Dr Robert Jay Lifton THE NAZI DOCTORS:
                        Medical Killing and the
                            Psychology of Genocide ©
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3. Patients who are in custody as criminally insane.

4. Patients who are not German citizens, or are not of German or kindred blood, giving race and nationality.

There are added instructions about filling in the section on work, including that of noting “patients in the higher diet categories [who] perform no work though they might be able to do so.” (The original questionnaire, translated, is reproduced on pages 68-69.) By mid 1940, these report forms were required not only on patients who came under the four categories but on all inmates of these institutions.46

The process was haphazard from the start. It was required that forms be returned quickly, and one institutional doctor had to fill out fifteen hundred questionnaires in two weeks. Early confusion about the purpose of the form led some doctors to exaggerate the severity of patients’ conditions as a way of protecting them from what was assumed to be a plan to release them from institutions in order to send them to work. The extent to which psychiatrists could continue to disbelieve what was happening — especially when they did not want to believe it — is suggested by a leading professor of psychiatry’s later description of his response to a rumor he had heard that patients were being “euthanized”:  
I considered the rumor completely unbelievable … Thinking that the questionnaire did not give the slightest cause to suppose such an action, . . . I imagined the intended action was a way of separating the curable patients, or those able to work, from those who were incurable, in order to provide better food for the first group and to provide the second group . . . only the amount of food necessary to keep them alive . . . [My staff] was persuaded by my argument, and we all worked innocently on the questionnaire project.47*  
The “expert evaluation” differed from the children’s program in that the three medical (usually psychiatric) authorities, drawn from among the leaders of the project, did their reviewing independently. Of every questionnaire collected, four or five photocopies were made in the Reich Interior Ministry, one for each of these three “experts” (Gutachter) the other one or two for the later death procedure with the original usually kept in the central files. Each of the experts wrote in a special thick black frame at the lower left-hand corner of the form, “+” in red pencil meaning death “-” in blue pencil meaning life or “?” sometimes with a comment, which was most often “worker.” He then initialed the mark. If anything, their work was even more mercurial and superficial than the initial filling out of the forms. Each doctor was sent at least 100 photocopied questionnaires at a time during one seventeen-[...day]
* This statement is especially significant as having been made by Dr. Gottfried Ewald who, as I discuss in chapter 3, became one of the very few significant psychiatric voices of dissent. His initial disbelief could have been due partly to his then ardent Nazi sympathies.  
Medical Killing and the
Psychology of Genocide

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