[Pages 53-86]

Whatever proportions these crimes finally assumed, it became evident to all who investigated them that they had started from small beginnings. The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as 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. But it is important to realize that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude toward the non-rehabilitable sick. – Leo Alexander[276] Jews do not transform themselves into Germans by writing books on Goethe – Fritz Lenz[277]

In Germany the term “Race Hygiene” was in use long before the label of “eugenics” became common, and the German Society for Race Hygiene (Deutsche Gesellschaft für Rassenhygiene) was to eventually represent all eugenicists. In 1931, two years before Hitler's assumption of power, Fritz Lenz, in his capacity of professor of race hygiene at the University of Munich, declared: “Hitler is the first politician with truly wide influence who has recognized that the central mission of all politics is race hygiene and who will actively support this mission.”^[2787] And support it he did, for example in a speech to the National Socialist Physicians League in which he announced that he could manage without lawyers, engineers, and builders, but “you, you National Socialist doctors, I cannot do without you for a single day, not a single hour. If not for you, if you fail me, then all is lost. For what good are our struggles, if the health of our people is in danger?”^[279] It was a typically melodramatic pronouncement, and Hitler was preaching to the converted, but it doubtless had the intended impact on his audience, filling them with an enhanced sense of their self-importance. Hitler was not simply firing up a group of fanatics. He spoke from conviction. After a meeting with him in June 1937, Gerhard Wagner, the Reich Doctors' Leader reported that “the Führer considered the cleansing of the medical profession more important than for example that of the civil service, as the task of the physician was in his opinion one of leadership, or should be such.”^[280] By “cleansing”, Hitler of course meant the removal of Jews.

In 1931 Ernst Rüdin, a Swiss psychiatrist, who together with Ploetz had been one of the founding members of the Society for Race Hygiene, and was a long time associate of Lenz, had become director of the Kaiser Wilhelm Institute for Psychiatry in Munich. In a speech delivered one year later, Rüdin stated: “People who are themselves mentally ill or hereditarily feebleminded should not have children.”^[281] Rüdin had been a long term advocate of a radical eugenic policy, proposing the compulsory sterilisation of alcoholics, among others,^[282] as well as emphasising that “[an] avalanche-like explosion of financial burdens” were inevitable because of “the increase of necessary care for defectives and sick persons of all types.”^[283] In 1933 he was appointed by the Nazis to head the Society for Race Hygiene. Author of the 1933 Nazi Sterilisation Law, in 1934, Rüdin stated: “The psychiatrist and the healthy person are allies against the genetically defective. The psychiatrist must render his service to the ultimate aim of a hereditary pure, able and superior race.”^[284] Rüdin joined the Nazi Party in 1937, somewhat later than might have been anticipated. In 1939 Hitler personally awarded him the Goethe Medal for Art and Science, and in 1942 bestowed on him the title of “Pioneer of Racial Hygiene”. Unstinting in his praise of Hitler and Nazism, in 1943 Rüdin commended both for their “decisive...path-breaking step toward making racial hygiene a fact among the German people...and inhibiting the propagation of the congenitally ill and inferior.” Moreover both the laws for “preventing the further penetration of the German gene pool with Jewish blood,” as well as the SS for “its ultimate goal, the creation of a special group of medically superior and healthy people of the German Nordic type,” were sans pareil.^[285]

There were exceptions to the prevalent zeitgeist. Samuel Beckett pointed out the irony in this Nazi obsession with the creation of a race of “supermen.” An “Aryan”, he wrote, must be blonde like Hitler, thin like Göring, handsome like Goebbels, virile like Röhm – and be named Rosenberg.^[286] Nor did every physician advocate unbridled sterilisation and euthanasia as being entirely salutary. At a 1931 conference of Bavarian psychiatrists in Munich, Professor Oswald Bumke made some remarkably prescient and morally impeccable observations:

I should like to make two additional remarks. One of them is, please for God's sake leave our present financial needs out of all these considerations. This is a problem which concerns the entire future of our people, indeed, one may say without being over-emotional about it, the entire future of humanity. One should approach this problem neither from the point of view of our present scientific opinion nor from the point of view of the still more ephemeral economic crises. If by sterilisation we can prevent the occurrence of mental disease then we should certainly do it, not in order to save money for the government but because every case of mental disease means infinite suffering to the patient and to his relatives. But to introduce economic points of view is not only inappropriate but outright dangerous because the logical consequence of the thought that for financial reasons all these human beings, who could be dispensed with for the moment, should be exterminated, is a quite monstrous logical conclusion; we would then have to put to death not only the mentally sick and the psychopathic personalities but all the crippled including the disabled veterans, all old maids who do not work, all widows whose children have completed their education, and all those who live on their income or draw pensions. That would certainly save a lot of money but the probability is that we will not do it.

The second point of advice is to use utmost restraint, at least until the political atmosphere here in this country shall have improved, and scientific theories concerning heredity and race can no longer be abused for political purposes. Because, if the discussion about sterilisation today is carried into the arena of political contest, then pretty soon we will no longer hear about the mentally sick but, instead, about Aryans and non-Aryans, about the blonde Germanic race and about inferior people with round skulls. That anything useful could come from that is certainly improbable; but science in general and genealogy and eugenics in particular would suffer an injury which could not easily be repaired again.^[287]

Yet three years later at another convention, in reviewing the Weimar Republic years, Bumke stated:

Gentlemen, today we have gathered in quite another Germany. Today once again each German heart is filled with hope. But this time around it is not the last onset of a people slowly tiring, but an uprising that has definitively lifted the whole of Germany out of the timidity of the post-war years, an uprising that will fortify us once more, after earnest application, internally as well as externally.^[288]

Admittedly not a wholehearted endorsement of the regime's eugenic policies, but hardly a staunchly anti-Nazi line either. And even in his 1931 remarks, Bumke had effectively prescribed involuntary sterilisation in certain circumstances. The war over, he was quick to disassociate himself from National Socialist excesses, stating in June 1945 that other than the Nazi “hotheads” among them, he and other psychiatrists “never really cooperated with the sterilisation law…we have sabotaged the law…sterilisation fell gradually into disuse, especially since 1943.”^[289] This was at best disingenuous. With widespread “euthanasia” available, there was no longer any need for sterilisation, as Bumke well knew. In fact, only about 5 percent of all sterilisations occurred after 1939.^[290] The fact that adult “euthanasia” began in the same year is hardly coincidental.

At the 1929 party rally, Hitler had suggested that countless lives could be eliminated by racial measures:

If Germany was to get a million children a year and was to remove 700-800,000 of the weakest people, then the final result might even be an increase in strength. The most dangerous thing is for us to cut off the natural process of selection and thereby rob ourselves of the possibility of acquiring able people. The first born are not always the most talented or strongest people… As a result of our modern humanitarianism we are trying to maintain the weak at the expense of the healthy.^[291]

At another 1931 conference, this time of the Inner Mission's Standing conference on Eugenics,^[292] the chairman, Hans Harmsen, called for the eugenic sterilisation of the “less valuable.”^[293] Only one courageous voice dissented from the general acceptance of the proposal. “Sterilisation will become a fashion lacking any foundations”, he declared. “We know nothing about this, drawing our conclusions only from experiments with animals and plants…Operations such as sterilisation may well be admissible in individual cases, [but] on the whole they are to be rejected.” He continued:

Should a doctor be obliged in these instances to execute such a death sentence, or should it be the state's responsibility to compel the doctor to do so? Or is the state prepared to form a special class of professional executioners which carries out these matters? These considerations should be energetically brought to the attention of those in public office. It would imply that a certain group of doctors would have to be entrusted with it. The medical profession would then not only be a profession of helpers, but also of hangmen.

From whom did this outspoken opposition emanate? None other than Carl Schneider, a man who over the next decade became one of the leading lights in the “euthanasia” programme, adjudicating over the right to life of countless individuals, as well as devoting himself to research at his Heidelberg clinic on the freshly removed brains of murdered children.^[294] How men like Schneider could attempt to justify their conversion to barbarism will be examined later.

Schneider's objections notwithstanding, with some exceptions the Protestant Church was happy to embrace compulsory sterilisation, seeking only to conduct operations within their own institutions rather than incurring the cost of sending patients to state-run clinics or hospitals. Even some prominent Catholics found the application of the new law quite acceptable. Whilst Christian organisations of all denominations, not surprisingly, welcomed the advent of National Socialist government as a “bulwark against Bolshevism,” both Protestant and Catholic leadership was much more circumspect about so-called “euthanasia”, although there were a number of eugenic enthusiasts in positions of authority in both faiths. But there were also those who were not prepared to become accomplices to murder, and fought to preserve the lives of helpless individuals condemned out of hand by a merciless regime.^[295]

Very soon after attaining power in 1933, the Nazis commenced an extensive propaganda campaign with the object of acquainting the German nation with the benefits of first, mass sterilisation, and subsequently, “euthanasia”. Goebbels, a master in the manipulation of public opinion, used newspapers, magazines, radio, and film to suggest that life would be so much better for the worthwhile many if the worthless few, who were such an encumbrance to the Volksgemeinschaft (racial community), were prevented from reproducing their genetic fault line. The logical extension of that reasoning was that the valueless (as suitably defined) should not just be simply prevented from propagation; they should be eradicated. Would it not be preferable if an end was put to the misery and suffering of their hopeless lives?

Film in particular played an important role in preparing the public for the acceptance of compulsory sterilisation of the mentally and physically handicapped. Five 16mm silent films were made by the Racial and Political Office in the mid 1930s.^[296] These films consistently equated sickness with criminality, whilst stressing how the resources spent on asylums and prisons could be put to so much better use. They contrasted the allegedly luxurious conditions in which mental patients were kept with the miserable existence of slum dwellers in the cities. Why waste money on such hopeless cases? Subtle, the message was not. Far more sophisticated was the sound film Opfer der Vergangenheit (Victims of the Past), a 1936 joint production of the Racial and Political Office and the Reich Propaganda Ministry. On Hitler's instructions, the film was shown in all 5,300 German cinemas. It went much further than its predecessors, speaking ominously of Jewish mental patients and the consequences of the abandonment of the law of natural selection. It contrasted “healthy German citizens” (that is, girls performing gymnastic exercises) with asylum inmates, then provided the solution to the surmised problem - compulsory sterilisation.^[297]

Even more insidious were the films planned to endorse “euthanasia”, by then already in progress. Hermann Schweninger, a recruit to the killing programme with some experience of filmmaking, was commissioned to visit a number of asylums in autumn 1940.^[298] He shot some10,000 metres of material for editing, much of it with sound. In September 1940, Jewish patients at the Eglfing-Haar psychiatric hospital were filmed as part of the film Abschaum der Menschheit (Scum of Humanity), a self-explanatory title. With filming completed, the patients involved were transferred to the Brandenburg killing centre and gassed later the same month.^[299] The principal films resulting from Schweninger's odyssey were Dasein ohne Leben (Existence without Life) and a documentary, Geistig Kranke (Mentally Ill). Both films were unequivocal in their depiction of medically sanctioned murder. Believed lost for ever, eight of the twenty-three rolls of film shot by Schweninger were discovered in Potsdam by Michael Burleigh in 1989-1990.

