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Overview of the Aktion T4 the euthanising of disabled and psychiatric patients

Secret program with around 300.000 victims

Aktion T4: Nazi Euthanasia Program

Systematic murder of people with disabilities or suffering from psychiatric problems

Aktion T4, the Nazi program for involuntary euthanasia

Aktion T4 was the name for the mass murder by involuntary euthanasia in Nazi Germany's eugenics program based on "mercy killing" and mandatory sterilization. As soon as 1925, in his book "Mein Kampf", Hitler left no doubt that in the long run, only the Aryan race had the right to exist. When the National Socialists came to power in 1933, the improvement of the race of the German people was therefore high on the agenda. For example, with the introduction of the Nuremberg Race Laws, sexual relations and marriages between Aryans and non-Aryans were banned. Almost at the same time, the “Lebensborn project” was launched, which aims to increase the birth rate of pure bred Aryan children.

Who was responsible for Aktion T4?

The program started in October 1939 on the orders of Adolf Hitler. The office that had to implement this Sonderprogram worked under the leadership of Philipp Bouhler a German senior Nazi Party functionary who was both a Reichsleiter (National Leader) and Chief of the Chancellery of the Führer of the NSDAP. He was also the SS official responsible for the Aktion T4 euthanasia program that killed more than 250.000 disabled adults and children in Nazi Germany, as well as co-initiator of Aktion 14f13, also called "Sonderbehandlung" ("special treatment") that killed between 15.000 - 20.000 concentration camp prisoners.

Also appointed as an organiser was Karl Brandt Hitler's personal physician. Trained in surgery, Brandt joined the Nazi Party in 1932. A member of Hitler's inner circle at the Berghof, he was selected by Philipp Bouhler, the head of Hitler's Chancellery, to administer the Aktion T4 euthanasia program. Brandt was later appointed the Reich Commissioner of Sanitation and Health (Bevollmächtigter für das Sanitäts- und Gesundheitswesen). Accused of involvement in human experimentation and other war crimes, Brandt was indicted in late 1946 and faced trial before a US military tribunal along with 22 others in United States of America v. Karl Brandt. He was convicted, sentenced to death and later hanged on 2 June 1948.
The name T4 is derived from the address of their office, Tiergartenstraße 4 in Berlin.

The original directive to commence the Aktion T4, written out by Adolf Hitler.
Orders for Aktion T4
On September 1, 1939, Adolf Hitler issued the directive to initiate Aktion T4, coinciding with Germany's invasion of Poland, marking the commencement of World War II.
The name T4 is derived from the address of their secret office located at Tiergartenstraße 4 in Berlin.

What objective did Aktion T4 aim to achieve?

The goal of the Aktion T4 program was to preserve the genetic purity of the Germanic people by systematically murdering people who were disfigured, disabled or suffering from some form of psychiatric illness. Arguments to justify this murder were the in Nazi eyes "meaningless existence" and the "meaningless suffering" of these patients.

Aktion T4 was designed to facilitate of purification program was called "mercy killing" because the Nazi doctors saw it as an act of mercy and presented it as the most humane way to put these sick out of their suffering. This thesis belonged to Karl Brandt, Gruppenführer in the SS and Generalleutnant in the Waffen-SS and one of the people who initiated the Aktion T4. He was sentenced to death in the Medical Trial, one of the Nuremberg Trials, and later hanged. In addition, there were also economic considerations: those who worked in the care of the disabled could not serve as a soldier or work in the war industry.

Disabled children were separated from their families and taken to special hospitals. The media at the time responded to the fear that within a few years a large part of the German people would be mentally disturbed, reason to act as quickly as possible. The word "euthanasia" was not used in Nazi propaganda about the Aktion T4, leaving the real intentions of the Nazis (at the beginning) undiscovered. The program was later expanded to include adults, most of whom underwent compulsory sterilization.

How were the patients brought to the euthanasia centers?

The patients were brought into the euthanasia centers in a variety of ways. In some cases, they were simply transferred from their homes or hospitals. In other cases, they were tricked into believing that they were being transferred to a better facility. For example, some patients were told that they were being taken to a spa or am sanatorium.

