# UNITED STATES HOLOCAUST MEMORIAL MUSEUM

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## Euthanasia Program

The term "euthanasia" (literally, "good death") usually refers to the inducement of a painless death for a chronically or terminally ill individual. In Nazi usage, however, "euthanasia" was a euphemistic term for a clandestine program which targeted for systematic killing institutionalized mentally and physically disabled patients, without the knowledge or consent of themselves or their families.

In the spring and summer months of 1939, a number of planners -- led by Philipp Bouhler, the director of Hitler's private chancellery, and Karl Brandt, Hitler's attending physician -- began to organize a secret killing operation targeting disabled children. Beginning in October 1939, children with disabilities, brought to a number of specially designated pediatric clinics throughout Germany and Austria, were murdered by lethal overdoses of medication or by starvation. Some 5,000 disabled German infants, toddlers, and juveniles are estimated to have been killed by war's end.

Euthanasia planners quickly envisioned extending the killing program to adult disabled patients living in institutional settings. In the autumn of 1939, Hitler signed a secret authorization in order to protect participating physicians, medical staff, and administrators from prosecution; this authorization was backdated to September 1, 1939, to suggest that the effort was related to wartime measures. The secret operation was code-named T4, in reference to the street address (Tiergartenstrasse 4) of the program's coordinating office in Berlin. Six gassing installations for adults were eventually established as part of the Euthanasia Program: Bernburg, Brandenburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein.

Beginning in January 1940, adult patients were selected by specially recruited T4 physicians for death. These doctors rarely examined the patients themselves, but often based their decisions on medical files and the diagnoses of staff at the victims' home institutions. Those selected were transported by T4 personnel to the sanatoria that served as central gassing installations. The victims were told they would undergo a physical evaluation and take a disinfecting shower. Instead, they were killed in gas chambers using pure carbon monoxide gas. Their bodies were immediately burned in crematoria attached to the gassing facilities. Ashes of cremated victims were taken from a common pile and placed in urns without regard for accurate labeling. One urn was sent to each victim's family, along with a death certificate listing a fictive cause and date of death. The sudden death of thousands of institutionalized patients, whose death certificates listed strangely similar causes and places of death, raised suspicions. Eventually, the clandestine Euthanasia Program became an open secret.

Hitler ordered a halt to the Euthanasia Program in late August 1941, in view of widespread public knowledge of the measure and in the wake of private and public protests concerning the killings, especially from members of the German clergy. According to internal T4 statistics, approximately 70,000 adult disabled patients were murdered during this initial gassing phase. However, this did not mean an end to the Euthanasia killing operation. The child Euthanasia Program continued as before.

Moreover, in August 1942, the killings resumed, albeit more carefully concealed than before. Victims were no longer murdered in centralized gassing installations, but instead killed by lethal injection or drug overdose at a number of clinics throughout Germany and Austria. Many of these institutions also systematically starved adult and child victims. The Euthanasia Program continued until the last days of World War II, expanding to include an ever wider range of victims, including geriatric patients, bombing victims, and foreign forced laborers. Historians estimate that the Euthanasia Program, in all its phases, claimed the lives of 200,000 individuals.

The Euthanasia Program instituted the use of gas chambers and crematoria for systematic murder. The personnel who participated in the Euthanasia Program were instrumental in establishing and operating the extermination camps Belzec, Sobibor, and Treblinka, later used to implement the "Final Solution."

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