Adult Euthanasia programs of Nazi Germany

In 1939, Hitler issued an order to expand the euthanasia program to "the worthless lives of seriously ill mental patients" which would "result in certain savings in terms of hospitals, doctors and nursing staff" (Friedlander, 1995, p. 63). In order to do this, the Reich Committee was expanded from the original three members to include a number of academics and asylum directors. The organization went by the name "Aktion T-4", named after the location of the offices, Tiergartenstrasse 4 in Charlottenburg [a district of Berlin].

In July 1939, these men were told that a number of psychiatric patients had to be killed to make hospital space for war casuals and to free up nursing staff (Burleigh, 1994, p. 119). Six killing centers were set up in existing psychiatric hospitals - Grafeneck, Brandenburg, Hartheim, Sonnenstein, Bernburg, and Hadamar (Office of US Chief of Council for the Prosecution of Axis Criminality, Document Number 630-PS, 17 September 1945).

In 1941, Hadamar "celebrated the cremation of its ten-thousandth patient in a special ceremony, where everyone in attendance - secretaries, nurses, and psychiatrists - received a bottle of beer for the occasion" (Proctor, 1992, p. 25). Although the children were killed with injections or starvation, these methods were not efficient for the large number of adults at the killing centers. In these locations, gas was used. Patients were transported by bus from local and regional hospitals to the killing centers. "At the killing center, the arriving patients were met by the staff and led to the reception room by a male or female nurse, who might have accompanied them on their trip" (Friedlander, 1995, p. 94). Patients were examined individually by a physician, photographed, and measured. They were then taken to gas chambers which were disguised as shower rooms. "The patients were already prepared for the showers because, while they were undressing, the nurses had told them that they would be bathed" (Friedlander, 1995, p. 95). "Most patients accepted the nurses' explanation that they were going to the showers..." (Friedlander, 1995, p. 96). "On rare occasions, nurses might even have to remove bodies from the gas chamber, a job usually reserved for unskilled laborers" (Friedlander, 1995, p. 101).

By 1941, more than 70,000 patients from German mental hospitals had been killed (US National Archives and Records, Record Group 338, Microfilm Publication T-1021, Roll 18, Frame 98). Later the killing centers were used for the killing of selected concentration camp prisoners in the "Special Treatment 14f13" euthanasia program (Office of Chief Counsel for War Crimes, Document Number 3354).

After almost fifty years of postwar proceedings, proof has not been provided in a single case that someone who refused to participate in killing operations was shot, incarcerated, or penalized in any way, except perhaps through transfer to the front which was, after all, the destiny of most German soldiers. But it is possible that putative duress did apply, that is, these young, impressionable nurses might have believed that the intimidating Christian Wirth [ the supervisor at Hartheim hospital] would place them in a concentration camp" (Friedlander, 1995, p. 235-236).

The following reasons for not refusing to participate were provided by the nurses of Meseritz-Obrawalde hospital:

Helene Wieczorek [accused of killing 'several hundred' patients]: Director Grabowski told us we had to help the senior nurses - it was too much for them. We also would have to give the injections. First I refused and he said that there was no point in it because, being a civil servant of many years standing, I would perform my duty, especially in times of war. He added, it would be a law that the incurable mentally ill persons were to be released from their suffering. (...) I only did my duty and I did everything on order of my superiors. The Director Grabowski always warned us of the Gestapo. He said he would inform the Gestapo if we didn't do what he ordered (Ebbinghaus, 1987, p. 219).