The patients were often transported in unmarked vans or buses. The windows of the vehicles were often covered to prevent people from seeing the patients inside. The patients were usually accompanied by nurses or doctors, who told them that they were going to a new hospital where they would receive better care.

Patients were collected in blinded buses (to keep the program a secret from the public) and taken to the six main euthanasia centers located in Germany and Austria.
A clandestine photograph of a bus collecting patients from the Liebenau psychiatric hospital, 1940. Copyright: Archiv der Stiftung Liebenau, Meckenbeuren

When the patients arrived at the euthanasia centers, they were taken to a reception area. They were then examined by a doctor, who would determine whether they met the criteria for euthanasia. If the patient met the criteria, they would be taken to the gas chamber and killed.

The Nazis took great care to conceal the Aktion T4 program from the public. They did not want people to know about the killings, so they took steps to make sure that the patients were brought into the euthanasia centers without anyone knowing what was happening.

Transport of patients
Nazi propaganda picture to justify the Aktion T4 program
Propaganda photos like this one are used to educate children about the inferiority of the mentally handicapped. Copyright: Archiv Bezirkskrankenhaus Kaufbeuren
In Germany an estimated 200.000 people were murdered by gassing, asphyxiation, lethal injections, starvation and drug overdoses. Another 100.000 people, mainly from Eastern Europe, also fell victim to the Aktion T4 program.

Involuntary euthanasia on disabled patients

The involuntary euthanaisa of the Aktion T4, was carried out by gassing, asphyxiation, injections, poisoning, starvation and drug overdoses. The first experiments with gas vans were carried out in March 1940 at the hospital in Kochanowka near Łódź. Soon after, the Nazis conducted further experiments in which they poured carbon monoxide from the exhaust of a truck into a closed room. Many of these exterminations during the Aktion T4, were overseen by psychiatrists Carl Hans Heinze Sennhenn and Werner Villinger. Sennhenn supplied hundreds of brains to Nazi researchers. Werner Villinger conducted experiments on humans before sending them to death. Even before the Holocaust and to carry out the Aktion T4, the first gas chambers were built in Hartheim, where adults in particular were killed with carbon monoxide.

Medical personnel paid to kill

The SS functionaries and hospital staff associated with Aktion T4 in the German Reich were paid from the central office at Tiergartenstraße 4 in Berlin from the spring of 1940. The SS and police from SS-Sonderkommando Lange responsible for murdering the majority of patients in the annexed territories of Poland since October 1939, took their salaries from the normal police fund, supervised by the administration of the newly formed Wartheland district; the programme in Germany and occupied Poland was overseen by Heinrich Himmler.

Tiergartenstrasse 4 in Berlin the address of the office of the secret euthanasia organization Aktion T4
The office of the secret euthanasia T4 organization was located at Tiergartenstrasse 4 in Berlin

Individuals responsible for initiating the Aktion T4 program


Philipp Bouhler
Philipp Bouhler, NSDAP Reichsleiter Head of the T4 program
NSDAP Reichsleiter and head of T4 program

Born: 11 September 1899
Died: 19 May 1945 (aged 45)
Karl Brandt
 Karl Brandt Hitler's doctor and organiser of Aktion T4
One of  Hitler's doctors organiser of Aktion T4

Born: 11 September 1899
Died: 19 May 1945 (aged 44)
Viktor Hermann Brack
 Viktor Hermann Brack Chief of Office II
Chief of Office II

Born: 9 November 1904
Died: 2 June 1948 (aged 43)

How many disabled and psychiatric patients died because of Aktion T4?

Before 2013 it was believed, that during the Aktion T4, approximately 70.000 people were murdered in the euthanasia programme. Recently the German Federal Archives reported that research in the archives of former East Germany indicated that the number of victims in Germany and Austria from 1939 to 1945 was about 200.000 people and that another 100.000 people were victims in other European countries.

The German Aktion T4 centers upheld the resemblance of legality in keeping records and writing letters. In Polish psychiatric hospitals no one was left behind during the Aktion T4. Killings were inflicted using gas-vans, sealed army bunkers and machine guns; families were not informed about the murdered relatives and the empty wards were handed over to the SS.

