Action T4 - Killing of Adults

Killing of Adults

Brandt and Bouhler soon developed plans to expand the programme to adults. In July 1939, they held a meeting attended by Dr. Leonardo Conti, Reich Health Leader and state secretary for health in the Interior Ministry, and Professor Werner Heyde, head of the SS medical department. This meeting had made preliminary arrangements for a national register of all institutionalised people with mental illnesses or physical disabilities.

The first adults with disabilities to be killed by the Nazi regime, however, were not Germans, but Poles, as the SS men of Einsatzkommando 16 cleared the hospitals and mental asylums of the Wartheland, a region of western Poland which was earmarked for incorporation into Germany and resettlement by ethnic Germans following the German conquest of Poland. In the Danzig (now Gdańsk) area, some 7,000 Polish inmates of various institutions were shot, while 10,000 were killed in the Gdynia area. Similar measures were taken in other areas of Poland destined for incorporation into Germany. At Posen (occupied Poznań), hundreds of patients were killed by means of carbon monoxide gas in an improvised gas chamber developed by Dr Albert Widmann, chief chemist of the German Criminal Police (Kripo). In December 1939, the SS head, Heinrich Himmler, witnessed one of these gassings, ensuring that this invention would later be put to much wider uses.

The idea of killing "useless" mental patients soon spread from occupied Poland to adjoining areas of Germany itself, probably because Nazi Party and SS officers in these areas were most familiar with what was happening in Poland. These were also the areas where Germans wounded from the Polish campaign were expected to be accommodated, creating a demand for hospital space. The Gauleiter of Pomerania, Franz Schwede-Coburg, dispatched 1,400 patients from five Pomeranian hospitals to Poland, where they were shot. The Gauleiter of East Prussia, Erich Koch, likewise had 1,600 patients killed. In all, more than 8,000 Germans were killed in this initial wave of killings. These were carried out on the initiative of local officials, although Himmler certainly knew and approved of them.

The programme for killing adults with mental or physical disabilities began with a letter from Hitler issued in October 1939. The letter charged Bouhler and Brandt with "enlarging the authority of certain physicians, to be designated by name, in such a manner that persons who, according to human judgement, are incurable, can, upon a most careful diagnosis of their condition of sickness, be accorded a mercy death." The letter was backdated to 1 September to provide legality to the killings already carried out, and to link the programme more definitely to the war, giving it a rationale of wartime necessity. This letter, which provided the sole legal basis for the programme, was not a formal "Führer decree", which in Nazi Germany had the force of law. For this reason Hitler deliberately bypassed Health Minister Conti and his department, who were held to be not sufficiently imbued with National Socialist ruthlessness and who might have raised awkward questions about the legality of the programme, and entrusted it to his personal agents Bouhler and Brandt.

The programme was administered by Brack's staff from Tiergartenstraße 4, under the guise of the Charitable Foundation for Cure and Institutional Care, supervised by Bouhler and Brandt. Others closely involved included Dr Herbert Linden, who had been heavily involved in the children's programme, Dr Ernst-Robert Grawitz, chief physician of the SS, and August Becker, an SS chemist. These officials chose the doctors who were to carry out the operational part of the programme. They were chosen for their political reliability, professional reputation, and known sympathy for radical eugenics. They included several who had proved their worth in the child-killing programme, such as Unger, Heinze, and Hermann Pfannmüller. The new recruits were mostly psychiatrists, notably Professor Carl Schneider of Heidelberg, Professor Max de Crinis of Berlin and Professor Paul Nitsche from the Sonnenstein state institution. Heyde became the operational leader of the programme, succeeded later by Nitsche.

In early October all hospitals, nursing homes, old-age homes, sanatoria were required to report all patients who had been institutionalised for five years or more, who had been committed as "criminally insane", who were of "non-Aryan race", or who had been diagnosed with any of a list of specified conditions. These included schizophrenia, epilepsy, Huntington's chorea, advanced syphilis, senile dementia, paralysis, encephalitis and "terminal neurological conditions generally". Many doctors and administrators assumed that the purpose of the reports was to identify inmates who were capable of being drafted for "labour service". They therefore tended to overstate the degree of incapacity of their patients, to protect them from labour conscription — with fatal consequences. When some institutions refused to co-operate, teams of T4 doctors (or in some cases Nazi medical students) visited them and compiled their own lists, sometimes in a very haphazard and ideologically motivated way. At the same time, all Jewish patients were removed from institutions and were killed during 1940.

As with the child inmates, the adults had their cases assessed by a panel of experts, working at the Tiergartenstraße offices. The experts were required to make their judgments solely on the basis of the reports, rather than on detailed medical histories, let alone examinations. Sometimes they dealt with hundreds of reports at a time. On each they marked a + (meaning death), a - (meaning life), or occasionally a ? meaning that they were unable to decide. Three "death" verdicts condemned the person concerned. As with the children, over time these processes became less rigorous, the range of conditions considered unsustainable grew broader, and zealous Nazis further down the chain of command increasingly made decisions on their own initiative.