Luise Erdmann. [the main defendant of the trial, accused of participating in the killing of 210 patients]: Through the behavior of Dr. Wernicke I realized that incurable patients were to be released by giving them Veronal [barbituric acid] or another medicine. I also declare that I, neither by Dr. Wernicke nor any other person at the home, have been informed about the euthanasia. I wasn't sworn to secrecy in this respect... I was of the opinion that one took it for granted or believed that I would approve of euthanasia. My attitude to euthanasia was, should I become incurably ill - I don't make a difference between mental or physical illness - I would consider it as a release if a physician or, on direction of a physician, another person would give me a dose releasing me from everything. Despite my attitude to euthanasia, I have - when confronted with the problem - fought out serious inner conflicts. Euthanasia, in the form I experienced it at that time, after all was a killing of people and I asked myself if a legislator had the right at all to order or permit the killing of people. Never, however, did I hear about a corresponding law on the use of euthanasia but, on the other hand, Dr. Mootz explained to me once that there was no need for reservation as, should the situation arise, he would cover up for me. From this statement I concluded that there had to be a legality for euthanasia (Ebbinghaus, 1987, p. 232).

In my first questioning I expressed that, for me, there were justified and unjustified cases of euthanasia. In my opinion, I described so clearly what I understand by justified and unjustified cases during my first questioning, that I don't need to give an additional explanation in this matter. A refusal in those cases which I regarded as justified would have been illogical so I don't have to give further explanation of this.

It was different with the cases where I didn't regard the killing as necessary or appropriate. When I did participate in those killings and thus acted against my inner attitude and conviction, this happened because I was used to obey strictly the orders of the physicians. I was brought up and instructed to do so. As a nurse or orderly, you don't have the level of education of a physician and thus one can't evaluate if the order of the physician is right. The permanent process of obeying the order of a physician becomes second nature to the extent that one's own thinking is switched off. (...) (Ebbinghaus, 1987, p. 234).

I was and still am without interruption of the Protestant faith. I must say that basically I describe the whole Protestant faith also as my faith. I would like to express by this that the commandment "Du sollst nicht toten" (Thou Shall Not Kill) is truth for me. When I did the killings, I must admit that I offended this commandment. But as I expressed in my questioning, I didn't do it with a light heart but only after serious inner fights I obeyed the orders. ... I had to consider that one physician who, after all, also is only a human being, could make mistakes in diagnosis or prognosis. I realized that I offended seriously the divine and moral law by participating in the killings. I would only moderate my guilt by trusting strictly that the physician didn't make a mistake. But as I couldn't completely exclude a mistake, I prayed to my God to forgive me in such a case. In addition, I have to suppose that the ill people selected to be killed by the physicians were such seriously ill people that even in case of a mistake I had to see it as a release for them.

I estimate it important to say that the attitude of people to life and death depends on the situation. I spent my whole life in nursing and experienced more than usual the living and dying of people. I'll not express by this that by experiencing it I became harder, but only that my attitude and position to these human problems was a different one. I was aware of the fact that a person was killed but I didn't see it as a murder but as a release (Ebbinghaus, 1987, p. 236).

Anna G. [accused of participating in the killing of 150 patients]: It is true that I was brought up as a Christian and that for my whole life I was convinced of the Christian faith. On the other hand, during my work, especially on the ward for the insane, I have seen such horrible misery and have seen all of the different sicknesses until the terminal stage. In view of these experiences, I have seen it as an act of mercy and a release when the killings were done.... I herewith declare that I have never been forced by anybody to participate.... I would never have committed a bank robbery or other theft because that is just not done. In addition, theft wouldn't have belonged to my tasks. I would never have committed a theft because I know one isn't allowed to do it (Ebbinghaus, 1987, p. 236).

Martha W. [accused of participating in the killing of 150 patients]: I've always disapproved of euthanasia. In the course of my work as a nurse, I could see that a lot of patients were sent to the mental institution who before had been very estimable people. It was a big injustice for me to kill those people because of their illness. When I'm reproached for the fact that I was brought up as a Catholic and the commandments also represent my convictions, this is correct. Until today, it is my conviction that people are not allowed to interfere. Nevertheless, I participated in the killings and I recognize that I acted against the commandments and my conviction and have burdened my conscience seriously. 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 (Ebbinghaus, 1987, p. 240).

Erna D.: Please believe me, that I didn't do it readily because I really detested it. I repeat, I didn't do it readily. In fact, I can't say why I didn't refuse (Ebbinghaus, 1987, p. 243).

