45. Considered pejorative today, this term refers to Down’s syndrome.
2) Microcephaly;
3) Hydrocephaly in severe or progressive stages;
4) Deformation of every kind, especially the absence of limbs, severe malformation of the head and the spine, etc.
5) Paralysis, including Little’s Disease [cerebral palsy].
In the case of birthing centers and maternity wards of hospitals, the midwife has the obligation to register only when a chief physician (para. 5) is not available or is unable to complete the registration.
3. Furthermore, all physicians are to register children who are afflicted with one of the conditions named in para. 2, items 1–5 and have not yet reached their third year in those instances where physicians discover such cases in the practice of their profession.
4. The midwife will receive a compensation of 2 RM [Reichsmark] for her efforts. The payment of this sum is to proceed through the public health office. In addition, she will be reimbursed for any postal fees she has incurred.
5. On the basis of §46, para. 2, items 3 and 4 of the Reich Physicians’ Order of December 13, 1935 (Reich Law Gazette I, p. 1433), the Reich Health Leader [Reichsgesundheitsführer] requires all chief physicians of birthing centers and maternity wards to give the required notification for those children born in their institution or ward to the public health office in whose jurisdiction the child’s place of birth lies.
All physicians are further required to send notification of registration to the responsible public health officer [Amtsarzt] at the child’s place of residence in those cases in which children fall under para. 2 of this circular decree and have not yet reached their third year, and who have come to the attention of the physician in the exercise of his duties. In the possible event of a prolonged stay in an institution, the notification of registration is to be sent to the public health office in whose jurisdiction the institution lies.
6. For the filer of the registration suit (physician, midwife), the obligation to report, in accordance with article 3, para. 4 of the First Ordinance for the Implementation of the Law for the Prevention of Progeny with Hereditary Diseases46 of December 5, 1933 (Reich Law Gazette I, p. 1021), is fulfilled with this registration. Further obligatory registrations, especially according to the Prussian Law for the Welfare of Cripples47 of May 6, 1920 (Law. S., p. 280), remains, as before, in effect.
46. This refers to the compulsory sterilization law; see a discussion of the law and its ramifications in the first section of this chapter.
47. In German, the law was called Krüppelfürsorgegesetz.
7. For each incoming registration, the public health officer is personally required promptly to satisfy himself as to the accuracy of the registration form presented to him. In the event that he is unable to do so personally, the public health officer may appoint a physician with a full-time or part-time appointment to the public health office as his proxy.
8. The public health officer must confirm the completeness of the data in the registration forms which he receives and, after supplying any requisite supplementary information, is to send the form, together with an accompanying findings report from him or his representative, promptly to the Reich Committee for the Scientific Registration of Severe Hereditary and Congenital Disorders [Reichsausschuss zur wissenschaftlichen Erfassung von erb- und anlagenbedingten schweren Leiden] in Berlin W 9, Post Office Box 101.
9. The funds (compensation for special registrations, waiver of fees) paid out by the public health offices (including the communal offices) are to be requisitioned monthly from the Government Central Treasuries [Regierungshauptkassen] [. . .] On January 2 and July 1 of each year, the sums of funds paid out by the Government Central Treasuries [. . .] are to be reported to me in accordance with the appended example. The sums will be reimbursed by me through Reich funds. Negative data reports [Fehlanzeigen]48are required.
48. Such a statement, usually from a regular recording post, indicates that there is no data to convey within a given time frame.
10. A copy of this decree is to be prepared for the public health officer of each district. From these, a copy of this decree with the enclosed example is to be prepared together with a certificate of receipt for all midwives [and] chief physicians of birthing centers and maternity wards of hospitals in the district of the public health office. A corresponding number of carbon copies of the decree abstract will be sent to you by separate cover. With reference to the licensing of new midwives and the establishment of new installations of the aforementioned institutions, the same procedures should be followed.
At every opportunity, the public health officers should make midwives cognizant of the registration procedure.
11. The necessary registration forms are to be requested by the public health offices from the higher administration offices, whose needs will be covered by the Reich Printing Office. The forms will be dispensed from this source at no cost. A larger number of carbon copies for the first instance of usage will be sent to the higher administration offices by the Reich Printing Office by order of this decree. The shipping costs will be paid from this office in advance, and accounts of the same should be sent to me with the calculated balances as discussed in para. 9.
By Proxy,
[Signed W. Stuckart49]
49. Wilhelm Stuckart (1902–1953), state secretary in the Reich Ministry of the Interior, was a legal advisor for the fledgling Nazi Party. Stuckart was heavily involved in the early persecution of Jews, cowriting the Nuremberg race laws imposed in 1935. A representative for the Interior Ministry at the Wannsee Conference on January 20, 1942, Stuckart supported forced sterilization for Mischlinge instead of deportation. Stuckart was convicted by an American military commission at the Nuremberg Ministries Trial, but his sentence was reduced to time served, and he was released in April 1949.
Document 6-7. Annamarie R., a young disabled girl born in Kassel, Germany, on January 30, 1935. She was murdered, likely by an overdose of medication, in the Eichberg “euthanasia” facility c. June 27, 1941, USHMMPA WS# 58297/HHStAW Abt. 3008 Picture collection, courtesy of the Hessisches Hauptstaatsarchiv Wiesbaden.
