Aktion T4: Euthanasia, Killing of the Innocents


There are hundreds and hundreds of stories within the twelve years of Nazism. Some of the stories are good and uplifting and some, like this one, show just how cruel humans can be to each other. One of the ways that I like to teach others about the Holocaust, is to give them a new perspective, make it relatable to them. In this story, all true, my way to relate is through my cousin Cliffy. Cliffy was born with mental slowness. If he had been born in the 1930’s or 1940’s he most likely would have been placed into an institution to care for him. Luckily, Cliffy was born in the 1970’s and went to school with his brothers and lived with his family. When I think that IF Cliffy had been born during the time of Hitler in Germany, this could have happened to him.


The Creators

Inside the Reich Chancellery building, Hitler had five different offices with five different personal secretaries- all men and all SS officers. Hitler surrounded himself with sycophants and these men knew that as Hitler had no interest in actually running the country, they could make policy and influence him into approving policies that played into his own personal hatreds. One way to get to Hitler was through his mail. All his closest secretaries and advisors wanted to read through his mail for him. One of the men who won this position was Philipp Brouhler, an ambitious SS man.

Philipp Brouhler was born in Munich in 1899, he was wounded in World War I and joined the Nazis in 1922. In 1934 he joined the SS and worked directly under Hitler. Hitler received thousands of letters each day. Marriage proposals were common, as were favors, and as were special requests of the Fuhrer. One such request came from a father of a disabled child. The father wanted Hitlers permission to kill his disabled child as the child was a drain on the family and its resources. Brouhler took the letter directly to Hitler and thus Aktion T4 was born.

Hitler appointed Brouhler and his personal physician, Karl Brandt, to run Aktion T4. Brandt was born in Alsace in 1904 and joined the Nazis in 1932. In 1933 he joined the SA and by 1934 had joined the SS. Brandt started working with Brouhler in October of 1939.


Philipp Brouhler
Karl Brandt. Photo from US Holocaust Memorial Museum

The Program

August 18, 1939 Hitler issued a decree that required all doctors, nurses and midwives to report newborns and children under the age of three who appear to have signs of mental or physical disabilities. That same year, the Nazis formulated questionnaires that were sent to hospitals, care homes and institutions. The questionnaires were carefully designed to look as though the Nazis were gathering statistics, when what they were really gathering was information on the patient’s capability to work. The questionnaires required that patients suffering from schizophrenia, epilepsy, dementia, encephalitis and other chronic psychiatric and neurological disorders, anyone not of German or “related” blood, the criminally insane or those committed on criminal grounds and those confined to the institution in question for more than five years.

Aktion T4 was the forerunner for gassing the in concentration camps, and it was one of the Nazis most heinous crimes. It began with the murder of infants, children and youths. It was aimed to destroy lives that the Nazis felt unworthy to live. They referred to them as “burdensome lives” and “useless eaters”. As the program progressed, the Nazis expanded it from infants and children to the incurably ill, anyone with a physical or mental disability, anyone who was emotionally distraught, elderly people and even bombing victims.

The Nazis secretly recruited “medical experts” to review the questionnaires. These were often doctors who had achieved prominence in their fields. It was their job to review the information on the questionnaires and decided who should live and who should die. They never examined the patient or the patient’s medical records, just the questionnaires that the Nazis had specially formulated to fit their purpose.


Photo from US Holocaust Memorial Museum

The Killing

The Nazis set up six killing centers in Germany and Austria in the towns of Hartheim, Sonnenstein, Grafeneck, Bernberg, Hadamar and Brandenburg. Parents and family were not allowed to visit their children that they had placed in these centers. People thought that these were simply facilities to care for the disabled, elderly and mental instable, they didn’t realize what was going on inside them for over a year.

Unfortunately, almost the entire psychiatric community of Germany was involved in the program and doctors became killers under the auspice of “scientific justification”. Even some of Germany’s politicians got into it. The Bavarian minister of Health proposed that mentally ill, psychopaths and other “inferior” people should be separated from the rest of society and killed.