But the most effective film treatment of “euthanasia” was Ich klage an (I Accuse) scripted by Schweninger in 1941, an adaption of the 1936 novel Sendung und Gewissen (Mission and Conscience) by the ophthalmologist, Hellmuth Unger, a man destined to become a leading figure in “euthanasia” affairs. The message was more understated than the blatant propaganda of the earlier films, and consequently all the more potent. “Would you, if you were a cripple, want to vegetate forever?” rhetorically asks a doctor in Ich Klage an.^[300] In picturing euthanasia as a voluntary action, actually going so far as to have a character hypocritically suggest that the most important precondition was that the patient personally request euthanasia, the film was a blatant distortion of real Nazi policy.^[301]

In January 1942 the SD^[302] collated public reaction to the film (by then seen by some 18 million people),^[303] which, with a relatively small number of exceptions, was acceptance of the film's central theme – people suffering from incurable illnesses or diseases should be granted a quick, legally sanctioned death.^[304] Some, however, were more sceptical, as the SD report made clear, quoting the comments of one viewer:

You can think what you like about this, but who is going to guarantee that there won't be any abuses? As soon as laws like this are introduced it will be easy for the government to have anyone they consider undesirable declared incurable by a commission for any reason at all and eliminate them. And moreover, people with enough influence or money to criticise others will soon have somebody declared insane.^[305]

By this time the “euthanasia” programme, officially halted in August 1941, had entered an even more sinister phase, but Ich klage an can be seen as part of the attempt to pave the way for general acceptance of an eventual “euthanasia” law. After the war, Schweninger continued his motion picture career, this time as a maker of corporate and advertising films. Others involved in the making of Ich Klage an were equally successful in continuing with their cinematic endeavours in the new Federal Republic.^[306]

Leonardo Conti expressed this mystical obsession with the purity of the Volk in yet another film made in about 1942, long after both the sterilisation and “euthanasia” policies had been determined:

We have identified a decreasing birth rate, negative selection and race-mixing as the major dangers which can lead people into the abyss; but this does not describe in full the dangerous influences affecting a civilised people…The destiny of a people is never at rest, it must either rise or fall; a people must be either hammer or anvil – the value of their blood, the value of their race is decisive. The German people have proven their value. They have to become the core of a Great German Reich; then we will succeed in proving that although the individual human being is mortal and his or her life ends with death, a people can renew itself and become more beautiful and stronger from generation to generation, an eternal life.^[307]

Or as Reinhard Heydrich ominously defined Nazi dogma in 1936, “[National Socialism] no longer begins with the state but rather with the Volk…Accordingly, we National Socialists recognise only enemies of the Volk. They are always the same, and they will always remain the same. They are the opponents of the racial, völkisch and spiritual substance of our Volk.”^[308]. Central to Nazi ideology was this concept of the Volksgemeinschaft, the “racial community”, a fantastic creation imagined as a homogeneous nation consisting entirely of racially, politically, and physically desirable subjects. Although there is no doubt that Heydrich regarded Jewry as the principal opponent of the Volksgemeinschaft, given his definition the list of potential enemies of the Nazi state was clearly terrifyingly long, and their fate equally clearly preordained.

In the same year that Heydrich's völkisch comments were published, Dr Wilhelm Hinsen had attended a conference at which Fritz Bernotat, the district administrator responsible for asylums in the Wiesbaden area, had stated: “If I was a doctor, I would do away with these patients.” To his credit, Hinsen replied if that was the case “German medicine can congratulate itself that you are not a doctor.”^[309] Although there was no doubting the eventual aim, like the persecution of the Jews with which to some extent it ran parallel, “euthanasia” was only gradually and carefully introduced, Bernotat's comments notwithstanding. Asylums were deliberately neglected during the 1930s. Specialist wards were closed, and conditions deliberately exacerbated to the extent that basic hygiene and feeding, let alone treatment, often became impossible.^[310] As the level of funding for mental hospitals decreased, the quality of psychiatric help declined with it. A significant number of psychiatrists were SS members, already imbued with contempt rather than compassion for their patients. It was often the case that those responsible for the administration of hospitals were no more than SA thugs or simply card-carrying members of the Party, men who owed their escape from unemployment and the dole not to any degree of expertise, but rather to political influence. They were totally unsuited for the tasks at hand.^[311] Many asylums developed into little more than freak shows as the general populace were admitted to witness the often disturbing conditions of the patients.^[312] This all formed part of the deliberate manipulation of public opinion towards acceptance of “euthanasia” as a beneficial answer to many of society's problems. Beginning with handicapped or sick young children, “euthanasia” was systematically extended to include “impaired” older children, then “defective” adults, and finally individuals selected on racial rather than medical grounds.^[313] Hitler had set out his thoughts on the subject quite clearly in Mein Kampf:

The right of personal freedom recedes before the duty to preserve the race. There must be no half measures. It is a half measure to let incurably sick people steadily contaminate the remaining healthy ones. This is in keeping with the humanitarianism which, to avoid hurting one individual, lets a hundred others perish. If necessary, the incurably sick will be pitilessly segregated -- a barbaric measure for the unfortunate who is struck by it, but a blessing for his fellow men and posterity.^[314]

With the early introduction of legislation (the “Law for the Restoration of the Professional Civil Service” of 7 April 1933), the Nazis intended to thoroughly purge long-established ethical and administrative public supervisory bodies.^[315] The decree not only affected the lives of Germany's 1.5 million civil servants, but also that of tens of thousands of others employed in public service. The purge, however, was not entirely effective; by late 1935, some of those who had been dismissed were being considered for re-employment, and the exigencies of war made the acceleration of that process inevitable.^[316] On 1 June 1933, the “Law for the Reduction of Unemployment” came into effect. This popular measure was intended not only to achieve the purpose stated in its title, but also to force women out of the workplace and back into the home in their “natural” capacity of wives and mothers. It did so by providing loans to newly married couples, which could be repaid through fecundity. The debt was reduced with each birth, and considered repaid on the arrival of the fourth child.^[317] The loans were also conditional upon the female partner ceasing paid employment. Loans could be refused “if one of the prospective marriage partners is suffering from a hereditary or mental physical illness which renders their marriage undesirable to the whole national community.” By a subsequent amendment, all applicants for such loans were to be subjected to a medical examination prior to approval. Further tax benefits and other measures introduced in 1934 and 1935 to stimulate procreation were denied to those considered of “lesser racial value.”^[318] Depending upon one's point of view, this public welfare legislation can be viewed as an exemplar of either positive or negative eugenics, since it contained elements of both.

In 1932, the Weimar government had drafted a law for the voluntary sterilisation of the handicapped. On attaining power, the Nazis wasted little time in implementing a statute which accorded with their interpretation of birth control. “We want to prevent the poisoning of the entire bloodstream of the race” commented Göring's legal assistant.^[319] On 14 July 1933, the “Law for the Prevention of Genetically Diseased Offspring” was approved by Hitler's cabinet. Amended on 7 December 1933, it came into force on 1 January 1934.^[320] The new law decreed not voluntary, but compulsory sterilisation for persons characterized by a wide variety of disabilities.^[321] As part of the new system Hereditary Health Courts were established to decide whether compulsory sterilisation was appropriate for such citizens.^[322] These courts, normally forming part of local civil courts, consisted of a lawyer and two doctors, one of whom was a supposed expert on genetic pathology.^[323] The verdict of the lower court could only be challenged in a Higher Hereditary Health Court. If an appeal failed, sterilisation took place irrespective of the wishes of the victim or their family.^[324]Importantly, this legislation was intended to be explicitly eugenic in nature, that is to say no criminal act had to have been committed for which punishment was prescribed.^[325] Since eugenicists had devoted so much time and effort attempting to prove a link between perceived hereditary flaws and criminality, it is to be supposed that this principle was not always applied, and that conviction of a criminal offence was of itself sometimes sufficient to result in a ruling for sterilisation. In the first year that the new law was in operation, the Hereditary Health Courts confirmed sterilisation in more than 90 percent of cases heard. If an appeal to the Higher Hereditary Health Court failed (during the entire Nazi era only about 3 percent of appealed decisions were reversed), those still refusing to report for sterilisation were usually sent to concentration camps.^[326]

The size and scope of the sterilisation programme had changed the very nature of German medicine. Every physician was perforce a genetic doctor, supposedly able to provide an expert opinion on matters of hereditary racial characteristics. These opinions were sometimes based on peculiar techniques. Matters such as the shape of teeth, gums and tongue, the form and structure of the ear, the manner of walking and the posture when resting, as well as patients' answers to dubious IQ questions, could often form part of the evidence produced by these “experts” before the health courts, frequently determining sterilisation issues.^[327] Psychiatric patients considered eligible for release were offered a stark choice – either submit to sterilisation or have further institutionalisation paid for by themselves or their family.^[328] This option, which was in effect no option at all, helped convince those most susceptible to accepting their ideas from those in positions of authority (in this case nurses from doctors), that patients could be divided into the “good”, that is those who voluntary accepted sterilisation, and the “bad”, those who had to be coerced into it. The extent to which this mindset may have influenced individual nurses' subsequent actions when “euthanasia” was introduced is worthy of consideration.^[329]

One practitioner enthused about how the new law freed the psychiatrist “in the realm of eugenics from the emotional difficulties that we have found more and more embarrassing over the last ten years.”^[330] Typical of the fervour with which the sterilisation law was embraced was the action of Werner Villinger, chief physician of the nursing home at Bethel, who registered 1,700 of his 3,000 patients as being suitable for the operation.^[331] Having first ordered the sterilisation of a young female inmate of the Kaufbeuren mental home, in his capacity as a Hereditary Health Court judge the psychiatrist Hermann Pfannmüller (of whom more later) investigated a further twenty-one allegedly “degenerate” members of the woman's family, recommending the highly urgent sterilisation of ten of them on the grounds that “the danger of reproduction appeared imminent.”

