T-4: Was "Life Unworthy of Life?"

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Life Unworthy of Life

Mat 18:6 But whoso shall offend one of these little ones which believe in me, it were bett er for him that a millstone were hanged about his neck, and [that] he were drowned in the depth of the sea.

Lebensunwertes Leben

Are there lives that are best extinguished for the good of society? That question has been debated since the beginning of time, and in various cultures and societies down through the ages some have since certain persons such as those with developmental delays [retardation], the mentally ill, the elderly, the infirm and 'misfits' as 'unworthy' of life or as causing a burden to society. Most societies have some form of death penalty for criminals, but have been far more clandestine in their treatment of innocents who they interpret as a burden.

Even before Hitler came into power, the Eugenics movement was burgeoning in Germany , Britain and the US. Eugenics looked at persons in the same way they looked at any other form of life, that the human race, like roses and cattle could be bred for superiority, and for many including Margaret Sanger and Davies in America, and in Germany, this was a positive goal. There was already talk of 'bloodlines' and racial and social characteristics or inclusions which hindered 'German Blood' from being all that it could be. While the Jews are the well-known victims of the shoah, the first victims of mass killings outside of P.O.W.s were the mentally infirm, including the developmental delayed, or retarded, and the mentally ill. Others targeted for institutionalization, either prison or hospitals, were alcoholics, chronic offenders, misfits, and even the chronically unemployed.

The Men Behind the Movement

Philip Bouhler and Karl Brandt

Bouhler born in Munich, September 02, 1899 and Karl Brandt, Hitler's personal physician, are credited with the foundation of the T-4 movement. Named after the address of the headquarters at Tiergarten 4, Bouhler, who had come up through the ranks and proved himself as a party loyalist went on to streamline the T-4 program into a mass extermination effort so effective against the mentally infirm that he would later with his cohorts be asked to do the same for the mass extermination of the Jews. Bouhler was once Business manager of the NSDAP and worked on the Volkische Beobachter and in June of 1922 was elected to the Reichstag representing Westphalia. In 1934 he was appointed Police President of Munich and Chief of the Chancellery of Nationalsozialistishe Deutsche Arbeiterpartei [National Socialist German Worker's Party], and headed the National Coordinating Agency for Therapeutic and Medical Establishments, the arm of Gleichschaltung or "The Coordination" for the mentioned Medical Professions and Institutions. In this role, Bouhler was able to coordinate processes of extermination in the facilities for the Mentally Retarded and Mentally Ill. As mentioned elsewhere, while the beginning of these efforts saw a was to carefully assess the 'fitness' of each patient by a qualified board with safeguards, but the process was soon facilitated into a rubber stamp for all cases within demographic/medical record criteria, and there was little recourse, even for parents or loved ones of the infirm. Bouhler is recorded as having personally visited some of the initial parents of victims of what became mass 'euthanasia' of the mentally infirm to edify their 'national identity' and purpose and confirm their enlistment in seeing the need for this effort of purifying German bloodlines. He committed suicide in May of 1945 after a career central to the Nazi Party in clarifying and developing the most efficient methods of genocide ever in warfare.

Dr. Karl Brandt was the Führer's Physician and played a role in the effort also. Brandt came to know the Fuhrer when he had been called to treat the Führer's niece in a car accident. Brandt had been in the Waffen SS as a Major General* , and was rather young when Hitler took office and began to rise in Hitler's administration. He was appointed to the position of Reich Commissioner for Health and Sanitation. He was the physician who held Dr. T. Morrell under suspicion for unnecessary shots and drug dosages to the Führer, although Hitler refused to heed his advice. Brandt was one of the few who began to have misgivings towards the end. On April 16, 1945, he left his family in Thuringia and surrendered to the Allies and was put on trial at the Doctor's Trial and sentenced to death by hanging.

Viktor Brack

Brack, 1904-1948, was appointed to the Chacellery where he was acquainted with Brandt and Bouhler. He had the rank of Colonel [Standartenführer] and later 'Reichleiter, a regional leader in the Nazi party. Among his accomplishments was the overseeing of Concentration Camp construction in Poland. Viktor Brack was with Brandt put on trial at the Doctor's Trial, and sentenced to death at Nuremberg. He died of death by hanging at Landesburg Prison on June 2, 1948. While most have heard of physicians charged with cruel medical experimentation in the camps, such as drug trials, hypothermia studies, typhus and bacterial disease experimentation and induction, jaundice and bone grafting experiments, gas trials including mustard gas experiments and eugenics studies, Brandt, Brack and others were charged with Mass Sterilization without cause in violation of basic civil liberties, sterilization by X-ray and medication, and deaths by injection and starvation.

