fter Nazi Germany passed its racist laws, the time had come to obtain public acceptance of eugenic measures, especially euthanasia. Various propaganda methods, with films heading the list, were employed to bring people to believe the lie that there is no point in making great efforts to keep harmful people alive. Newspapers published reports and articles about how much money was being spent on the mentally handicapped, and how that money could be more usefully spent elsewhere. The campaign was initiated on such a scale that it even entered school textbooks.
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Germany's first euthanasia measures were taken at the end of 1938, at which time a certain Knauer from Leipzig wrote Hitler a letter, saying that he wanted a doctor to put an end to a child of his who was born blind, with only parts of its arms and legs and seemed to be an idiot. In response, Hitler sent his private physician, Professor Karl Brandt, to Leipzig, where the child was duly put to death.
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Hitler signed a document authorizing Karl Brandt and Reich-leader Philip Bouhler to permit euthanasia in special cases. The official permission, known as the "Führer-Order," read:
Reichsleader Bouhler and Dr. Brandt, M.D. are charged with the responsibility of enlarging the authority of certain physicians to be designated by name in such a manner that persons who according to human judgement can upon most careful diagnosis of their condition of sickness be accorded a mercy death. Signed - A. Hitler
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This authority, which made murder a part of daily life, formed the basis for crimes perpetrated by the psychiatrists of the Nazi Germany. Later, ironically, the defendants in the Nuremberg and other war crimes trials tried to depict it as an order and a mitigating factor in their crimes.
How Was the T4 Euthanasia Program Put into Practice?

Smoking chimney from the ovens used to burn the corpses at the Hadamar killing center.
In mid-1939 the final preparations for the program were initiated. In October, questionnaires about the mentally ill, prepared by advisors and the Psychiatry Committee, were sent out to hospitals and institutions. These sought the following information: "Name of patient, marital status, nationality, next of kin. Is patient visited on a regular basis? If so, by whom? With whom does financial responsibility lie? How long has patient been in hospital? How long has patient been ill? Diagnosis, main symptoms. Is patient bed-ridden? Is patient under restraint? Was patient admitted because of an incurable disease or condition? Is the patient war-wounded? And patient's race." Front groups operating under the T4 program distributed the questionnaires.
Under the T4 system, four front groups had been set up to carry out orders from the real T4 team, and in the event of any investigation, the groups would conceal the true source of the operations. Any hospital or family investigating a death warrant or the form of death found it impossible to reach anyone further back than the four front groups.
Working in parallel to these four groups was another group, whose members had become expert on the killing of children in particular. This group was named the Realms Committee for Scientific Approach to Severe Illness due to Heredity and Constitution and had two other organizations in association with it. The Charitable Company for the Transport of the Sick was responsible for transporting patients to the killing centers. The Charitable Foundation for Institutional Care dealt with final arrangements and procedures.

Photographs from different angles of the Bernburg killing center.
One of the Nazis' heartless practices was to demand "expenses" from the families of the patients killed, although the families were unaware they were actually paying for their relatives' murder.
The questionnaires were filled in by the doctors or psychiatrists responsible for the patients in the asylum. The returned forms were evaluated by T4's own psychiatrists and other experts. No patients were examined or observed directly. The decision on whether or not a patient was to be killed was based on information in the questionnaires.
When the forms were first sent out, a number of mental hospitals and suitable buildings were re-arranged for use as killing sites and murder training schools. The death chambers inside the buildings were camouflaged as showers.
This is how this terrifying system functioned: After the questionnaires' responses were received, a notice was sent to the institutions caring for those patients selected for death, announcing that space was to be made available for war-wounded, or that patients were to be removed elsewhere to receive better treatment. One of the front groups collected these patients and transported them to one of the killing centers. There, they were exterminated within a few hours of their arrival.

The above picture shows a model of the Bernburg Psychiatric Hospital. Blue arrows indicate the route taken by patients on their way to the killing area, and the circled building contains the crematorium and gas chambers. Far right: Dr. Kathe Leichte, a professor in the field of social sciences, was sent to the Ravensbrück concentration camp in 1940. In 1942, she was gassed to death by the Gestapo at the Bernburg Euthanasia Institute. Right: Margarita Singer, the daughter of a professor of zoology, was killed under the euthanasia program. In order to conceal the T4 operations, great efforts went in to making the death centers appear like ordinary mental hospitals. This was admitted at the Nuremberg trials by Viktor Brack, head of the 2nd unit of the KdF (a term used to refer to the Chancellery of the Führer) and one of the main figures responsible for the euthanasia program. Brack stated that on entering the death chambers, the patients carried towels and soap and thought they were going to have a real shower. Instead of water, though, they were "showered" with poison gas .
Not only the mentally incurable were butchered. As the practice of euthanasia gained pace, the Nazis began to include other "undesirables." Death warrants were issued for the mentally unstable, schizophrenics, the elderly and infirm, epileptics, and people suffering from Parkinson's disease, paralysis, multiple sclerosis, brain tumors and other organic neurological disorders. Children were killed in the same way, and orphanages and reformatories were investigated in detail to discover new victims.
One very important point must be made clear: 50% of those killed might have recovered had they been permitted to do so.
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High-level Nazis devoted to Hitler selected the students who carried out the killings, who were given very special training. At first they would watch the killings and, as their training progressed, they would take patients to the chambers and begin to switch on the poison gas. They would watch the victims in their death throes, and after death had been ascertained, they would ventilate the chambers and remove the bodies. They thus massacred thousands of innocent victims.
These murders were all carried out under tight security, with every possible precaution to prevent the slightest leak of information, because the people killed in these buildings were not members of "other races." Most were Germans and Austrians. If the German public ever learned that their compatriots were being killed in this way, the Nazis would find this difficult to explain, and so adopted all possible security measures.
The students, who had now turned into executioners of sorts, soon grew used to the murder procedures, and became immune to the pleadings, screams and writhings of the victims. During this process, their instructors closely observed their reactions and wrote reports about them. It was calculated that if students had no difficulty in killing members of their own race simply because they were sick, then it would be even easier for them to kill members of "inferior races," and they were trained for "wider ranging" practices in future. Students who were unable to bear these killings or who protested were sent to the front and placed in "suicide squads" by their unit commanders.
In order to become executioners, the students were trained to be cold-blooded, "flawless assassins"—to withstand the cries and writhings of the dying and the smell of burning human flesh and, to be able to speak to the people they were sending to their deaths as if they really were just going to the showers. They were rewarded and encouraged in various ways. In addition to these various incentives, they were also awarded the Iron Cross Second Class medals, for "Secret Reich matter."
Slowly the public became aware of what was going on in these institutes, and protests began. It was then announced that Hitler had issued an order for the killings to cease. They did not, however, and all that happened was a change of methods, involving either lethal injection or starvation, with the dead buried in mass graves. In this way, the savagery of euthanasia continued throughout the war.