthanasia as a loving and compassionate act. In the Nazi propaganda film, "I Accuse! (Ich klage an!)", a woman with multiple sclerosis asks her husband who is a doctor to permanently relieve her of her suffering. He agrees to give her a lethal injection of morphine while his friend (who is also a doctor) plays tranquil music on the piano. At his trial he argues that he committed an act of mercy, not murder. He is acquitted.

The situation depicted in "I Accuse!" is almost identical to Dr. Jack Kevorkian's murder of a woman with multiple sclerosis by lethal injection only a few years ago. Like the character in the film, Kevorkian's attorney used emotional arguments to sway the jury, and Kevorkian was acquitted. The only difference is that Kevorkian did not play music for his victim.

"I Accuse!" and similar propaganda films greatly influenced German public opinion. It is not surprising, then, that the first phase of the Nazi euthanasia program (titled Operation T4) actually began with parental requests for the "merciful deaths" of their severely disabled or ill children.

The Third Reich soon set up a commission to establish criteria for euthanasia candidates. Those who qualified included children under the age of three suffering from "idiocy and mongolism (Down syndrome), microcephaly, hydrocephaly, malformations and paralysis." The child program eventually led to the adult euthanasia program and Hitler's edict that "Reichsleiter Bouhler and Dr. Brandt are hereby commissioned to allow certain specified doctors to grant a mercy death to patients judged incurably sick, by critical medical examination."

Operation T4 excluded Jews. Third Reich officials believed that the Jews did not deserve the "benefit" of euthanasia. It was considered too compassionate and humane.

In fact, Nazi doctors justified the euthanasia program on grounds of compassion when defending themselves at Nuremberg. The words of Dr. Karl Brandt, who headed the program, sound strikingly contemporary:

"Do you think that it was a pleasure for me to receive the order to permit euthanasia?...It is a pity for the incurable, literally. Here I cannot believe like a clergyman or think as a jurist. I am a doctor and I see the law of nature as being the law of reason."

This same "law of reason" is at work today in the Netherlands, where euthanasia and physician-assisted suicide are both legal and common. The Dutch government's own research has documented that in more than 1,000 cases a year physicians actively cause or hasten death without the patient's permission.

IN an effort to ensure that the Nazi euthanasia program was carried out in a painless manner, Nazi medical staff at hospitals such as Hadamar originally killed patients by lethal injection. They eventually switched to carbon-monoxide gassing, however, as the program expanded. In the end, more than 75,000 "patients" were killed under Operation T4.

When Operation T4 switched over to gassing, Nazi officials made what they considered a useful discovery - gassing was an efficient form of extermination. After the euthanasia program was officially suspended in 1941 (although lethal injections continued throughout the war), the gassing equipment at Hadamar and other hospitals was dismantled and transported to Treblinka, Auschwitz and other death camps in preparation for the Final Solution.

Elise Ehrhard
Reprinted from The American Feminist, Summer 1999

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Last revised August 21, 1999