Nazi mass murderers were omnivores of sorts – they killed children and adults; men and women; citizens of Greater Germany (Germany + Austria) and German-occupied territories in Europe and in the Soviet Union; free individuals (however limited was the idea of freedom under the Nazis) and prisoners of concentration camps.
According to the circular from the Reich Minister of the Interior of August 18th, 1939, Ref: IVb 3088/39 – 1079 Mi, (marked “Strictly Confidential” to keep the program secret), the following congenital disorders qualified the newborn for euthanasia:
- Idiocy (significantly impaired intellectual and adaptive functioning) and Down syndrome – especially cases combined with blindness and deafness
- Microcephaly – a medical condition in which the brain does not develop properly resulting in a smaller than normal head of an infant
- Hydrocephalus (excess fluid build-up in fluid-containing cavities of the brain) to a severe or advanced degree
- Malformations of all kinds, particularly the absence of limbs, severe midline defects of the head and spine, etc.
- Cerebral palsy and related disorders
Another obvious criterion was Jewishness (which means that murder of Jews began almost two years prior to the commencement of the Holocaust in June of 1941).
Older children – from toddlers to teenagers – were marked for euthanasia if they were diagnosed with schizophrenia or other mental diseases thought to be incurable, were mentally or physically handicapped… or simply had severe behavioral problems and thus were deemed “unfit for society”.
The total number of children murdered in the euthanasia program is estimated at about 5,000 – a relatively small number compared to the number of euthanized adults.
Criteria for euthanizing adults were much more simple and straightforward – all institutionalized individuals with mental illnesses or physical disabilities deemed incurable by psychiatrists and/or physicians were to be euthanized (and actually were).
These criteria were stated by Adolf Hitler himself in a 1939 letter (backdate to September 1st, although it was actually issued in October):
“Reichsleiter Bouhler and Dr. Brandt are entrusted with the responsibility of extending the authority of physicians, to be designated by name, so that [adult] patients who, after a most critical diagnosis, on the basis of human judgment, are considered incurable, can be granted mercy death”
However, those responsible for the selection (mostly psychiatrists) deemed necessary to establish more specific selection criteria (selection for euthanasia that is).
So in early October of 1939, all hospitals, nursing homes, old-age homes and mental health sanatoria in Greater Germany were required to report all patients who had been institutionalized for five years or more, who had been committed as “criminally insane”, who were of “non-Aryan race” (especially Jewish) or who had been diagnosed with any on a following list of conditions:
“Schizophrenia, epilepsy, Huntington’s chorea, advanced syphilis, senile dementia, paralysis, encephalitis and “terminal neurological conditions generally”.
Euthanasia program was kept secret hence no reason for compiling these lists were given. So many doctors and administrators of these facilities understandably (and incorrectly) assumed that the reports were to identify inmates who were capable of being drafted for “labor service”
Out of the goodness of their hearts (they genuinely cared for their patients) they decided to overstate the degree of disability of their patients, to protect them from labor conscription. And thus doomed them to being murdered by the T4 killers.
Managers and doctors in some institutions smelled serious trouble for their patients and flatly refused to cooperate with the government authorities. The latter predictably sent teams of T4 doctors (or Nazi medical students) to compile the lists, which was often done in a haphazard and ideologically motivated way.
Adult patients of Jewish nationality (“Jewish blood”) predictably suffered the same fate as Jewish children with mental disorders. During 1940, all of them were removed from the abovementioned institutions and murdered – almost a year before the Nazis commenced the Holocaust (Shoah).
Up until 2013, the consensus among historians was that the death toll of Aktion T4 stood at about 70,000. However, that research in the archives of former East Germany conducted and subsequently published by the Federal Archives of now united Germany indicated that the number of euthanasia victims was more than four times (!) higher.
This research estimated that the death toll in Greater Germany from 1939 to 1945 was about 200,000 individuals and that another 100,000 human beings were killed in German-occupied territories in Europe and the Soviet Union.