Christian Wirth

Born in November 24, 1885 and dying on May 26, 1944 Christian Wirth came up through the ranks of Nazism and the SA. Described as a crass and blunt man, Wirth had been at Stuttgart where he was the head of the Kripo or Criminal Police. He later became a top aide to Globocnik with Aktion Reinhard, and is noted as having increased and developed the T4 Killing Programs. By 1941 with the end of most of the T4 deaths, Wirth was transferred to Chelmno where the methods he acquired during the 'Euthanasia' program were put to use killing prisoners in Chelmno, including monoxide poisonings and other gassing methods. He became Inspector of the Operation Reinhard camps. Wirth was so reknown for his brutality that at Chelmno he was tagged 'the Savage Christian', a reputation well deserved not only from the camps but from his days as an investigator known for using torture techniques to exact information. He was tranferred first to Italy where his killing tactics continued and then to Yugoslavia where he was killed by partisans.14, 15

Other Physicians

Other physicians also had central roles in the T-4 Nazi Euthanasia Program not only in the Chancellery but as heads of the hospitals for the 'feeble-minded', mentioned below. Several other physicians involved in the program include Dr. Karl Gebhardt, HImmler's personal physician, and Chief Surgeon to the Reich who was also for a time President of the German Red Cross Joachim Murugowsky, was a Berlin professor and Chief of Hygiene Institute of the University of Halle. He held the rank of colonel in the SS and worked in Medical Services in that capacity. Wikipedia notes:

Since 1930, Mrugowsky had been involved in the Nazi ideology, first being the group leader of a local National Socialist German Students' Association then the NSDAP party member (No. 210,049). In 1931, he joined the SS where he achieved the rank of colonel in both the General SS and the Waffen SS. In 1940, as the troop physician of an SS "Das Reich" Division hospital company, Mrugowsky participated in the conquest of the Western Europe. He was implicated in all medical experiments, with the exception of the aviation ones, which were conducted on concentration camp prisoners. He was prosecuted at the Nuremberg Medical Trial. Mrugowsky was condemned to death in August 1947, and executed on June 2, 1948.
Karl Genzken was an MD and the Chief of Medical Services and a Major General of the Waffen-SS and the Chief of the Medical Office of the Waffen-SS. He was instrumental also and later found guilty and sentenced to 20 years in prison for war crimes at Nuremberg. He went on from the T-4 Program as did so many of his cohorts to involvement in the medical experimentation in the Killing Centers Mennecke, also bears mentioning, as a physician who headed a transitional facility feeding into Hadamar, which was responsible for additional deaths including those of disabled children. The Center for Holocaust and Genocide Studies notes:

he became a physician and in 1939, he was appointed director of the Rheingau based "Nassauische" Landesheilanstalt Eichberg. From January 1941, this institution served as an interim facility "for the transfer of patients to the killing institution of Hadamar. From April 1941, the institution also held a so-called special branch for the killing of disabled children. It was also active in the killing of an unknown number of patients. Mennecke who since 1940 was an "expert" of "Operation T-4", also participated in the extermination procedures of "Operation 14f 13" and began, as of 1942, with the "selection" of concentration camp prisoners. At least 2,500 people fell victim to his "expert activ ity ". Sentenced to death in 1947, Mennecke died a short time after the judgement in the state prison of Butzbach.10

An excellent study of these physicians may be found in Robert Lifton's more detailed study, The Nazi Doctors: Medical Killing and the Psychology of Genocide