Unveiling the victims of the Aktion T4 Program

The victims of Aktion T4 were a diverse group, but they were all considered to be "undesirable" by the Nazis. They included people with schizophrenia, epilepsy, dementia, and other chronic psychiatric or neurological disorders. They also included people with physical disabilities, such as paralysis, blindness, and deafness. In some cases, children were also killed if they were considered to be "mentally defective."

Aktion T4 was a horrific crime against humanity. The victims were murdered simply because they were different. Their deaths were a stain on the history of Germany and a reminder of the dangers of intolerance and discrimination.

The victims of the Aktion T4 program deserve to be remembered, not only as a commemoration of their individual lives but also as a collective call to reject any form of dehumanization or prejudice. By honoring their memory, we strive to create a more empathetic and compassionate future, where the intrinsic value of every human life is safeguarded and cherished.

Temporary stop due to pressure from the church

On 18 August 1941, Hitler temporarily halted the program under pressure from Cardinal Clemens August von Galen of the Catholic Church, other churches and families of the victims. More than 70.000 people had already been murdered by then. The German public resistance slowed down but not completely halted; the program was continued in utmost secrecy. Trained troops kept going. Some parts of the program were transferred to military concentration camps.

The murder of the disabled patients continues

But the program did not stop in 1941. Doctors and nurses continued to perform in hospitals in Germany, Austria and Poland. The murders were carried out in such a way that the mistrust of the German population was minimized.

Such precautions however were not taken when people from the occupied territories were murdered. Brutal and violent action have been reported and recorded. The total of victims of the Aktion T4 program in the Nazi occupied territories is estimated at around 100.000 people.

Many of those involved in the program also took an active part in the Holocaust. Some of them were engaged in the development of the gas chambers in Bełżec, Treblinka and Sobibór extermination camps as part of Aktion Reinhard. Besides Auschwitz-Birkenau, Majdanek and Chełmno, these were the main sites of the murder of millions of people.

The results of the Aktion T4 program

Aktion T4, the Nazi Euthanasia program in Germany, killed an estimated 200.000 people. By the end of 1941, every third resident of a mental institution in Germany was already dead, either from murder or from starvation, resulting in 93.000 available beds.

Hitler's grandniece, Aloisia Veit, was among the victims

Aloisia Veit, the niece of Adolf Hitler, was killed in the Nazi euthanasia program in December 1940. She was 49 years old and had schizophrenia. Veit's inclusion in the program was likely due to rumors that circulated among the Nazi leadership about a mental illness in Hitler's family. It is not clear whether Hitler himself knew that his niece had been killed. However he was aware of the euthanasia program and approved of it.

What happened with the perpetrators after the war?

Many of the doctors and nurses who participated in the program were never brought to justice. Some were tried and convicted after the war, but others escaped prosecution. In 1961, a West German court convicted 16 people for their role in the Nazi euthanasia program. However, many other perpetrators were never brought to justice.

A monument to the victims of the Nazi euthanasia program was finally laid in Tiergartenstraße, Berlin, on 8 July 2013. The monument is dedicated to the memory of the 200,000 to 300,000 people who were killed in the program. The monument is a reminder of the horrors of the Nazi euthanasia program and the importance of fighting against all forms of discrimination and intolerance.

Clemens A. von Galen
 Clemens August von Galen, Bisschop of Münster

Born: Dinklage, 16 march 1878
Died: Münster, 22 march 1946

Bisschop of Münster
The beatification process for Clemens A. von Galen began in 1955 and was concluded positively in November 2004. He was beatified on October 9, 2005, in St. Peter's Basilica in Rome by the Portuguese Cardinal José Saraiva Martins.
Aloisia Veit
Aloisia Veit (1891 – 6 December 1940) was the grandniece of Adolf Hitler. She was born in Pontafel, Austria-Hungary, and was diagnosed with schizophrenia. She spent many years institutionalized, and in 1940, she was killed as part of the Nazi euthanasia program.
Aloisia was born in Pontafel, Austria - Hungary in 1891 and died on December 6th, 1940. She was the grandniece of Adolf Hitler and was diagnosed with schizophrenia. She spent many years institutionalized. She was killed as part of the Nazi euthanasia program.
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