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The Nazi Euthanasia Program
Deadly Medicine: Creating the Master Race

From 1933 to 1945, Nazi Germany’s government led by Adolf Hitler promoted a nationalism that combined territorial expansion with claims of biological superiority—an “Aryan master race”—and virulent anti-Semitism. Driven by a racist ideology legitimized by German scientists, the Nazis attempted to eliminate all of Europe’s Jews, ultimately killing six million in the Holocaust. Many others also became victims of persecution and murder in the Nazis’ campaign to cleanse German society of individuals viewed as threats to the “health” of the nation.

Following Germany’s defeat in World War I and during the ensuing political and economic crises of the Weimar Republic, ideas known as racial hygiene or eugenics began to inform population policy, public health education, and government-funded research. By keeping the “unfit” alive to reproduce and multiply, eugenics proponents argued, modern medicine and costly welfare programs interfered with natural selection – the concept Charles Darwin applied to the “survival of the fittest” in the animal and plant world. In addition, members of the “fit,” educated classes were marrying later and using birth control methods to limit family size. The result, eugenics advocates believed, was an overall biological “degeneration” of the population. As a solution, they proposed “positive” government policies such as tax credits to foster large, “valuable” families, and “negative” measures, mainly the sterilization of genetic “inferiors.”

International Eugenics

German proponents of eugenics were part of an international phenomenon. The English scientist Francis Galton coined the term eugenics, meaning “good birth,” in 1883. German biologist August Weissmann’s theory of “immutable germ plasm,” published in 1892, fostered growing international support for eugenics, as did the rediscovery in 1900 of Austrian botanist Gregor Mendel’s theory that the biological makeup of organisms was determined by certain “factors” that were later identified with genes. (The term gene was first used by a Danish scientist in 1909.)

Reform-minded proponents of eugenics worldwide offered biological solutions to social problems common to societies experiencing urbanization and industrialization. After classifying individuals into labeled groups using the scientific methods of the day—observation, family genealogies, physical measurements, and intelligence tests—they ranked the groupings from “superior” to “inferior.” When perfected, surgical sterilization became the most common proposal for preventing unproductive “inferiors” from reproducing and for saving on the costs of special care and education. But sterilization gained only limited political support. Catholics objected to interfering with human reproduction, and liberals decried the violation of individual rights. Before 1933, the passage of national statutes legalizing “voluntary” sterilization of inmates of prisons and state mental hospitals proved politically feasible only in Denmark, where the law was little used. Eugenicists more successfully promoted sterilization laws in individual provinces, cantons, or states in CanadaSwitzerland, and the United States.

THE BIOLOGICAL STATE: Nazi Racial Hygiene, 1933-1939

Nazism was “applied biology,” stated Hitler's deputy Rudolf Hess. During the Third Reich, a politically extreme, antisemitic variation of eugenics determined the course of state policy. Hitler’s regime touted the “Nordic race” as its eugenic ideal and attempted to mold Germany into a cohesive national community that excluded anyone deemed hereditarily “less valuable” or “racially foreign.” Public health measures to control reproduction and marriage aimed at strengthening the “national body” by eliminating biologically threatening genes from the population. Many German physicians and scientists who had supported racial hygiene ideas before 1933 embraced the new regime’s emphasis on biology and heredity, the new career opportunities, and the additional funding for research.

Hitler’s dictatorship, backed by sweeping police powers, silenced critics of Nazi eugenics and supporters of individual rights. After all educational and cultural institutions and the media came under Nazi control, racial eugenics permeated German society and institutions. Jews, considered “alien,” were purged from universities, scientific research institutes, hospitals, and public health care. Persons in high positions who were viewed as politically “unreliable” met a similar fate.

The Battle for Births

Echoing ongoing eugenic fears, the Nazis trumpeted population experts’ warnings of “national death” and aimed to reverse the trend of falling birthrates. The Marital Health Law of October 1935 banned unions between the “hereditarily healthy” and persons deemed genetically unfit. Getting married and having children became a national duty for the “racially fit.” In a speech on September 8, 1934Hitler proclaimed: “In my state, the mother is the most important citizen.”

Acting on earlier eugenic concerns about the effects of alcohol, tobacco, and syphilis, the Nazi regime sponsored research, undertook public education campaigns, and enacted laws that together aimed at eliminating “genetic poisons” linked to birth defects and genetic damage to later generations. In 1936, the Reich Central Office for Combating Homosexuality and Abortion was established to step up efforts to prevent acts that obstructed reproduction. In a 1937 speech linking homosexuality to a falling birthrate, German police chief Heinrich Himmler stated: “A people of good race which has too few children has a one-way ticket to the grave.”

The Mass Sterilization Program

On July 14, 1933, the Nazi dictatorship fulfilled the long-held dreams of eugenics proponents by enacting the Law for the Prevention of Genetically Diseased Offspring, based on a voluntary sterilization law drafted by Prussian health officials in 1932. The new Nazi law was coauthored by Falk Ruttke, a lawyer, Arthur Gütt, a physician and director of public health affairs, and Ernst Rüdin, a psychiatrist and early leader of the German racial hygiene movement. Individuals who were subject to the law were those men and women who “suffered” from any of nine conditions assumed to be hereditary: feeblemindedness, schizophrenia, manic-depressive disorder, genetic epilepsy, Huntington’s chorea (a fatal form of dementia), genetic blindness, genetic deafness, severe physical deformity, and chronic alcoholism.

Special hereditary health courts lent an aura of due process to the sterilization measure, but the decision to sterilize was generally routine. Nearly all better-known geneticists, psychiatrists, and anthropologists sat on such courts at one time or another, mandating the sterilizations of an estimated 400,000 Germans. Vasectomy was the usual sterilization method for men, and for women, tubal ligation, an invasive procedure that resulted in the deaths of hundreds of women.