Drs. Heyde and Conti also figured prominently; Heyde a Nazi Party member and idealist supported the T4 Program's philosophical infusion into German life in his role. He worked at Cottbus, a mental hospital and at the University Hospital at Berlin-Wittennau, and upon meeting Eicke, became SS-Hauptsturmführer, and medical director with the SS Deathheaders. He preceded Nitsche as director of the T4 program. Heyde was a German psychiatrist, and was a consultant with the Gestapo, and later held a place at SS Headquarters. and from 1940 on, he was a Professor of Neurology and Psychiatry, and became director of the Mental Hospital. Escaping at the end of the war, he lived under an assumed identity, until revealed, and committed suicide before his trial in 1964. Leonardo Conti, a long term nazi loyalist, had many titles and positions including head of the Reichsërztekammer [Reich Physicians' Chamber, or Registry], Reich Health Leader, and Nazi Doctor's League. It was Brandt and Bouhler, Conti and Heyde who met to develop a systematic registry of patients in mental facilities for the purpose of euthanizing what Hitler and others referred to as 'feeders'. Hitler and others decried the injustice of German men of a 'higher order' losing their lives on battlefields while the mentally infirm took up space in hospitals at the state's expense [see above]. Part of their argument was bloodlines, part was economic as these mentally ill children and adults were seen as incurable and forever stressing tax-payers. As the systematic euthanization was developed, it began first by the Einsatzguüppen in the Wartheland in Poland, and before 1941 most of the hospitals became instead sites of mass graves. In October of 1939, Hitler had written an authorization to Bouhler and Brack to euthanize essentially without discrimination, and this policy carried through till the end: the deaths were not without value to the Nazis though as even experimentation with gassing and carbon monoxide poisonings went on in Posen, which later were developed into the systematic gassings in camps like Auschwitz, Belzec and Treblinka. Bouhler received directives from Hitler initially to keep the Chancellery and the Fuhrer out of the project's mention, but eventually, word got out as witnesses to events, e.g. at Hadamar, began to understand the enormity of what was being done and public outcry followed. The T4 Program was notably one of the only programs of the Reich against which massive protest arose, and which though many deaths were accomplished before the end, the protest had the effect of bring the project to an end.11

The Hospitals and Sanitoriums

Hadamar Institute, near Wiesbaden in Hessen-Nassau

Originally a prison, the Hadamar Institute became a State mental hospital in 1906 closing by 1939 to serve as a military hospital. By 1940, headed by Dr. Erst Baumgard, it became a Euthanasia center with the T-4 program, in which 10,000 were gassed or killed by lethal injection before the end of the war. To disguise the exterminations, by 1941, it was again converted to hospital beds, only to reopen in 1942 for the purpose of further euthanasia. At the end of the war, it was converted to a displaced persons institution for the ill, the elderly and others. The head nurse was Irmgard Huber.1


Headed by Irmfried Eberl, an Austrian doctor,2 who later went on to direct Treblinka as well as various staff who became instrumental in Aktion Reinhold. Death Camps.org lists the following persons as former members of Brandenburg's staff:Rudolf B-r, Kurt Bolender, Kurt D., Werner Dubois, Irmfried Eberl, Kurt Franz *, Erich Fuchs, August Hengst, Willy M-tzig, Josef Oberhauser, Karl Putzinger, Friedrich Tauscher, Max Biala and Christian Wirth. Opened in the late 1700s as a paupers' house, it later became a prison closing in 1931 for prisoners and being transformed by the Nazis into a lager with police barracks. From 1933 on some euthanasia was taking place, but in 1940, one of the first mass gassings of mental 'defectives' was conducted in the presence of Himmler and other high level officials by Wirth. Brandenburg is reponnsible for over 9000 deaths, using mostly carbon monoxide poisoning. Victims were brought in by bus, disrobed, and led to a shower room for gassing. In 1940, in addition to two krema, bodies were cremated at the disguised Paterdam Street Chemical-Technical Research Center. The last killing took place in August of 1940. 5


Established in 1929 as a home for physically and mentally disabled children and adults, the Castle Grafeneck near Marbach was headed by Dr. Horst Schumann. In 1939 it was perused for the site of a major T4 center by the Chancellery in May of 1939 and by October, the center had been converted into a Killing Center, with Christian Wirth assuming the position of Chief of Administration. Not only those interred at Grafeneck were killed in the Aktion, but those registered with the criteria of mental infirmity by the Reich were identified and bussed to Grafeneck for the so-called "euthanasia." By December of 1940, essentially all those in the designated area around Grafeneck had been killed and the project ceased. Kurt Franz and Christian Wirth along with a number of others went on from this institution to become key figures in Aktion Reinhard: the central Machine for the Final Solution or "endlosung". An estimated 10,824 were killed there, and only 8 went on trial in 1949 in a war crimes trial in Tubingen, the site of the University and School of Theology from which emanated the new theology making Nazism 'theologically acceptable'.12


Hartheim Castle, which later became part of the Mauthausen System was used originally as a hospital for the mentally ill and infirm. Earning its name from the converted castle it occupied, Hartheim was reknown for carrying out the euthanasia of the T-4 Program, but later was used for processing and killing inmates from Mauthausen, Melk and Ebensee. The notorious method of telling prisoners they were going to have a photograph taken and then shooting them in the head from a gun within the camera, occurred in this hospital. Bythe time shoah victims were killed here, most of the mentally retarded and mentally ill had either been killed or removed.