School teachers were instructed to encourage children to construct their own family trees in order to discover any eugenically suspect family members.^[332] The biologist and fervent Nazi, Paul Brohmer, devoted his 1933 book Biologieunterricht und völkische Erziehung (Biology Classes and Ethnic Education) to outlining the manner in which the young were to be educated in matters of racial hygiene. Since they were already familiar with the symptoms of degeneration in animals and plants from their own everyday observations, it did not require a great deal of initiative for pupils to also find similar indications of decline and degeneracy in man. Thus racial eugenics could be introduced at an appropriate point, not just in the study of zoology and biology, but in geography and history too. He continued:

Not one elementary school pupil should leave school without having internalized the iron command that he is to bear part of the responsibility for the fate of his fatherland, without the awareness that he is only a link in the chain of his ancestors and descendants and the carrier of future generations…It can be suggested that the student draw up a genealogical chart of his family as far back as he can go. In addition, he can be asked questions about the physical characteristics of his parents and other forbears as far as they can be determined (size, figure, shape of head and face, colour of hair and eyes, form of nose, etc.), about their intellectual and characteroligical qualities, their special achievements(for example, rescues during the war, scientific or literary publications, compositions), their life span and cause of death. In given cases, deformities and hereditary diseases should also be reported. The number of children produced by the student's ancestors should be determined.^[333]

The promotion of racial hygiene was remorseless. A women's magazine article confronted the accusation that the sterilisation policy was “going against the laws of nature” in the following terms:

Until National Socialist rule, the German people neglected the laws of nature…It not only disregarded the laws of heredity, of selection and of eradication, but directly opposed them by not only keeping the unfit alive at the cost of the healthy, but even guaranteeing their procreation…Every hereditarily sick German woman will, once she realises this, take this operation upon herself in order to keep her whole race healthy. “But doesn't that mean she's sinning against life?”…What does life mean then? Just go to a lunatic asylum…^[334]

Within the medical profession it was not only physicians who were encouraged to embrace the tenets of National Socialism. In 1933, Dr. Friedrich Bartels, deputy leader of the health department of the Reich Ministry of the Interior, called on nurses to concentrate less on individual patient care and more on collective prevention. It was their duty to “secure and promote a genetically sound, valuable race and…not to expend an exaggerated effort on the care for genetically or racially inferior people…at the cost of the more valuable people.” Nurses should improve the health of the sick and weak “only so far as their inherited biological predisposition allows.”^[335] On completion of their training under the new regime, nurses were required to swear an oath of allegiance:

I solemnly swear that I will be steadfastly faithful and obedient to Adolf Hitler, my Führer. I promise to fulfil my duties, wherever I may be designated to work, faithfully and conscientiously as a National Socialist nurse in service to the national community, so help me God.^[336]

The Frankfurter Zeitung reported in October 1936 that National Socialist nurses had sworn this oath in the Cologne-Aachen district for the first time. Ominously, the article continued: “The future would present tasks which could properly be performed only by men and women fully imbued with the philosophical attitude of National Socialism.”^[337] The nature of that `philosophical attitude' soon became apparent.

It is impossible to be certain of the extent to which this politicalization of nursing helped to influence later individual behaviour, but it is not unreasonable to think that it would have had an affect on the actions of at least some of those taking this oath, as it did in similar circumstances with members of the Wehrmacht, who found themselves bound by the oath of allegiance to Hitler that they had been made to swear. Kate Gumbmann, a nurse at Hadamar testified: “I thought it was assumed by a nurse that she followed all orders that were given her.”^[338] Whilst refuted as a defence in early allied post-war legal proceedings, there is little doubt that this blind acceptance of superior authority was a trait deeply imbedded in the German psyche.

In at least one respect, the National Socialist regime was merely heir to an existing racist policy of sterilisation. In the wake of the First World War, French colonial troops, many of them black, were among those occupying the Rhineland. Weimar government propaganda was quick to portray these troops in the worst possible (and wholly untrue) light, accusing them of spreading every kind of disease. Friedrich Ebert, the first president of the Weimar Republic, spoke of “the black scourge”, and a committee was formed in Munich with the intent of “educating the public concerning the dangers facing the white race.”^[339] The children of the inevitable coupling of the troops and local women were referred to as `Rhineland Bastards', their number grossly inflated; in truth they never represented the slightest threat to the “purity of the Germanic race.” By 1935 there were estimated to be 500-800 such individuals. Fifteen years earlier their insignificant number had not prevented a journal protesting:

Shall we silently accept that in future instead of the beautiful songs of white, pretty, well-formed, intellectually developed, lively, healthy Germans, we will hear the raucous noise of horrific, broad skulled, flat nosed, ungainly, half-human, syphilitic half-castes on the banks of the Rhine?

Needless to say, Hitler discovered a Jewish conspiracy behind all this; in Mein Kampf he wrote that the Jews had “brought the negroes into the Rhineland” with the intention “of ruining the hated white race by the necessarily resulting bastardisation.” The matter troubled the Nazis for years. In 1927 the Bavarian Ministry of the Interior had unsuccessfully suggested sterilizing the children, an idea that the Nazis took up again once in office.^[340] But it was not until 1937 that the Gestapo finally arranged for the compulsory sterilisation of many of these children, on no grounds other than their parentage. Others were subjected to medical experiments, or simply disappeared.^[341]

The adoption of enforced eugenic sterilisation on a national scale was by no means limited to Nazi theorists, or for that matter solely to Germany, although it was only the Nazis who linked the subject to a racist ideology. Nowhere was the concept of compulsory sterilisation more enthusiastically endorsed than in the United States, where 30,000 people had been sterilised before 1939, half of them in California alone.^[342] By 1 January 1950 the total of sterilised American citizens had risen to 50,707.^[343] Eventually more than 65,000 individuals were sterilised in 33 states under compulsory sterilisation programmes. After 1945 such legislation was revoked or if it remained on the statute books, ignored. Some American eugenicists, like Harry Hamilton Laughlin, had been extraordinarily naïve when discussing the subject. In 1929 he declared: “The possibility that sterilisation might become a political tool that might be used by one race against another, or by one religion against another, or by one social class against another, is extremely remote.”^[344] Yet it is self-evident that enforced sterilisation, by its very nature, would inevitably be aimed at the poor and under privileged, as well as the racially and genetically “inferior”. It would always be those most in need of protection that would provide the victims of such a policy.

A further example of the prevailing American sentiment was the opinion of Charles M Goethe, successful entrepreneur, founder of California State University, Sacramento, and a proponent of compulsory sterilisation and racially motivated discrimination, who wrote in 1935: “However one abhors dictatorship, one is also impressed that Germany, by sterilisation, and by stimulating birth rates among the eugenically high-powered, is gaining an advantage over us as to future leadership.” His enthusiasm for the Nazi eugenic model was still evident in October 1937, when he wrote: “

The Germans are forging far ahead of us in this matter of accumulated data. They say they have already 4 Nobel prizes to 1 of ours, population considered, and that if we do not accept their methods, they will run away from us with world leaders.^[345]

Such views were far from uncommon. The eugenic movement attracted many prominent and influential followers in the United States between 1908 and 1925, their number including scientists, educators, industrialists, and politicians.^[346] Although the movement's influence had begun to wane somewhat thereafter, by 1928 racial hygiene was being taught in almost three-quarters of all American colleges and universities.^[347] “The American Eugenics Society” was what nowadays might be termed a group of Nazi fellow-travellers. Clarence G Campbell, the Society's Honorary President, was even more vehement than Charles Goethe in his support of events then occurring in Germany, writing as he did in 1936:

The German nation has adopted a policy of biological improvement in its racial quality as its major national objective, to which all other objectives are regarded as subsidiary…This policy is not the creation of political opportunists designed to flatter national vanity or to engender racial antagonisms, but it is the integration of the well-considered conclusions of its anthropologists, its biologists, and its sociologists…No earnest eugenicist can fail to give approbation to such a national policy.

And what if the German template was not adopted by other nations? Campbell concluded his article with a dire warning:

If …they permit a progressive deterioration in their own racial quality and survival value, and if in subsequent generations they fall behind and fail in the inescapable competition for racial survival, the present generation could only be deemed to bear a heavy responsibility for such a failure.^[348]

The preceding year Campbell had represented the American eugenic movement at an international conference on population science held in Berlin, where he was effusive in his praise of Nazi policies. Having first commended the efforts of a number of non-German eugenicists, he continued:

It is from a synthesis of the work of all such men that the leader of the German nation, Adolf Hitler, ably supported by the Minister of the Interior, Dr Frick, and guided by the nation's anthropologists, its eugenicists, and its social philosophers, has been able to construct a comprehensive race policy of population development and improvement that promises to be epochal in racial history.^[349]

To the undoubted satisfaction of his hosts Campbell declared that the “difference between the Aryan and the Jew was as insurmountable as that between black and white.”^[350] It is hardly surprising to learn that as the most frequently quoted non-German “scientist”, Campbell was the darling of the Nazi press.^[351]

In an act of mutual admiration, in 1932 the German historian of science, Reinhold Müller, effusively praised American pioneering in matters of racial hygiene. Whilst until 1926, he wrote, discussion of the subject had been purely academic and scientific in nature, it had been the Americans who, through massive research, had “proved” Galton's thesis that qualities of the mind were as heritable as qualities of the body. Others quoted specific examples of American eugenically based legislation. In the same year as Müller, Walter Schultze, the Bavarian Health Inspector, admired racial laws placing restrictions on the immigration of Jews, Poles, and southern Europeans to the United States. Based upon its adoption of sterilisation laws and its restrictive immigration policies, the United States was a country where racial policy and thinking were much more the norm than elsewhere, declared Schultze.^[352] This was something to be commended – and emulated.

As late as 1940, the American eugenicist and racist, Lothrop Stoddard, spent four months in Germany, during the course of which he was invited by the Nazis to serve for a time as a judge in a Hereditary Health Court. Stoddard concluded that the sterilisation law was “being administered with strict regard for its provisions and that, if anything, judgements were almost too conservative.” The “worst strains in the Germanic stock” were being weeded out “in a scientific and truly humanitarian way.” The “Jews problem” was “already settled in principle and soon to be settled in fact by the physical elimination of the Jews themselves from the Third Reich.” Stoddard was well connected, counting Himmler, Darré, Ribbentrop, and even Hitler among his acquaintances, as well as leading German racial hygienists like Günther, Fischer, and Lenz.^[353] Given what is now known, it is natural to speculate exactly what Stoddard meant by “the physical elimination of the Jews”. In 1940, the enforced emigration of the Jews from Germany was still on the agenda, and it almost certainly this to which Stoddard referred, but it was nonetheless a revealing observation.