Views from Abroad

International reaction to the Nazi sterilization law varied. In the United States, some newspaper editors noted the mass scale of the policy and feared that “Hitlerites” would apply the law to Jews and political opponents. In contrast, American eugenicists viewed the law as the logical development of earlier thinking by Germany’s “best specialists” and not as “the hasty improvisation of the Hitler regime.”

In the 1930s, leading American and British geneticists increasingly criticized established eugenic organizations for freely mingling prejudices with a dated and simplistic understanding of human heredity. At the same time, sterilization gained support beyond eugenic circles as a means of reducing costs for institutional care and poor relief. Sterilization rates climbed in some American states during the Depression, and new laws were passed in FinlandNorway, and Sweden during the same period. In Great Britain, Catholic opposition blocked a proposed law. Nowhere did the number of persons sterilized come close to the mass scale of the Nazi program.


The Segregation of Jews

The sterilization of ethnic minorities defined as “racially foreign” was not mandated under the 1933 law. Instead, the “Blood Protection Law,” announced in Nuremberg on September 15, 1935, criminalized marriage or sexual relations between Jews and non-Jewish Germans. Soon after, Nazi leaders took biological segregation a step further, privately discussing the “complete emigration” of all Jews as a goal. After the incorporation of Austria in March 1938 (the Anschluss), SS officer Adolf Eichmann coordinated the forced emigration of tens of thousands of Austrian Jews. The Nazi-organized attacks on German and Austrian Jews and Jewish property of November 9–10, 1938—Kristallnacht—convinced many Jews remaining in the Reich that leaving was their only option for survival.

FINAL SOLUTIONS Murderous Racial Hygiene, 1939-1945

World War II provided both pretext and cover to new programs for killing “undesirables” regarded as burdens on national resources. Using arguments advanced by some physicians and jurists in the 1920s, the Nazis justified murder in the name of euthanasia—“mercy death”—and enlisted hundreds of asylum directors, pediatricians, psychiatrists, family doctors, and nurses. Many of those who had earlier rejected euthanasia as a eugenics measure came to support murder “for the good of the Fatherland.”

The first victims were German infants and children. The Reich Ministry of the Interior instructed midwives and physicians to register all children born with severe birth defects. Three expert physicians evaluated each case and, usually without seeing the potential victims, selected those to be killed. Officials deceived the children’s families by providing falsified causes of death. From 1939 to 1945, more than 5,000 boys and girls were killed in some 30 special children’s wards established at state hospitals and clinics.

Mass Gassings: Operation T-4

In October 1939, after Hitler authorized “mercy deaths” for patients deemed “incurable,” the murder program expanded from children to adults. Operation T-4—referring to the address of the secret program’s headquarters at Tiergartenstrasse 4, Berlin—mostly targeted adult patients in private, state, and church-run institutions. Individuals judged unproductive were particularly vulnerable. From January 1940 to August 1941, more than 70,000 men and women were transported to one of six specially staffed facilities in Germany and Austria and killed by carbon monoxide poisoning in gas chambers disguised as showers. Growing public awareness and unrest over the killings influenced Hitler to halt the gassing program. Euthanasia murders resumed in other guises; patients were killed by means of starvation diets and overdoses of medication in hospitals and mental institutions throughout the country. From 1939 to 1945, an estimated 200,000 persons were killed in the various euthanasia programs.

Racial Hygiene in Occupied Poland

While secret euthanasia programs were under way inside the German Reich, members of the SS, headed by Heinrich Himmler, were terrorizing or eliminating perceived biological threats in occupied Poland. Himmler, charged by Hitler with overseeing the radical restructuring of Poland along ethnic lines, sought to reduce Poland to a nation of manual laborers to serve their German “masters.” Nazi plans called for the elimination of Poland’s political and intellectual leaders through mass executions or imprisonment; the deportation of Poles, Jews, and “Gypsies” (Roma) out of areas incorporated into the Reich; colonization by resettled Germans; and the “Germanization” of racially “valuable” Poles. Hundreds of experts trained in racial hygiene helped screen tens of thousands of individuals for genetic and racial “fitness.”

Germans held Polish and other eastern Jews in special contempt, as “subhumans.” From the fall of 1939 to the summer of 1941, the Nazis concentrated some two million Jews in towns and cities and then segregated them into marked-off sections or ghettos. Some of the push to create sealed ghettos in Warsaw and other cities came from German public health officials who falsely linked Jews to the spread of typhus and other diseases.

Mass Gassings of Jews

Nazi racial hygiene culminated in the near-annihilation of European Jewry. The “Final Solution to the Jewish Question” began as special squads of SS and police followed German forces into the Soviet Union and killed more than one million Jews in open-air shootings. But the psychological stress of shooting men, women, and children face-to-face led SS chief Heinrich Himmler to seek a “cleaner” and “more efficient” method of killing. He turned to the example of the euthanasia murder program, and gassing was introduced, but on a vastly larger scale.

Nearly two million people, mostly Polish Jews, were transported for murder to Chelmno and to SobiborTreblinka, and Belzec (isolated SS camps in annexed and occupied Poland) where redeployed T-4 staff manned the gassing installations and crematoria. At Auschwitz-Birkenau, more than one million Jews deported from German-controlled countries perished. Nazi doctors selected “fitter” adults for forced labor, a temporary reprieve, and used both adults and children as guinea pigs in eugenic sterilization experiments and genetic research conducted at the camp.

After the war, few of the biomedical experts who helped, in varying degrees, implement and legitimize Nazi racial hygiene policies were ever indicted or brought to a moral accounting of any kind for their actions. Many continued their professional careers.

Source: U.S. Holocaust Memorial Museum