Schloss Sonnenstein was a hospital for the mentally ill from about 1811, one of the more long term care facilities in Germany. Designed initially as mere incarceration, it became later one of the first to provide therapeutic regimens. As many of the mental hospitals in 1939 it was closed and used for other purposes in the war effort, a portion was reserved as "Mariaheim" still used for the mentally ill. Headed by Dr. Nitsche, and Schumann from Grafeneck, the killings began in 1940 after the formal closing. In 1941 in July, before massive gassing deaths at Auschwitz and other camps, one attendant reported 190 deaths by gassing 11

It is estimated that about 15000 deaths from the T4 Program and a corollary program occurred there before the killings ceased, some as young as 15 or 16. Staff members who witnessed the events were told to falsify medical records as to cause of death.

The staff consisted of about 100 persons. One Third of them were ordered to the extermination camps in occupied Poland, because of their experiences in deception, killing, gassing and burning innocent people.6
Nitsche and two male nurses were among those tried at the Doctor's trial in Dresden, and sentenced to death for their roles in the mass killings. Fifty-three Sonnestein staff became key figures in Aktion Reinhard including Karl Richter, Kurt Blaurock and Kurt Seidel. Having learned systematized killing in the early T-4 institutions, these and men from other institutions developed methodologies for the killings in Operation Reinhard, and made possible the massive numbers of deaths with relative ease.7

The Economics of Caring for the Helpless

One of the most significant pushes Hitler and his men had for instituting the T-4 Program was not just a Eugenics or 'bloodlines' argument, but that the burden on the government of Germany financially was too great for German 'citizens' deemed unworthy of life, who in the estimation of Hitler were 'feeders' who never gave back to the state in ways such as paying taxes, voting or contributing to society. Based upon the Binder's early writing8, they developed a secondary argument, that life 'unworthy' of life which could be terminated by the State with proper consideration [which initially meant the three physician unanimous vote for each case to determine 'fitness', and later degenerated into a generic command for forced euthanasias without even the family's involvement] was also a drain on Federal finances for those determined not to be a 'valuable' life. Forced sterilizations were put in place also to reduce the mentally 'infirm' from reproducing since it was the view of the Reich that they would produce others deemed 'imbecilic', requiring State support. Posters, media reports and meetings were held to educate the public on the necessity of the program.

The argument followed basically along the lines of the cost per internee over the span of a lifetime, versus the cost of a 'mercy killing', although the mercy was entirely to the State. At first, most were appalled, but due to the severe economic positions of the time, and the older prejudices towards the mentally retarded, in time German society began at least to discuss the issue, not unlike we discuss Kevorkian and 'assisted suicides' today. A great percentage of German parents of mentally retarded children and adults kept their children in sanitoriums as was the method of the time. Most of the institutions, even those which were church-run, had government sponsorship as well, because of the unusually close Church-State ties.

The T-4 Experiments

In addition to the killings falsely described as 'mercy killings', the physicians in the hospitals conducted experiments just as did the physicians in the Concentration Camps. One of the most brutal types of 'experiments' was on starvation: physicians at Hartheim for example were interested in how to starve patients to death effectively. This had a two fold purpose, for it both yielded the sought for information, and also provided a death which could be more easily accounted for medically. Formidably though, it was gassing experimentation which lead to systematic and streamlined approaches to the killings of the deported Jews of Europe and others, which were first tried out in the hospitals during the course of T4: monoxide gassings were first tried out by hooking the exhaust of trucks up to holes in sealed rooms where patients were led. Those in charge of T4 though found these deaths too cumbersome, and found that it necessitated corpse removal which was labor intensive, so other sites were experimented with as were better gases and noxious substances. The beginning of disease research began there also, although it was not eminent until the camps: the methods used though in starvation and gassings took hold and were refined and used extensively later. Gassings at their height could kill the most people with the least manpower and loss of morale, and found thier apex at Auschwitz and Chelmno and other camps with the introduction of Zyklon-B, a pesticide/rodent killer which when released created a cyanide like gas. The starvation experiments and procedures likewise found their place in consistent Nazi usage with those deemed terminal or useless later in the camps. An example of this was in such camps as Mittelbau Dora where Nordhausen was used to discard the sick and dying, leaving them without treatment or food both to effectively kill and lessen the cost of care, and hide the cause of deaths. Many camps such as Melk-Mauthausen and others had 'sick camps' where patients determined not to be recoverable were left to starve and die, a remnant of the T4 procedures.

