Unlike Die Endlösung (“Final Solution to the Jewish Question”) Aktion T4 was not exactly a state secret. Well, theoretically it was, but no one really bothered to enforce it.
As I have already mentioned, it was triggered by petitions for a “mercy killings” from the relatives of mentally and/or physically ill or deformed individuals, so its managers (including Adolf Hitler himself) predicted (as it would turn out later, incorrectly) that the overwhelming majority of Germans would be at least neutral, if not outright supportive, of the program.
Consequently, no one (not the doctors, not the managers, not the police or even Gestapo, not the SS in general) bothered to conceal the fact that mass murders were taking place in so-called “Euthanasia Centers” (death factories, to be blunt) in Bernburg, Brandenburg, Hadamar, Hartheim, Grafeneck and Sonnenstein (the latter is translated as the “Sun Stone” – of all names).
In these towns lots of residents saw the patients/inmates arrive in buses which subsequently left the town empty. In a few hours the whole city could see the smoke from the crematoria chimneys that did not leave any doubt as to where the passengers of the buses went.
In Hadamar, ashes containing human hair rained down on the town (this horrific scene is very realistically re-created in the first episode of the hugely popular TV-series “The Man in the High Castle”).
Despite the strictest orders “from above” (that, however, no one took the trouble of enforcing), some of the staff at the euthanasia centers quite openly talked about what was going on (with no consequences for themselves whatsoever).
While some doctors and administrators in the killing centers covered their tracks with creative causes of death listed on death certificates, a not insignificant number of others were downright lazy and sloppy.
Some claimed that a patient in question was claimed to have died of appendicitis, even though his or her relatives knew that the appendix had been removed years earlier; a number (a lot, actually) of families would receive death certificates on the same day that their relative arrived at the center in question and so on.
Not surprisingly, in Hadamar and some the other “euthanasia centers” children almost constantly (and freely) yelled in the streets that people were being taken away in buses to be gassed (it appears that even the method of mass murder was public knowledge).
Contrary to Hitler’s expectations, the majority of Germans had no desire to let the authorities murder their relatives, no matter how mentally or physically sick the latter might have been.
More and more Germans and Austrians began to hastily withdraw (evacuate, actually) their sick relatives from asylums and sanatoria to care for them at home, often with great expense and difficulty. The latter did not bother themselves in the least – they were ready to do whatever it takes – including making enormous sacrifices – to save the lives of their loved ones.
Another unpleasant surprise for the leaders of Aktion T4 project was that even after six (and even seven) years of incessant and omnipresent Nazi propaganda and a very real threat of internment in a concentration camp, a sizable number of physicians and psychiatrists still put the Hippocratic Oath (“first do no harm”) above the will of the Führer.
These doctors co-operated with families to have patients discharged or if the families could afford it, transferred them to private clinics beyond the reach of T4 killers.
Some of their colleagues “re-diagnosed” patients instead, so that the latter no longer met the T4 criteria. It was a risky endeavor which could have landed the doctor in question in the nearest concentration camp if they were exposed by Nazi zealots from Berlin T4 headquarters during routine or surprise inspection.
Still, some doctors (unlike their Nazi colleagues, real medical professionals) were highly successful in saving lives of their patients. For example,
In Kiel, Professor Hans Gerhard Creutzfeldt (director of the university psychiatric and neurological division and the physician to first describe the Creutzfeldt-Jakob disease) managed to rescue nearly all of his patients from Hadamar gas chambers.
Which means that had all (or at least the overwhelming majority) of physicians and psychiatrists refused to cooperate with the euthanasia program, Nazis would not have been able to murder… maybe even anyone.
Unfortunately, all but a handful of the doctors behaved in exactly the opposite way – they collaborated with Aktion T4 through (deliberate) ignorance, agreement with Nazi eugenicist policies or fear of the regime.