Dr Robert Jay Lifton THE NAZI DOCTORS:
                        Medical Killing and the
                            Psychology of Genocide ©
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“Euthanasia”: Direct Medical Killing 
were available for children thus affected by fate facilities where “the best and most efficacious treatment is available,” and then declaring that “neither a delay nor a cancellation of the transfer is possible.” Should the parents continue to oppose it, “further steps, such as withdrawal of your guardianship, will have to be taken.”28 This threat to take away legal guardianship usually sufficed, but if it did not there could be the further threat of calling a parent up for special labor duty. The coercion here was in the service not only of the killing policy itself but also of maintaining its medical structure.

That structure served to diffuse individual responsibility. In the entire sequence — from the reporting of cases by midwives or doctors, to the supervision of such reporting by institutional heads, to expert opinions rendered by central consultants, to coordination of the marked forms by Health Ministry officials, to the appearance of the child at the Reich Committee institution for killing — there was at no point a sense of personal responsibility for, or even involvement in, the murder of another human being. Each participant could feel like no more than a small cog in a vast, officially sanctioned, medical machine.

Before being killed, children were generally kept for a few weeks in the institution in order to convey the impression that they were being given some form of medical therapy. The killing was usually arranged by the director of the institution or by another doctor working under him, frequently by innuendo rather than specific order. It was generally done by means of luminal tablets dissolved in liquid, such as tea, given to the child to drink. This sedative was given repeatedly often in the morning and at night — over two or three days, until the child lapsed into continuous sleep. The luminal dose could be increased until the child went into coma and died. For children who had difficulty drinking, luminal was sometimes injected. If the luminal did not kill the child quickly enough — as happened with excitable children who developed considerable tolerance for the drug because, of having been given so much of it — a fatal morphine-scopolamine injection was given. The cause of death was listed as a more or less ordinary disease such as pneumonia, which could even have the kind of kernel of truth we have noted.29

The institutional doctor, then, was at the killing edge of the medical structure, whatever the regime’s assurance that the state took full responsibility. Yet he developed — in fact, cultivated — the sense that, as an agent of the state, he was powerless: from his vantage point, as one such doctor reported, “these children were already marked for killing on their transfer reports,” so that “I did not even bother to examine them.” Indeed, whatever examination he performed was no more than a formality, since he did not have the authority to question the definitive judgment of the three-man panel of experts.

Yet later, program administrators countered with the insistence that the if, when, and how of carrying out a mercy death is up to the judgment of the doctor in charge, who voluntarily and out of conviction  
Medical Killing and the
Psychology of Genocide

Robert J. Lifton
ISBN 0-465-09094
© 1986
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