Margarete T. [accused of killing 150 patients]: I was brought up as a Christian and still today I'm a very religious person and, as far as possible, I attend the service regularly. For this reason, when the killings began at Ward U1, I felt deeply guilty and still do today. (...) Due to the many years of working as a nurse, practically from since I was young, I was educated to strict obedience, and discipline and obedience were the supreme rules among the nurses. We all, including me, took the orders of the physicians, head nurses, and ward nurses as orders to be strictly obeyed to and didn't or couldn't form our own opinion about the legality of these orders. (...) I was a civil servant at that time and, on one hand, I was sworn to secrecy and, on the other hand, I was obliged to obey given orders. I think at that time, I've always lived in conflict with my own opinion and the fact that I was a civil servant. On the one hand I saw the killing of people, even though it was incurable mentally handicapped people who exclusively were accommodated on Ward U1 as a big injustice and often asked myself why it was done. On the other hand, I was a civil servant and obliged to do my work and didn't see a possibility of getting around the orders. (...) You ask me if I had also committed a theft on order, I say that I wouldn't have done it. I saw, however, 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 (Ebbinghaus, 1987, p. 244).

Meta P. [when asked why she became implicated in the killing of patients]: Among the nurses there was strict discipline and every subordinate nurse was obliged to strictly execute the orders of the superior (Ebbinghaus, 1987, p. 244).

Berta H. [accused of participating in the killing of 35 patients]: In other words, at that time I thought, I wouldn't be guilty if I didn't do the actual killings. To my own conscience, I always felt a little bit guilty and I tried to cope with it as far as possible to forget everything (Ebbinghaus, 1987, p. 244).

Martha Elisabeth G. [accused of killing 28 patients]: Certainly I felt guilty about it at that time and, although I didn't do any killings by myself, I did help and I had a certain felling of guilt. I'm only an ordinary nurse,...and never realized that, legally speaking, I had become implicated in the killings. When I had to assist in the killings, I acted under duress and never with the intention to kill a person. (...) At that time, nobody would have helped us at Obrawalde if we had refused to do the work and there wasn't anybody to pour out one's heart to and who we could trust. As a sort of slaves we were completely at the mercy of the rulers and their political line (Ebbinghaus, 1987, p. 245).

Edith B.: Although I knew, respectively assumed from hearsay, that at Ward U2 (...) killings were done and the patients I moved to that ward possibly were condemned women, I didn't see anything wrong with it (Ebbinghaus, 1987, p. 245).

Margarete Maria M. [accused of killing three patients]: 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 Meseritz (Ebbinghaus, 1987, p. 245).

Gertrude F. [accused of killing five patients]: When I did it by preparing the medicine, I did it without any knowledge of legal consequences. The preparation of medicine in order to give it to the patient actually was one of my duties which was one of the reasons why I didn't realize that I did something wrong. I wasn't able to see a direct connection between my work and the killings. In addition you have to consider that I had worked in a mental institution for years and that the nurses were obliged to strictly obey their superiors, the senior nurses, the physicians and, last but not least, the director of the institution. In addition, I was the youngest nurse at our ward. Still today, I haven't completely become aware of my wrongdoing (Ebbinghaus, 1987, p. 245).

Erna Elfriede E. [accused of participating in the killing of 200 patients]: They didn't make me swear on a secret matter of the Reich and I wasn't sworn to silence. (...) I considered the killings as injustice. Something like that was not supposed to happen, because nobody was allowed to order it. I was brought up quite as a Christian. I already learned as a child what one may and mustn't do. I learned that one mustn't steal and mustn't kill. [When asked why she didn't refuse to participate in the killings] Because I was ordered to do it. When I am asked again, why I didn't refuse, although I realized that it was an injustice, I can't give an answer to this question. I do and did in the past have a strong feeling of guilt but it is impossible for me to give a reason for the fact that I didn't refuse. It simply was ordered and I had to execute the orders (Ebbinghaus, 1987, p. 246).

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