Bishop Galen and the Outcry Against T-4

During WWII, the Catholic Church had far more latitude than other denominations partly because many of the higher echelon of the Nazis had been raised Catholic or still were, and because at least half or more of the Catholic Clergy supported the new regime, which had initial but then wavering favor with the Vatican. The Wehrmacht saw many Catholic young men joining the ranks, in a 'God and Country' spirit during the early years as well. A few persons though, noted throughout that time, that the new Regime was not in accord with basic Christian and Catholic principles, and Catholic leaders such as Preysing, the Bishop of Berlin and Galen, stood against Nazi Racial Policies from the beginning, while others such as Faulhaber from Munich, supported and even hosted gala birthday parties for Hitler.

Catholic Clergy who opposed Hitler's policies often risked their lives as did those from other Christian denominations and some were imprisoned and killed. Notably, Galen, early wrote in vehement opposition to the policies of the T-4 Program in the massive State Killing of Innocents. It was one of his homilies which Sophie and Hans Scholl and the White Rose printed into pamphlets, distributing them at the University of Munich. The pamphlet called for the immediate end to the killings, leaning on traditional and contemporary Catholic doctrine. It was among the literature for which the Scholls and other members of the White Rose were tried, convicted and guillotined.

Galen's Sermon

Could it Happen Today?: Eugenics, Ethics and Extremities

While the T-4 program ended formally in 1941, many killings continued until after the war in 1945. The T-4 Program, and other Eugenics efforts, including modern 'euthanasia' movements and Planned Parenthood facilitated the way for the acceptance of similar programs in Europe, the US and the Orient. Indeed, recently in 2005, the case of Terri Schaivo brought many of the same issues to light, as in the press, the quality of life, economic considerations in sustaining life for those declared in PVS, and other critical issues of the value of life came forward as we watched for weeks as Ms. Schaivo was starved and dehydrated as a method of medical treatment.

Outside Links

References & Books

1United States Holocaust Memorial Museum Archives: T-4 Program.
1aUSHMM Archives: Hadamar
2Museum of Maddening Beauty: [http://www.psychiatrie-erfahrene. de/eigensinn/english.htm]
3The T-4 Program: Social Action Department: -www.segretariatosociale.rai.it/INGLESE/atelier
/altriluoghi/memorie/altriluoghi_T4.html 4http://www.chgs.umn.edu/Histories__Narratives__Documen/Hadamar
/The_Occurrence/ euthanasia_-_page_2/euthanasia_-_page_2.html
5Death Camps.org: Brandenburg; http://www.deathcamps.org/euthanasia/brandenburg.html
6Sonnenstein Clinic: History and Description: [http://sonnenstein-clinic.iqnaut.net/]
7Lifton, R. Doctors: Medical Killing and the Psychology of Genocide (Paperback) Basic Books; 1986.

Recommended Reading:

7Sonnenstein: Deathcamps.org
  • 8Binder, ... "Lebenunwerte Leben" TITLE.....[1921?]
  • 9Ernst Klee Euthanasie im NS-Staat - Die Vernichtung lebensunwerten Lebens
  • 10 Dr. Frederich Mennecke :Euthanasia Crimes in Hadamar.
  • 11Sonnestein Holocaust Research Project; http://www.holocaustresearchproject.org/euthan/sonnenstein.html

    http://www.chgs.umn.edu/Histories__Narratives__Documen/Hadamar/ The_Occurrence/euthanasia_-_page_2/euthanasia_-_page_2.html

  • 12 Action T4: Wikipedia.com
    T4: Euthanasia Program: Wikipedia.com
  • 13Grafeneck: Death Camps.org

  • 14Christian Wirth: Wikipedia.com
  • 15Christian Wirth: History Learning Site: http://www.historylearningsite.co.uk/christian_wirth.htm Photo Credits: Original of colorized T4 Baby above from Credit: USHMM, courtesy of National Archives and Records Administration, College Park Copyright: Public Domain;Date: May 1945 Locale: Kaufbeuren, Germany:Close-up of Richard Jenne, the last child killed by the head nurse at the Kaufbeuren-Irsee euthanasia facility. [Photograph #78606]

    Poster: T4 Poster from WWII Germany, argues that the Mentally Infirm are a burden to society.