The first victims were infants, toddlers and children up to age 17 who were already in facilities for care. In October of 1941 propaganda began to circulate encouraging parents to place their children in the care of the state, where they would receive “excellent care”. It was a lie. The first victims were killed by starvation, with orders coming from the Chancellery to withhold food.

As the program grew from infants and children into adults, it required more personnel and faster ways of killing. Starvation and lethal injection were to slow and costly. Gas vans were the next move by the Nazis. Members of the SS would dress in white lab coats to keep up the charade of “medical testing”, while herding disabled people into vans. The vans had pipes running from the exhaust pipe and into the van, pumping in carbon monoxide. This proved to be to public for the Nazis, and they designed showers for each facility with carbon monoxide pumped directly in from running vehicles.

The bodies of those that they murdered were then placed in crematoriums and burned. The family received a condolence letter, a box of ashes (possibly not even of their relative as victims were burned in piles) and falsified death certificates. The death certificates would often list failure to thrive, measles or influenza as the cause of death.


Gassing van, notice SS soldiers in white coats.

Outcry and Shut Down?

After nearly two years, public outcry had begun to cause the Nazis problems. The Bishop of Munster, Count Clemens August von Galen, openly challenged the Nazi regime in his sermon on August 13, 1941. He stated in it that it is the duty of Christians to oppose loss of life even if it means losing their own life. This did catch some by surprise as the Catholic church was surprisingly silent on the Jewish question.

On August 24, 1941 Hitler ordered that the euthanasia program be shut down, however it was just a ruse. The program went underground and continued until the end of the war. Within a year, August of 1942, the killing resumed, however the Nazis had learned the lesson of secrecy and the killing became more carefully concealed. It was no longer centralized; local authorities determined the pace of the killing and the killers started using more covert ways of killing such as drug overdose and lethal injections. However, they did continue to use systematic starvation of adults and children, and they expanded the program to, include geriatric patients, bombing victims and foreign forced laborers.

The killing was not just limited to Germany and Austria, it moved into the Eastern European countries that the Nazis had taken over. In those areas the killing was given to the SS and local police forces. Disabled victims in Poland and the Soviet Union were shot in masses, sometimes murdered in their own beds in their hospital wards. For the SS the murders were not ideologically motivated, they were motivated by money and economics.

In West Prussia and occupied Poland, the SS killed 30,000 patients in the autumn of 1941 alone, and it was just so Germans could come and settle the area. The SS and Wehrmacht would often use the emptied facilities for barracks, reserve hospitals or munitions storage, and in one instance in Tiegenof, Poland the emptied facility became a killing center.


The Deaths and Afterwards

Between January of 1940 and August of 1941, the T4’s own records show that they murdered 70,273 people. Between the supposed shut down in August of 1941 and the end of the war in 1945 it is estimated that over 200,000 men, women, children (5,000 children), teens and infants were murdered because the Nazi’s felt that they were an embarrassment to the “master race”. Adolf Hitler himself is quoted as saying “Wartime is the best time for the elimination of the incurably ill”.

The Aktion T4 program was the forerunner to the extermination camps. Everything the Nazis learned about killing, quickly and efficiently from murdering the disabled, infirmed, etc. they took to the camps and used. Even the doctors from the program went to the camps, they had already lost their humanity, sense of decency and moral compass, they were now just killers.

Philipp Brouhler did not face a war crimes trial, he killed himself in Dachau concentration camp on May 19, 1945. Karl Brandt however did face a trial and was found guilty of war crimes against humanity and was executed on June 2, 1948.


Man’s capacity for cruelty to man is frightening. The fact that human beings could place no value on any human life is even more frightening. Each life, no matter its capabilities, has worth. Each life is a gift. Every person has the capacity to do great things, as well as do horrible things, it all depends on the choices we make. The hatred that permeated the Nazi regime put them on the path to do horrible things without a conscience. I hope that the world has learned its lesson and that we keep vigil to look for history to repeat itself.

I would like to share a quote with you, that I feel fits into this story rather well. The quote is from Father Flanagan who started Boys Town in the United States, as a place for wayward boys to go and learn about love, compassion and faith.

“It costs so little to teach a child to love, and so much to teach him to hate.” – Father Flanagan

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