In Great Britain in 1931, A G Church, a Labour Member of Parliament and General Secretary of the National Union of Scientific Workers, introduced a bill in the House of Commons proposing the voluntary sterilisation of “mental defectives.” The consent of the patient and their family would be required, and the process would be subject to government and judicial approval. The example of California was enthusiastically cited. Unless such legislation was adopted, it was suggested, the mentally disabled would remain free to breed, thereby posing a threat to the future of the nation. The bill was defeated.^[354] But sterilisation laws were introduced in Denmark (1929), Norway (1934), Sweden (1934), Finland (1935), Iceland (1938), and a number of eastern European countries. More than 100,000 people were sterilised in Denmark, Norway and Sweden alone, the majority after 1945. The 1982 Swedish Nobel Peace Prize winner, Alva Myrdal, commented in 1941:

In our day of highly accelerated social reforms the need for sterilisation on social grounds gains new momentum. Generous social reforms may facilitate home-making and child-bearing more than before among the groups of less desirable as well as more desirable parents. This may not be regretted in itself as the personal happiness of these individuals and the profitable rearing of their children already born are not to be neglected. But the fact that community aid is accompanied by increased fertility in some groups hereditarily defective or in other respects deficient and also the fact that infant mortality among the deficient is decreasing demands some corresponding corrective.^[355]

Some were prepared to go further. Hildur Nygren, a Social Democrat Member of Parliament, and in 1951 Minister of Ecclesiastic Affairs, favoured compulsory sterilisation, stating: “We must not be so taken up with the idea of freedom and civil rights for each and every person in this generation, that we forget the just demands of the next”^[356] Another Social Democrat, Karl Johan Olsson, commented: “I think it is better to go a little too far than to risk bringing unfit and inferior offspring into the world.”^[357]

In a complete volte-face, in August 1997 the Swedish government denounced the policy of its predecessors. Margot Wallstrom, the Swedish Minister for Social Policy, issued a statement, saying: “What went on is barbaric and a national disgrace.” She pledged to create a law ensuring that involuntary sterilisation would never again be used in Sweden, and promised compensation to the victims of sterilisation legislation.^[358]

In another example of what was then contemporary thought, Traian Herseni, racial “expert” in the Iron Guard, the Romanian version of the Nazi party, enthusiastically endorsed what had been German practice for many years when he wrote in 1941:

We need eugenic laws and eugenic practices. Reproduction cannot be left to chance…Certain people must not be allowed to reproduce, and inferior races must be completely isolated from the main [ethnic] group. The sterilisation of certain categories of people must not be conceived stupidly as a violation of human dignity, but as a tribute to beauty, morality, and perfection.^[359]

Not everybody bought into this interpretation of inherited hereditary characteristics. As early as 1918, the American psychiatrist Abraham Myerson had pointed out that the results of his studies suggested that whilst insanity occasionally reappeared over generations, mentally ill people often had perfectly normal children and siblings, and were themselves the children of normal parents.^[360] “There is no such thing as insanity, no such thing as feeble-mindedness, no such thing as delinquency,” Myerson wrote in 1922.^[361] If mental deficiency was related to anything, it was to itself.^[362] Environmental factors (meaning nurture) were more important than nature in attempting to arrive at an understanding of human development.^[363] In Myerson's view, individuals suffering from mental illness should avoid marriage, not because they might produce disabled progeny, but simply because they could not afford to support their children, disabled or not. Instead of punishment, the concern should be with social improvement: “Better diet, more sunshine, more leisure, more freedom from stress and strain, better education, and sound mental hygiene.”^[364] At the time he was swimming against the tide, but in his persistent opposition to the more outlandish claims of the eugenicists he proved completely justified.

Initially, the methods of sterilisation prescribed in Germany were standard surgical procedures, but the second amendment to the law, issued on 4 February 1936, provided that under certain conditions the Reich Ministries of Interior and Justice could prescribe a non-surgical method, and the regulation of 25 February 1936 permitted the use of X-rays for the sterilisation of women over the age of thirty-eight, or in cases where a surgical procedure might prove hazardous.^[365] Whatever the method, it has been estimated that by 1939, at least 300,000 men and women had been sterilised, many of whom subsequently became victims of the “euthanasia” programme.^[366] A probable 75,000 further persons were sterilised after 1939, largely in areas newly incorporated within the Reich.^[367] Between 1934 and 1937, an estimated 480 individuals died as a result of the operation.^[368] How many women fell victim to cancers induced by exposure to radiation as a method of sterilisation is unknown.^[369]

Franziska Schwarz was a 16 year-old deaf girl, whose younger sister suffered from a similar disability, as did some of her father's brothers. Her parents too, were hard of hearing. One day in 1935 the family received a letter instructing Franziska and her mother to report to a health office to arrange for their sterilisation. Her uncle appealed on their behalf to the Hereditary Health Court, pointing out that deafness was not necessarily hereditary. He himself had perfect hearing. Moreover, Franziska's mother was menopausal, and promised to have no further children. The court therefore ruled that her mother did not have to be sterilised; however, the order for Franziska's sterilisation was confirmed. She was ordered to report to the Women's Hospital in Munich. In great pain after the operation she applied for sick pay – which was refused. As matters transpired the operation had been unsuccessful, and in 1938 Franziska found herself pregnant. When she reported to a gynaecologist for consultation, he ordered the forcible termination of her pregnancy – which was carried out. Unable to marry the father of the aborted child without a certificate confirming that she had been sterilised, in 1941 she consented to a further operation resulting in her permanent sterilisation.^[370] It was a typical case. Those who were in less than perfect physical condition, the promiscuous, the inefficient, the careless and others who were simply deemed “socially feeble minded”, all fell victim to the sterilisation measures.^[371]

The example of Else K. is another that illustrates the working of both the compulsory sterilisation policy and the marriage health law. Before being granted permission to marry, Else was required to undergo a medical examination, part of which included an intelligence test, which she failed. Furthermore it was discovered that her deceased brother had suffered from schizophrenia, and had been confined to an asylum. As a consequence of these two factors she was not only sterilised, but also prohibited from marrying the man of her choice, since unlike Else he was “hereditarily fit”. Because she had been sterilised their union could produce no offspring; if the marriage were permitted to proceed, the potential husband's valuable genetic material would therefore be lost to the nation.^[372]

In 1999, Dorothea Buck described the lifelong traumatic effect of enforced sterilisation:

While I was a patient at the evangelical church institution in Bethel for three-quarters of a year when I was just 18 years old, I had not one single consultation with a doctor, neither before nor after the forced sterilisation, by which I was in fact completely surprised and which was carried out without giving me any reasons beforehand why it was about to take place or afterwards why it had already taken place. At that time a person aged 19 was not yet responsible for her or himself. During her very first visit my mother was given the choice: either she agreed to my sterilisation or I would be put into an institution up to the age of 45. “This would be very much worse!” In a state of shock, she agreed. She told me this later.

The clergyman at the Bethel institution cited words from the Bible at our beds without ever speaking to us personally. The most anguishing experience of human indignity, which remains indelibly in me to this day, is that the doctors and ministers in the Bethel institution didn't deem us worthy or capable of a discussion and in addition kept us in custody without any useful activity under a barrage of biblical words. The Bethel doctors and clergymen left us completely alone with our concerns about being labelled as “inferior hereditarily ill”, the life-long consequences of the marriage ban, and the rigorous restrictions in our educational and occupational possibilities.^[373]

As early as August 1933, Professor Walter Schultze, the State Health Commissioner for Bavaria, had made the Nazi government's intentions clear. “Coddling of [the] physically and mentally hopelessly worthless” was a waste of resources. Sterilisation alone was not the answer. Positive selection was part of the solution, but what was really needed was a policy of extermination; he added: “This policy has already partially been set in motion in our present-day concentration camps.”^[374]

In November 1933 the Nazis enacted the “Law Against Dangerous Habitual Criminals”, thereby further obscuring the distinction between actual criminal activities and the unacceptable social behaviour that typified many people with disabilities. The law stipulated that in addition to the penalties already provided by the penal code, these criminal “asocials” (Asozialen) could be committed to state asylums, held in protective custody for an indeterminate period, and, in the case of sex offenders, officially castrated. In addition the law provided for the prohibition of defendants practicing their professions or occupations.^[375] Among those held to be “asocial” were many Gypsies, a large number of whom were taken into protective custody in 1938.^[376] In September 1934, Gerhard Wagner, the Reich Doctors' Leader, advised physicians that Hitler would sanction abortions performed where the union of either parent was likely to produce a child with a hereditary complaint. Moreover, it was now permissible for abortion and sterilisation to be performed concurrently, thereby ensuring that a potential problem pregnancy would not occur again.^[377] But when it came to “the natural fertility of the German people”, that is those racially and genetically acceptable to the regime, the Nazis were totally anti-abortion. In 1937, doctors performing unauthorized abortions on women of “valuable” stock could be sentenced to lengthy terms of imprisonment. When war began, terminating such a pregnancy could in some circumstances result in a death sentence for the physician involved.^[378]

A succession of such laws and decrees prepared the ground for the Nuremberg Laws of 1935,^[379] which, whilst aimed primarily at Jews, were also a precursor of legislation concerning marriage among people with disabilities. On 18 October 1935, the “Law for the Protection of the Hereditary Health of the German Nation” was enacted, the so-called “Marriage Health Law” (Ehegesundheitsgesetz), prohibiting any marriage if either of the parties suffered from some form of mental disability, had a “hereditary disease” as legally defined, or suffered from a communicable infection, especially tuberculosis or venereal disease.^[380] Possession of a “certificate of fitness to marry”, issued by a local health authority, was made compulsory for any couple wishing to wed.^[381] Although the law stated that every individual intending to marry should first possess such a certificate, resources for so doing were inadequate. In practice, only those suspected of significant “genetic defects” were examined thoroughly. For most applying for the certificate, the medical examination was brief and superficial.^[382]

These laws did not spring fully formed from the minds of inventive Nazi jurists. They had a long pre-history, having been the subject of debate in Germany since the late nineteenth century. In 1905 the geographer Paul Langhan had proposed the prohibition of mixed marriages and the adoption of involuntary sterilisation. Fifteen years later the last German governor in Africa, Heinrich Schnee, was an early proponent of apartheid in advocating strict racial segregation and the avoidance of sexual relations with the autochthonous population so as to prevent “the regression of Europeans to the cultural level of a native.” Nor were these exclusively German concerns, shared as they were by all of the western imperial powers, who treated the “inferior races” of their newly formed empires with a disdain that soon evolved into a policy of extermination. As has been illustrated above, the roots of Nazi racism can be found in the attitudes common to many nations as part of the exploitation of their newly acquired territories. Combining this racist precedent with the dogma of social hygiene was to produce a lethal brew under National Socialism.^[383]

Much of the eventual Nazi legislation had been pre-empted by Heinrich Himmler in 1931, when he had set his stall out regarding marriage so far as it involved members of the SS and their partners, and the anticipated subsequent parturitions. On 31 December of that year, a Race Office of the SS (Rasseamt der SS) was established to ensure that all SS marriages (and subsequently all sexual relations involving SS-men) were in accordance with Nazi eugenic and racial principles.^[384] Inspired by the Blud und Boden (Blood and Soil) “expert”, Walther Darré, Himmler's “Engagement and Marriage Decree” thus read:

1. The SS is an association of German men of Nordic determination selected on special criteria.

2. In conformity with the National Socialist Weltanschauung and recognizing that the future of our people depends on the selection and retention of racially and hereditarily sound good blood, I establish with effect from 1 January 1932 the “marriage consent” for all unmarried members of the SS.

