Dr Robert Jay Lifton THE NAZI DOCTORS:
                        Medical Killing and the
                            Psychology of Genocide ©
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“Euthanasia”: Direct Medical Killing  
only hopeless mental patients: “Those cases ... we in psychiatry know as burned-out ruins (awgebrannte Ruinen) '”42 But many of those present knew of Hitler’s views on eliminating genetically inferior people in general. Although the phrase “life unworthy of life” was liberally invoked, another doctor could feel “not quite clear on where the line was to be drawn.”43 There was stress on constructing a careful medical sequence of evaluation before any patient would be put to death. And the entire project was to be “unconditionally kept secret.” In those important early meetings, just one doctor — Max de Crinis — refused (and only for tactical reasons [see pages 120-221) to participate fully. The general response was that “nobody mentioned any misgivings.”44

What was secret was the actual killing project, not the idea. Some months earlier (April 1939), an article had appeared in a semi-official Nazi magazine, estimating that it would probably be desirable to exterminate one million people.45
Organizing for Killing

Unlike the children’s “euthanasia” program, the T4 program, with its focus on adult chronic patients, involved virtually the entire German psychiatric community and related portions of the general medical community. The camouflage organization created for the medical killing was the Reich Work Group of Sanatoriums and Nursing Homes (Reichsarbeitsgemeinschaft Heil- und Pflegeanstalten, or RAG) operating from the Berlin Chancellery at its Tiergarten 4 address — hence, the overall code name “T4” for the adult project. Questionnaires were worked out by the leadership group of psychiatrists and administrators and distributed, with the help of the Health Ministry, not only to psychiatric institutions but to all hospitals and homes for chronic patients. The limited space provided for biographical and symptomatic categories, as well as the cowering letter, gave the impression that a statistical survey was being undertaken for administrative and possibly scientific purposes. All the more so because the questionnaire for patients was accompanied by an institutional questionnaire, which focused on such matters as annual budget, number of beds, and number of doctors and nurses. But the sinister truth was suggested by the great stress put on a “precise description” of the working ability of the patients, as well as by the juxtaposition of the following four categories:

1 . Patients suffering from specified diseases who are not employable or are employable only in simple mechanical work. The diseases were schizophrenia, epilepsy, senile diseases, therapy-resistant paralysis and other syphilitic sequelae, feeblemindedness from any cause, encephalitis, Huntington’s chorea, and other neurological conditions of a terminal nature.

2. Patients who have been continually institutionalized for at least five years.  
Medical Killing and the
Psychology of Genocide

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