3. The goal striven for is the hereditarily sound, valuable extended family of German, Nordically determined type.

4. Marriage consent will be granted and denied solely and exclusively on the criteria of race and hereditary health.

5. Every SS-man who intends to marry has to apply for this purpose to the Reichsführer-SS for the marriage consent.

6. SS members who marry despite having been denied the marriage consent will be dismissed from the SS; they will be given the option of resigning.

7. The appropriate processing of marriage requests is the task of the Race Office of the SS.

8. The Race Office of the SS-manages the “Clanbook of the SS”, in which the families of SS members will be entered after the granting of the marriage consent or approval of the request for registration.

9. The Reichsführer-SS, the head of the Race Office, and the specialists of this office are bound to secrecy on their word of honour.

10. The SS is clear that with this order it has taken a step of great significance. Derision, scorn, and misunderstanding do not affect us; the future belongs to us.^[385]

Both SS-men and their prospective brides were required to genealogically prove the purity of their bloodline as far back as five generations. Girls had to provide medical evidence of their own and their family's good physical and mental health, undergo a comprehensive medical examination, and be measured and assessed to ensure that they conformed to the required “Nordic” criteria.^[386]

Side by side with the negative eugenics exemplified by the expanding application of sterilisation policy, the Nazis practised positive eugenics by attempting to encourage a reversal of the declining “Aryan” birth rate. In the wake of the terrible death toll of the Great War, The National League of Large Families (Reichsbund der Kinderreichen – RdK), had been established long before the Nazi attainment of power as part of a policy intended to stimulate child bearing within German society as a whole. Under Nazi government it became a very different organisation. No longer were those deemed “valueless” by the regime to be encouraged to reproduce - quite the reverse.^[387] The League's objectives under Nazism were made clear by its leader, Wilhelm Stüwe: “The more hereditarily healthy families a nation possesses, the more certain its future is.” The organisation was “the storm troop in the field of National Socialist population policy.”^[388] Since it was believed that, on the basis of probability alone, the larger the family the more likely it was to produce an outstanding individual, perhaps even a genius, much time and effort was spent in propagandising the ideals of the RkD. Stüwe pronounced: “The phrase `father of a large family' or `mother of a large family' must again become a title of honour, as it always was in the best periods of German history [before] the cult of Liberalism…with Marxism and Jewry as its apostles” had eroded those traditional values.^[389]

There were some benefits arising from membership of the RdK, although these usually took the form of added status rather than anything more tangible. The costs of utilities or transportation were sometimes reduced for large families, and legislation provided for some favourable treatment regarding taxation and child allowances. Most of all, motherhood was glorified; three children entitled a woman to preferential shopping rights, whilst from 1938, fecundity entitled receipt of the Honour Cross of the German Mother^[390] - four children meant bronze, six, silver, and eight, gold, an idea probably stolen from the Berlin Olympiad of two years earlier. Nor were mothers the only beneficiaries. Karl Frenzel, a Brenner (burner) at three “euthanasia” killing centres and a particularly brutal guard at Sobibor extermination camp, fathered five children, which not only entitled him to the honorary title of `kinderreicher Familienvater' (literally `a child-rich family father'), but ensured his exemption from military service.^[391]

The British psychiatrist Eliot Slater, a student of Ernst Rüdin, published an article in the Eugenic Review in 1936 entitled German Eugenics in Practice, which neatly summarized the prevailing climate in Germany:

With successive hammer-blows the German citizen is driven into a swastika-shaped hole. The atmosphere of compulsion pervades the whole of his life. The fact that he and his fellow men are now to be selected and bred like a herd of cattle seems to him hardly more distasteful than a hundred other interferences in his daily life. There is little doubt that these measures will have at least a partial success. If commanded with authority the German docilely obeys. The command now is to breed.^[392]

On 1 September 1939 the health courts were ordered to only authorize sterilisation where there would otherwise be an abnormally high risk of undesirable progeny resulting.^[393] The large-scale sterilisation programme had effectively been concluded. Perceived genetic problems would now be resolved by more radical measures.

In July 1933, Niek de Rooy, a Dutch journalist with the `Noordbrabantsch Dagblad Het Huisgezin' newspaper was one of a party of 22 invited to inspect the `New Order' in Nazi Germany. On 13 July he reported that “the people have to get used to the new situation, but once they discover the new regime also does good things, they will certainly decide to support it with heart and soul.” De Rooy, who was either a fellow-traveller or else easily duped, continued that on being questioned that rumours were spreading to the effect that Hitler intended “to kill 800,000 weak people”, his unnamed German interlocutor explained that it was intended to strengthen the German race, but killing? No, “weak and less valuable people” would be housed in institutions, and only be prevented from marrying.^[394] Little more than a year later, in autumn 1934 a Nazi doctor was writing:

It must be made clear to anyone suffering from an incurable disease that the useless dissipation of costly medications drawn from the public store cannot be justified. Parents who have seen the difficult life of a crippled or feeble-minded child must be convinced that, though they may have a moral obligation to care for the unfortunate creature, the broader public should not be obligated…to assume the enormous costs that long-term institutionalization might entail.^[395]

Fritz Bartels, Gerhard Wagner's lackey in the Nazi Physician's League, was reflecting the views of many, and not just the Party, when he commented:

From time immemorial, the nation has always eliminated the weak to make way for the healthy. A hard, but healthy and effective law to which we must once again give credence. The primary task of the physician is to discover for whom health care at government expense will be worth the cost.^[396]

In neighbouring Austria, the eminent physician, Julius Wagner-Jauregg, renowned for being, in 1927, the first neuropsychiatrist to receive the Nobel Prize, was another fervent racial hygienist and latent National Socialist. In fact, shortly before his death in 1940 he applied to join the Nazi party, an application denied because his first wife had been Jewish. He supported the German sterilisation law, criticizing the then Austrian government for rejecting policies of racial hygiene. Wagner-Jauregg was of the opinion that people with mental diseases or “criminal genes” were “individuals who, because of lasting genetic mental defects, are a danger to the community and unable to fit in.”^[397] It was becoming increasingly apparent which way the eugenic wind was blowing.

By 1935 Hitler was already proposing that he would use the cover of war to murder psychiatric patients in fulfilment of a long-held belief he had expressed in Mein Kampf. The war, Hitler reasoned, would provide both a distraction and an excuse for officially killing those deemed undesirable. If war should break out, he informed Gerhard Wagner that he would take up the “euthanasia” question and implement it.^[398] Wagner had not attained his eminent position without reason. In the wake of the Nuremberg Laws, he spoke at the 1935 Party Rally of “the inherently different value” of different lives. The concept of equality was not only wrong, but pernicious, since it resulted in valuing “the sick, the dying, and the unfit on a par with the healthy and the strong.” At last Germany was recognizing “the natural and God-given inequality of men.” At the following year's rally he expanded on this theme.:

We must oppose the three great dangers of racial and biological decline that have repeatedly destroyed states, peoples, and cultures in the past if they did not succeed in resisting them in good time. We must therefore contend with these three issues: the decline in the birth rate, the increase in sick and unfit genes in our people, and the mixing of the blood of our people with that of foreign and unrelated peoples, in particular with Jewish blood…The millions and billions that we have spent and the past, and the about one billion marks that we sacrifice today for the care of the genetically ill, is a squandering of our national resources that we National Socialists cannot justify when we consider the needs of the healthy population… The National Socialist state cannot repair the failings of the past, but through the “Law for the Prevention of Genetically Ill Offspring,” it has seen to it that in the future the inferior will not be able to produce more inferior children, saving the German people from a steady stream of new moral and economic burdens resulting from genetic illnesses.^[399]

Yet in 1936, the Ministerial Committee for Penal Law still felt able to declare: “There can be no question of an authorization of the extermination of so-called unworthy life…the strength of the moral standard of the prohibition on killing should not be allowed to weaken through the exemption for victims of severe illnesses or accidents because of considerations of mere expediency…” Compulsory sterilisation was to mark the limit of attempts to enhance the nation's biological inheritance.^[400] Or so many assumed; others had different ideas. Commenting on the proposed introduction of voluntary assisted suicide in England that same year (a measure which was never implemented), one psychiatrist felt the drafting of the English law was seriously at fault because “the possibility of being permitted to kill incurable mental patients…has been entirely unconsidered; precisely this question demands a solution.”^[401]

In 1937, the result of legal proceedings against a farmer who had shot his sleeping adolescent son was reported in a Frankfurt newspaper. Accused of murder, the father defended his action on the grounds that the boy had been “mentally ill in a manner that threatened society”. At the ensuing trial, the father's attorneys and attending Nazi Party officials contended that, amongst other things, the son had been a heavy financial burden on his family – the kind of economic reasoning that was increasingly being applied to cases of mental illness. The father received a sentence of only three years' imprisonment, of which he served just one.^[402] The climate was ripe for the kind of radical action Hitler had promised.

Albert Hartl, a former Catholic priest who joined the SD in 1934, claimed that in the second half of 1938 he had been ordered by Reinhard Heydrich to report to Viktor Brack at the KdF, where Hartl was informed that the commencement of the “euthanasia” programme was under consideration. However, before a final decision was made, it was necessary to establish the position of the Catholic Church on the matter. Therefore, in early 1939 Hartl had met with Joseph Mayer, a Catholic professor of moral theology, in an attempt to gauge the position of the Church with regard to “euthanasia.” Mayer, by no means an opponent of compulsory sterilisation, then produced a one hundred page long document arguing the pros and cons of such a policy, without coming to any firm conclusions. Hartl claimed to have relayed the contents of Mayer's memorandum to Brack, who thereafter informed him that since “a unanimous and unequivocal opposition from the…Churches was not to be expected”, the “euthanasia” programme would begin. Hitler felt sufficiently emboldened by Mayer's position, so Hartl stated, to pass on to members of the Catholic hierarchy his intentions regarding the subject. Consequently, it is claimed that the Catholic Church was forewarned of the intention to commence “euthanasia”, and by not objecting, gave their tacit approval to it.^[403]

Whether Hartl's account can be regarded as entirely reliable is a matter for conjecture. There is no doubt that meetings did take place between Herbert Linden and Hans Hefelmann of the KdF on the one hand and Bishop Heinrich Wienken of Berlin on the other, with the purpose of seeking at least a degree of approval of the “euthanasia” policy on the Church's behalf. But the discussions collapsed after Pius XII issued an unmistakable condemnation of the destruction of “life unworthy of life” – although he was careful to refer to “killing” rather than “murder” – on 2 December 1940.^[404]

What is incontrovertible is that by the end of 1938, the regime was receiving requests from the families of newborn or very young children with severe deformities and brain damage for the grant of a “mercy killing” (Gnadentod). The extent to which such appeals were at least encouraged, if not initiated, by local Nazi party officials is unknown, but seems to have been likely. These petitions were directed to the KdF, an agency headed by Philipp Bouhler and created by Hitler in 1934, ostensibly to keep him in direct touch with the concerns of the population, but acting in practice as Hitler's private office.^[405] In particular, a petition was received (probably from the child's father) in respect of an infant named Gerhard Herbert Kretschmar, the so-called “Knauer” child, who had been born on 20 February 1939 in Pomssen, a small village in Saxony, blind, with one leg and part of one arm missing, and who was described as an “idiot.”^[406] It was Hans Hefelmann, head of department IIb of Amt (Central Office) II at the KdF who dealt with petitions to Hitler, and he passed this one on without comment to Albert Bormann (brother of Martin), head of Amt II. Bormann in turn forwarded it to Hitler, who instinctively understood that this was an opportune moment to put into practice what he had for so long been preaching.^[407] As an agency of the Nazi party the KdF was outside the ambit of the state bureaucracy, and was thus perfectly placed to undertake any command of Hitler's without supervision, still less interference, on the part of others.^[408]

Hitler ordered Karl Brandt, his escort physician, to visit the child at a hospital in Leipzig. Brandt testified at his post-war Nuremberg trial he had been instructed that if the facts provided by the child's father proved to be correct, he was to inform the attending physicians in Hitler's name that “euthanasia” could be carried out – which it was, on 25 July 1939.^[409] Brandt's testimony also clarified two important points. Firstly, the parents were not to be made to feel that they were responsible for the child's demise. For that reason a fictitious cause of death was to be registered – in the case of Gerhard Herbert Kretschmar, it was “heart weakness.” Brandt stated: “…members of the family were told that the child had other weaknesses, that it had some sort of heart disease too…” This provided the template for the mass murder to come.

Secondly, Brandt testified that he had been instructed to state that “if these physicians were to become involved in any legal proceedings because of this measure, these proceedings would be quashed by order of Hitler.” Although in fact Hitler did not possess the authority to issue such a dispensation, Brandt's words provided the medical staff concerned with the comfort they needed. And it would have been a brave man or woman in Nazi Germany who would have contested a Führer-Befehl (Führer order). It also suggests that everybody involved, from Hitler down to the parents, was aware of the illegality of the matter in which they were involved.^[410]

It is arguable that the “Knauer” case was the catalyst for all that followed, although it could equally be argued that Hitler's dedication to “euthanasia” was such that its introduction was inevitable at some point in the brief history of National Socialism. There is some evidence that “euthanasia” was being unofficially practised even before the killing of the “Knauer” child, since asylum death rates began to rise unnaturally in 1938, and a 1942 planning commission report referred to “…certain active psychiatrists with positive attitudes [who] were already practising medical euthanasia extensively in their asylums in completely inconspicuous form even before the Operation” (a code word for the official “euthanasia” programme).^[411] In his post-war testimony, Brandt commented that under certain circumstances, it was the practice for doctors to perform “euthanasia” on newly born children in cases such as that of the “Knauer” child; “No precise instructions were given in that respect.”^[412]

In May 1939, Hitler had instructed Brandt to pave the way for the killing of children by setting up a body with the impressive, if somewhat cumbersome title of “The Reich Committee for the Scientific Registration of Severe Hereditary Ailments” (Reichsausschuss zur wissenschaftlichen Erfassung von erb- und anlagebedingter schwerer Leiden).^[413] This organization, usually referred to simply as “The Reich Committee”, was completely fictitious, and was created simply as a cover for the KdF.^[414] By a decree dated 18 August 1939, in return for a payment of 2 Reichsmarks per case, doctors and midwives were ordered to communicate all cases of “malformed” newborn to the Reich Committee. “The earliest possible registration” of all children under 3 years of age in whom “serious hereditary diseases” were “suspected” was required. Included on the initial list of diseases were certain physical conditions; mental retardation, microcephaly, hydrocephaly, paralysis, spastic conditions, and malformations of all kinds, but especially of the limbs, head and spinal column. Midwives were required to make these reports at the time of a child's birth, while doctors were to report all cases of impaired children known to them. District medical officers were responsible for the accuracy of the reports, and the chief physicians of maternity clinics and wards were notified that the reports - which took the form of questionnaires from the Reich Health Ministry - were required. Subsequently, additional conditions such as learning problems, behavioural difficulties, and even bedwetting were added to the list of reportable “defects”.^[415] By June 1940, the questionnaires had been expanded to include not only a child's specific illness or condition, but details of their family history as well, including particulars of hereditary illnesses and any cases of alcohol, nicotine or drug abuse within the child's family. The revised reports also required a more detailed evaluation of the child's condition by a physician, indicating possibilities for improvement, life expectancy, prior institutional observation and treatment, details of physical and mental development, and descriptions of convulsions and related phenomena. The parameters for inclusion in children's “euthanasia” were gradually extended; by July 1941, not only infants but all minors suffering from any of the listed ailments were required to be registered. Teachers were required to report handicapped pupils. Within a few months thereafter, the programme had been progressively broadened to include children as old as teenagers of sixteen or seventeen.^[416]

Even before war came in September 1939, the Nazis had thus established a government sanctioned process for murder. Two laymen (Hans Hefelmann and Richard von Hegener) made a preliminary selection of cases, which was then reviewed by three medical professors, Werner Catel, Hans Heinze, and Ernst Wentzler (all enthusiastic supporters of “euthanasia”), who determined the fate of the child.^[417] The adjudicators, masters of life and death, never saw those they condemned or consulted their medical histories. Their “expert” decision was based solely on the contents of a form, the Meldebogen, prepared by the reporting medical authority. A child's fate was decided by a simple mark on the form – a red plus sign for death, a blue minus sign for life. Should the expert be undecided, “observation” was recorded on the document, postponing a final decision. If selected for “euthanasia”, after approval by Brandt the child was transferred to one of a list of “Children's Wards for Special Care” (Kinderfachabteilungen), where, their parents were assured, the children would receive the most advanced available treatment for their condition.^[418] After admission the child was either killed immediately, or after a period of further observation would be reassessed, ostensibly in order to prevent mistakes. If there had been none made, and the child's condition was confirmed, the Reich Committee issued authorization for the child to be killed. In reality, few children escaped once committed to a killing ward.^[419]

In summer 1939 another of Hitler's personal physicians, Dr Theodore Morell, reviewed a survey of the views of parents of severely handicapped children, conducted in the 1920s by Ewald Meltzer, an asylum director.^[420] Morell reported to Hitler on the results of Meltzer's investigation:

A number of parents expressed the view: `If only you had done it [that is, “euthanasia”] and then told us that our child had died from an illness.' There is a lesson for us there. We need not suppose that we cannot carry out any salutary measure without the consent of the sovereign people.^[421]

In Morell's opinion, therefore, the conclusion to be drawn was that the regime could anticipate no great negative reaction to the “euthanasia” programme from the general populace. This view was confirmed by another survey conducted in April 1941 which revealed that 80 percent of the relatives of those murdered in the “euthanasia” programme were in agreement with the decision, 10 percent spoke out against it, and 10 percent were indifferent. In fact, the programme was far from unpopular; in many cases parents of handicapped children welcomed, and in some cases requested euthanasia for their afflicted offspring. By 1939, propaganda concerning the removal of mental patients of all ages had been so intensive and effective, that their eradication seemed both natural and desirable.^[422] It has been suggested that this policy of “official secrecy”, where people knew while pretending not to know, and only a very few protested, was an invitation to denial and moral indifference on the part of both the German establishment and the German nation as a whole. It laid the foundation for a similar reaction to the “Final Solution.” If people did not protest at the murder of their own relatives, they were hardly likely to do so when Jews, Gypsies, and foreigners were slaughtered.^[423] By 1945, institutionalized murder had become so much the norm that it no longer remained an issue in Germany.^[424]

Hitler must have taken comfort too from the almost complete dearth of public reaction to the raft of anti-Semitic legislation rapidly introduced after his attainment of power in 1933. Whilst not necessarily approving of such discrimination, protest by the clergy, academics, teachers, and the general populace was notable by its absence. In truth, other problems preoccupied them. This was not symbolic of a national eliminationalist anti–Semitism – merely of indifference and an overriding concern for self-preservation. Public acceptance of these early discriminatory measures was indicative of the extent to which questions of morality could safely be ignored in the Third Reich. The lack of concern shown by the great majority of Germans regarding the fate of their neighbours enabled Hitler to gradually expand the boundaries of what was acceptable. What began with the removal of Jews from the civil service was eventually to end in genocide.^[425]

As early as July 1939, Werner Heyde, who was to play a prominent role in the “euthanasia” programme, attended a meeting at which he learned of the forthcoming killing of adult mental patients.^[426] At this meeting, Bouhler reiterated that by eliminating some of the mentally ill, hospital space and medical personnel would be released for the forthcoming war. There was no compulsion to participate. But all of those present agreed to do so.^[427] One month later the committee responsible for drafting a new criminal code came up with a clause proposing that a person suffering from an incurable or terminal somatic illness be permitted to request euthanasia. Furthermore, it was suggested, the legislation should include provision for the life an individual suffering from incurable mental sickness to be involuntarily terminated in appropriate circumstances. The suggestion was quietly shelved, overtaken by events, but it was evident that some kind of policy for dealing with “life unworthy of life” was imminent.^[428]

Sometime immediately prior to the summer of 1939, it is suggested, Hitler had summoned Martin Bormann (head of the Party Chancellery), Hans Heinrich Lammers (head of the Reich Chancellery) and State Secretary Leonardo Conti (Reich Health Leader) to a meeting, at which Conti was instructed to implement the “euthanasia” programme.^[429] According to Lammers, Hitler stated that that seriously ill mental patients should be “got rid of.” The ending of the “worthless lives of such creatures” would result in savings of hospital and other medical costs.^[430] Lammers testified that Conti insisted upon having his position legalised by way of receipt of a written confirmation, whereupon a furious Hitler replaced Conti with Bouhler.^[431] But at Nuremberg, Brack suggested that in the never-ending struggle for supremacy among the Nazi hierarchy, the true reason for Bouhler's appointment was as the result of scheming on behalf of a coalition of Himmler, Frick, and Göring, who jointly considered that Conti was Bormann's puppet. Since Hitler was subsequently prepared to issue written authorization to Bouhler and Karl Brandt, this seems a conceivable scenario, although it should be born in mind that Brack's testimony was in many cases far from reliable.

In another variation on the origins of adult “euthanasia”, it is said that Helmut Unger had been informed by Gerhard Wagner sometime in 1939 that Hitler had issued an authorization to Conti for the commencement of the programme. Unger so informed Hefelmann, who in turn told Brack on 18 July 1939. Conti, Bouhler and Herbert Linden then conceived a plan for the elimination of all German mental patients.^[432] Karl Brandt's version of events was somewhat different. He claimed that so far as “euthanasia” was concerned, neither he nor Bouhler had attempted to manipulate events to their advantage out of ambition, or lust for power. Rather, the duo were of a mind; altruistic visionaries who had become involved in the affair for purely unselfish, compassionate reasons, Bouhler because he and the office he headed provided an essential link between Hitler and the general population, Brandt in order to ease the suffering of medically hopeless cases, both to prevent Bormann gaining control. Brandt claimed that shortly after the surrender of Poland, Hitler had summoned him and stated:

…that because of a document he [Hitler] had received from Reichsleiter Bouhler, he wanted to bring about a definite solution in the euthanasia question. He gave me general directives on how he imagined it, and the fundamental instruction was that any insane persons who were in such a condition that they could no longer take any conscious part in life were to be given relief through death. General instructions followed about petitions which he himself had received, and he told me to contact Bouhler himself about the matter.

Hitler wanted the KdF to be in charge of “euthanasia”; Brandt was to become involved only so that he could report directly to Hitler regarding developments in the programme.^[433] Thus this was not a position Brandt had sought, he claimed, but one that had been thrust upon him. Furthermore, it was only after this conversation that Brandt discovered that Bouhler had advised Hitler that unauthorised “euthanasia” was already being carried out by some Gau leaders, and that to ensure that there was some kind of management in place, the KdF should be placed in charge of the operation. This conveniently left the responsibility for the scrambling to gain control of “euthanasia” at Bouhler's door, which was probably largely true. However, that Brandt was more extensively involved in all of these Machiavellian dealings than he was prepared to admit seems certain.^[434] From a medical point of view he was quite unsuited to be responsible for a programme that was in any way dedicated to issues of mental health, since he was not a trained psychiatrist, had little knowledge of the subject, and may never have even visited an asylum prior to assuming joint control of the “euthanasia” programme.^[435]

Whatever the precise timetable of events, it would appear that Bouhler and Brandt somehow got wind of Hitler's decision, and anxious to keep “euthanasia” within the ambit of the KdF, pressed him to confirm his instructions.^[436] Ultimately, it is considered that Bouhler and Brandt were chosen by Hitler to head the programme because while Bouhler was considered to be in a position to eliminate the influence of Lammers and Franz Gürtner (the Minister of Justice), Brandt, as Hitler's escort physician since 1934 and the Party representative of the medical profession, was assumed to know doctors who would be prepared to cooperate with the proposed scheme. But Bormann proved too wise in the ways of Nazi government for Bouhler, Brandt, and their supporters. The two leaders of the newly established organisation were forced to consult with Conti, who is known to have signed the first “euthanasia” orders.^[437]

As with the “Final Solution”, “euthanasia” proved zygotic regarding the two essential elements of National Socialist ideology – the biological and the economic. For example, the director of Stetten mental hospital, Pastor Ludwig Schlaich reported:

When it became increasingly apparent, in the final years before 1939, that war was imminent, we learned that there had been discussion in the Reich Ministry of the Interior about putting the inmates of hospitals and nursing homes for the mentally ill, the mentally deficient and epileptics on drastically reduced rations in the event of war. When we objected that this would mean condemning our patients to a slow but certain death by starvation, they carefully began to sound out how the Home Mission would react if the state were to contemplate the elimination of certain categories of sick person in wartime, given that food supplies, once imports dried up, would no longer suffice to feed the entire population.^[438]

Notwithstanding Morell's view and the verbal authorization that had been given to the “euthanasia” enthusiasts sometime prior to July 1939, Hitler wished to avoid the passing of an official law. In a dictatorship, no debate was necessary, no act of government required. It was enough for Hitler to state his intentions in the most general terms. Thereafter it was up to the recipient to interpret those objectives to Hitler's satisfaction. Commands were frequently implied, rarely written. If the listener or reader so chose, Hitler's wishes could effectively attain the force of law, although as will be seen, in reality what is often incorrectly referred to as the “euthanasia decree” was no more than a dispensation. Hitler, indolent and often indecisive, bored by the minutiae of government, ruled not by edict, but by implication and inference. One needed sensitive antennae to interpret his often imprecisely expressed intentions and opinions, for in the National Socialist state the most important attribute for any aspiring courtier was to understand the importance of “working towards the Führer.”^[439] The “euthanasia” authorization was a classic example of this principle. So in October 1939, a brief unofficial sanction was issued on Hitler's private stationery and signed by him:

Reich Leader Bouhler and Dr Brandt are charged with the responsibility for expanding the authority of physicians, to be designated by name, to the end that patients considered incurable according to the best available human judgement of their state of health, can be granted a mercy death. (Reichsleiter Bouhler und Dr. med. Brandt sind unter Verantwortung beauftragt, die Befugnisse namentlich zu bestimmender Ärzte so zu erweitern, dass nach menschlichen Ermessen unheilbar Kranken bei kritischster Beurteilung ihres Krankheitszustandes der Gnadentod gewährt werden kann)^[440]

This sanction made no mention of mental patients per se, but the inference was clear. Asylums were expensive, ate up resources, and allowed patients to live who had no hope of being cured. Would it not be a relief to the nation and to the inmates themselves if they could painlessly be relieved of the burden of life? Such had been the arguments advanced by physicians and party apparatchiks, and which Hitler willingly endorsed.^[441]

Although Hitler supposedly dictated the text, given the ambition of Bouhler and Brandt it seems more likely that it was they who determined the format and wording of the document in order to ensure that the programme remained in their hands.^[442] For the reasons already stated Hitler was doubtless happy to do so. Deliberately drafted in the vaguest terms, the authorization allowed enormous leeway to the future perpetrators, a position they were more than ready to exploit. It should also be born in mind that even by the standards of Nazi government, this dispensation was not a law. It is feasible that some of those subsequently involved in “euthanasia” may have believed that such a law existed, or that a Führer decision (Führerentscheid) carried the weight of law, but it is simply a fact that it was not until 1942 that the Reichstag accorded Hitler the right to promulgate laws himself. The authorization was typed on Hitler's personal notepaper and not that of the Führer und Reichskanzler, was not countersigned by Lammers as head of the Reich Chancellery, and had not been published in the Reich legal gazetteer. These were points completely misunderstood by the Allies in presenting evidence at post-war trials.^[443]

So furtive was the dispensation that Franz Gürtner, the Minister of Justice, was only informed of its existence and shown a photocopy of the document almost one year after adult “euthanasia” had commenced.^[444] Gürtner had been informed of the Aktion by Pastor Paul Braun of the Inner Mission of German Evangelical Churches in June 1940. So shocked was Gürtner that he confronted Lammers, demanding that either the killings stop, or that they be given some kind of legal basis. Lammers referred Gürtner to Bouhler, who one month later, in August 1940, produced a copy of the authorization for the Minister of Justice (the only copy to have survived). On 5 September 1940, Bouhler informed Gürtner: “Based upon the authorization of the Führer as the only one responsible for the implementation of the requisite measures, I have issued directives that seemed necessary to me. Any additional written regulations for implementation are no longer required”.^[445] That was good enough for Gürtner; he offered no further resistance.

Brandt claimed never to have doubted the legality of the dispensation:

For us, who were involved, there was no doubt that (the authorization) had the force of law, and there was therefore no question that our responsible actions were also formally legitimate…For those who were involved in euthanasia there was no doubt…that their action was morally and ethically legitimate and legally secure. Without this assurance and the conviction of this fact, none of the doctors would have acted in the way they did.^[446]

Brandt recorded these comments in 1946, when he was facing a trial that he knew might very well end in his death sentence. His remarks may be viewed as an attempt to retrospectively rationalise the behaviour of himself and others, to justify his actions for the courtroom and for posterity. Whether in fact he gave the question of legality any thought at the time that “euthanasia” was implemented is another matter.

Those responsible for subsequent events later drafted several bills that would have made ““euthanasia”” legal, but all of these were rejected by Hitler.^[447] He believed (almost certainly correctly) that this would present an unacceptable propaganda opportunity to the enemy. It was necessary to wait until final victory had been achieved before passing such a law.^[448] In the meantime, this kind of ersatz legitimatization provided a sop to the consciences of those most intimately involved, whilst maintaining the programme's secrecy.^[449] The authorization was backdated to 1 September 1939 to coincide with the date of commencement of the Second World War.^[450] In the words of Alfred Rosenberg, “The new German style [...] is the style of a marching column, no matter where, or to what end, this marching column may be directed.”^[451]

Yet another example of a Führer-Befehl and eugenics can be seen in the state's attitude regarding abortions. Although abortions performed upon `Aryan' women could be punished by up to two year's imprisonment, and in wartime by death,<sup>[452]</sup> in another secret decree of 19 November 1940, Hitler orally authorized “abortions [in cases] where it can be assumed with great probability that the birth of additional children would be undesirable.” In the hands of Brandt and Brack, this became a blank cheque – abortions up until the sixth month of pregnancy became permissible for “eugenic, racial, and ethnic reasons.” As with the written “euthanasia” sanction, this authorization was completely illegal, but utilising it enabled T4 to organize the elimination of “inferior” children, even before their birth. However, should such a child slip through the net, “alternatives are available through the Reich Committee,” Brack noted.<sup>[453]</sup> There had been an earlier `Law for the Alteration of the Law for the Prevention of Genetically Diseased Offspring'^[454] introduced in 1935, which legalised similar compulsory abortion, but only in cases where the prospective mother had been ruled “hereditarily ill” by the Health Courts.^[455] And as previously described, from 1936 Himmler had his own personal anti-abortion programme. This new, illegal authorization significantly widened the scope for feticide.

At governmental level, Lammers was constantly bemoaning the lack of a legally constituted mandate for “euthanasia”, but Hitler was not to be persuaded on that issue. In late May 1940, when the German campaign in France was about to end in triumph, Hitler instructed Bouhler to contact Lammers and other officials with a view to finding “a solution to the euthanasia problem”. As Lammers described it, Bouhler was pushing for total control of the programme. However, Lammers was not to be moved: “In discussing this problem I drew Bouhler's attention to the serious concerns which I had and said that the matter could only be carried out on the basis of a published law.” Bouhler dismissed Lammers' proposals; it would take far too long to introduce a formal law, and anyway, although Lammers later claimed to be unaware of the fact, the killings had already started. In the event, these discussions made no difference. Shortly afterwards Hitler simply informed Lammers that he did not want a law “for political reasons”.^[456]

It is impossible to be certain about the identity of all of those involved and the precise chronology of the gestation of “euthanasia”. By the end of the war, many of those who made up what might be termed the “executive” of the programme were either dead (Hitler, Bouhler, Wagner, Conti, Linden, de Crinis), living under false identities or in hiding (Blankenburg, Bernotat, Heyde), or were simply at liberty, their participation in the murder of the “worthless” largely unknown - or ignored. Apart from Brandt and Brack in Nuremberg, and Nitsche in Dresden, none of the major figures making up the executive appeared in a courtroom in the immediate post-war years.^[457] It was not until the 1958 with the creation of Zentrale Stelle der Landesjustizverwaltungen zur Aufklärung nationalsozialistischer Verbrechen (The Central Agency of the National Justice System for the Investigation of Nazi Crimes) in Ludwigsburg that the importance of investigating these crimes was recognized in the Federal Republic, and a comprehensive prosecution policy introduced.^[458] Moreover, whether in the immediate aftermath of war or in later proceedings, the evidence provided by those involved in “euthanasia” affairs, either in their interrogation or under cross-examination, should be viewed with the utmost caution. Almost without exception they sought to present themselves and their living colleagues in the best possible light, and their own participation as insignificant. It is also true that few individuals can recall with certainty the exact wording of a conversation that occurred ten or twenty years earlier, where and when it happened, and who was or was not present. All of these factors need to be born in mind when considering testimony about the probable course of events.

There is also another consideration in evaluating the available evidence concerning the development of the “euthanasia” programme – the form of Nazi government. As described, Hitler ruled, not by debate and statute, but by hint and innuendo. He who had the ear of the Führer wielded power and influence. Hitler frequently conducted meetings with his cohorts “unter vier Augen”, (“under four eyes”), that is to say tête-à-tête.^[459] At such an audience, no secretaries were present, no minutes taken. If any “suggestions” were made, only Hitler and whichever other individual was present knew of them. The recipient of such a suggestion stood or fell by his ability to understand and interpret Hitler's intentions. This is what “working towards the Führer” meant in practice, and it was probably how the “euthanasia” policy developed. This anarchic method of government also provided Hitler with another important asset, what today would be termed “plausible deniability” – things done in his name could be blamed on a misinterpretation of his pronouncements, or on the misplaced initiative of others. It is an argument beloved of that peculiar breed, Holocaust “revisionists”. By apparently distancing himself from the excesses of the regime, Hitler could appear to be innocent of their instigation. “If only the Führer knew!” was a familiar cry in Germany. In fact he knew very well.

This technique of protecting oneself against accusations of criminal activity is familiar from the world of organised crime. Layers of management are created, so that the ultimate authority, responsible for ordering or endorsing the illegal act, is distanced as far as is possible from the perpetrator. The two, overlord and executor, rarely, if ever meet. Everything can subsequently be defended or denied by the leader. Among the Nazi hierarchy, Hitler was certainly not alone in practising this strategy. It reappears time and again in the defence offered at countless Nazi war crimes trials. Perhaps one of the best examples was Albert Speer, clearly a very intelligent individual, and equally clearly a very slippery customer. To the Nuremberg IMT his denial of any knowledge of and involvement in certain aspects of the Holocaust appeared plausible, even if we know today that it was a barefaced lie. But Speer was much cleverer than many others appearing before the post-war courts. No, he didn't know, he claimed, but as a responsible member of a government, he should have known. This mea culpa, coupled with his obvious distinction in comparison to the other gangsters in the Nuremberg courtroom, saved him from the hangman's noose. Nonetheless, had the proof accessible today been available to the International Military Tribunal (IMT), Speer's sentence of 20 years' imprisonment would instead almost certainly have been the same as Fritz Sauckel's, a man whose activities were directly comparable with Speer's. Indeed, Sauckel had simply been acceding to Speer's demands regarding the provision of slave labour.^[460] Instead of imprisonment, Sauckel's sentence was execution. So far as the implementation of eugenic policies in the Third Reich was concerned, there were a significant number of distinguished members of the German medical profession who also simply said, like Speer, “I didn't know” in answer to any charges. To prove otherwise was not always easy.

Of course `plausible deniability' in the wrong hands can become `implausible deniability', as for example in the case of Viktor Brack. He presented himself as a great humanitarian who had supported “euthanasia” out of ethical beliefs. At one point he even denied any knowledge of T4, the organisation responsible for carrying out the “euthanasia” programme, as well as supplying the majority of the killers of Aktion Reinhard, and an agency of which he was arguably the most important and influential member.^[461] In such cases, where an overwhelming amount of documentary and eyewitness evidence was available, denial became not just implausible, but little more than farcical. Yet it is also true to say that there was a significant degree of secrecy among the Nazi leadership concerning policies. Essentially, matters were discussed and determined on a “need to know” basis. As Karl Brandt stated: “It was so with many measures…there was no reason for more men – other than the very smallest circle of people – to know about such measures. In the circles around Hitler, no one discussed his tasks and assignments with others unless the Führer himself felt it necessary or spoke about it.”^[462] Albert Speer was not always necessarily the most reliable chronicler of conversations or events, yet his record of comments Hitler made in 1938 has the ring of truth about it. To a party which included Philip Bouhler and his wife, Hitler stressed “the need to keep to oneself things not meant for the ears of the public.” When Bouhler's wife protested that surely such restrictions did not apply to this group of the Führer's intimates, all of whom knew how to keep a secret, Hitler supposedly replied, pointing to Speer: “Nobody here knows how to keep his mouth shut, except for one person.”^[463]

There is an argument that the style of government adopted by Hitler was itself one example of the much abused theory of the “survival of the fittest”. This suggests that the endless rivalry and conflict amongst his henchmen was deliberately cultivated by Hitler. Doubtless the post-war statement of Otto Dietrich, Hitler's press secretary, that the political leadership of the Reich operated in a state of the greatest confusion, was entirely accurate. It could not be otherwise given the level of inefficiency, jurisdictional disputes, intrigue, plotting, alliances, counter-alliances, and enmities that existed at the highest levels of Nazi government, and which Hitler seemingly encouraged. Whether this state of affairs was regarded by Hitler as a practical demonstration of Darwinism in action is feasible, but perhaps credits him with too subtle a mindset.^[464] It is just as likely that Hitler functioned in the way he did out of a fundamental disinterest in the niceties of a rational system of leadership. And, of course, for so long as confusion reigned, so did Hitler. Divide and rule, like so much of Nazism, was not an original concept. Hitler was not remotely concerned with the day-to-day administration of the state; the Great Dictator was content to beget a succession of little dictators and simply leave the mundane details of management of the nation to them. As Ian Kershaw observed: “…it is…misleading to regard the Third Reich as a dictatorship with a coherent, unitary command structure providing for the regulated and centrally directed consistent implementation of Hitler's will.”^[465] A degree of power may have flowed downward from him to his minions, often by implication, but the demarcation lines of authority were usually blurred and frequently overlapped, so that it is often impossible to decipher exactly who was delegated to be responsible for what.^[466]

Despite this incoherent system of government, any suggestion that Hitler was somehow unaware of major policy decisions is simply inconceivable. Maintaining confidentiality may have been of paramount importance to Hitler, but he was the one man who knew all of the secrets. In a speech delivered in 1938, Hans Frank, head of the Nazi Association of Lawyers, made Hitler's omniscience quite clear. Not only was the Führer Head of State and leader of the government (in effect both President and Prime Minister), he was also Commander-in Chief of all armed forces and “supreme judge of the nation.” Whether he governed through a formal written constitution was irrelevant; “The legal question is only whether through his activity the Führer guarantees the existence of his people.”^[467]

At his Nuremberg trial, Brandt quite correctly insisted that the authorization of 1 September 1939 was not an order to kill. Rather it was a dispensation for killing to occur if, in the judgement of expert medical opinion, the patient was incurably ill. It was consequently a licence, not a directive.^[468] Given that so many defendants were to plead the exact opposite at future trials, that is that they were led to believe the authorization had the force of law, the Nuremberg court was wrong in rejecting Brandt's definition.

By 1938, Dr Walter Ott, head of the Austrian People's Health Office, was writing: “National Socialism does not focus on the mortal individual but on the immortal bloodstream of the race, the people. Thus eugenics and racial hygiene enter the life of our nation as a new task and model of its future.^[469] Hermann Pfannmüller felt able to comment in November 1939: “The problem of whether to maintain this patient material under the most primitive conditions or to eradicate it has now become a subject for serious discussion once more.”^[470] As one doctor confided to her diary: “We were told nothing about the operation officially; unofficially it was assumed that everyone had somehow already been sufficiently informed.” However, Werner Catel for one was under no illusions; “What we are doing here is murder,” he stated.^[471]

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