“Euthanasia” planners quickly envisioned extending the killing program from young children to adult disabled patients living in institutional settings. In the autumn of 1939, Adolf 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.50 “Euthanasia” functionaries called their secret enterprise T4. The operation took its code name from the street address of the program’s coordinating office in Berlin at Tiergartenstrasse 4. According to Hitler’s directive, Philipp Bouhler, the director of Hitler’s private chancellery, and Karl Brandt, Hitler’s attending physician, undertook leadership of the killing operation. Under their auspices, T4 operatives established six gassing installations for adults as part of the “euthanasia” action: Brandenburg, on the Havel River near Berlin; Grafeneck in southwestern Germany; Bernburg and Sonnenstein, both in Saxony; Hartheim, near Linz on the Danube in Austria (then the Ostmark); and Hadamar in Hessen.51
50. “Euthanasia” functionaries differ in their testimony concerning the exact dating of the Hitler authorization. T4 plenipotentiary Karl Brandt suggested that Hitler signed the document in late October 1939; see testimony of Karl Brandt, Trials of War Criminals before Nuremberg Military Tribunals under Control Council Law No. 10 (Washington, DC: Government Printing Office, 1951–1952), 1:893. According to “euthanasia” physician Horst Schumann, the document was signed in mid-October. The most reliable evidence may come from Viktor Brack, perhaps the person most clearly in a position to know, as the text was written and transcribed in his office. Brack placed the time of Hitler’s written authorization at late 1939 or early 1940, when the first killings bega
n. In this way the authorization clearly laid an extralegal basis for the measure that protected participating doctors and administrators; see Ernst Klee, “Euthanasie” im NS-Staat: Die “Vernichtung lebensunwerten Lebens” (Frankfurt am Main: Fischer Taschenbuch Verlag, 1985), 100.
51. Only four centralized gassing installations operated at any one time from January 1940 until August 1941. In late 1940 the Brandenburg and Grafeneck T4 facilities were closed down and replaced with killing centers at Bernburg and Hadamar.
Utilizing a practice developed for the child “euthanasia” program, T4 planners began in the autumn of 1939 to distribute carefully formulated questionnaires to all public health officials, public and private hospitals, mental institutions, and nursing homes for the chronically ill and aged. The limited space and wording on the forms, as well as the instructions in the accompanying cover letter, combined to convey the impression that the survey was intended to gather statistical data. The form’s sinister purpose was suggested only by the emphasis that the questionnaire placed on the individual patient’s capacity to work and by the categories of patients that the inquiry required health authorities to identify: those suffering from severe psychiatric disorders or physical disabilities, those not of German or “related” blood, those committed to a mental health facility on criminal grounds, and those who had been confined to the institution in question for more than five years. Secretly recruited physicians and psychiatrists—many of them of significant reputation—worked in teams of three to select patients for the program, often without seeing the individuals in question. On the basis of their decisions, T4 functionaries began in January 1940 to remove designated patients from their home institutions and to transport them by bus or rail to one of the central gassing installations for killing. Within hours of their arrival at such centers, the victims were murdered in specially designed gas chambers, disguised as shower facilities, utilizing chemically produced pure carbon monoxide gas. Thereafter, “euthanasia” personnel burned the bodies in crematoria adjacent to the gassing facilities. Other workers took the ashes of cremated victims from a common pile and placed them in urns to send to the relatives of the victims. The families or guardians of the victims received such an urn, along with a death certificate and other documentation, listing a fictive cause and date of death.
Because of the program’s clandestine nature, T4 planners and functionaries took elaborate measures to conceal its deadly designs. Even though, in every case, physicians and institutional administrators falsified official records to indicate that the victims had died of natural causes, the “euthanasia” program quickly become an open secret. In view of widespread public knowledge of the measure at a critical juncture in the war effort, Hitler ordered a halt to the “euthanasia” operation in late August 1941. According to T4’s own internal calculations, the “euthanasia” effort claimed the lives of 70,273 mentally and physically disabled adult patients at the six gassing facilities between January 1940 and August 1941.
Hitler’s call for a halt to the T4 action did not mean an end to the “euthanasia” effort. The child “euthanasia” program continued throughout the yearlong pause in T4 killing operations. Moreover, in the late summer of 1942, German medical professionals and health-care workers resumed the killing of adults, albeit in a more carefully concealed manner than before. More decentralized than the initial gassing phase, the renewed effort relied closely on regional exigencies, with local authorities determining the pace of the killing. T4 functionaries now employed drug overdose and starvation, methods already successfully utilized in child “euthanasia,” as a more covert means of killing. Resuming at a broad range of custodial institutions throughout the Reich, the “euthanasia” program continued until the last days of World War II. Historians estimate that Operation T4 and its ancillary operations claimed the lives of two hundred thousand individuals, among them five to seven thousand children.
During the second phase of “euthanasia” operations, T4 facilities often participated in the murder of both juvenile and adult patients. Institutions such as Eichberg in Hessen, Langenhorn in Hamburg, Stadtroda in Thuringia, and Kaufbeuren, near the Bavarian city of Augsburg, housed adult killing wards as well as the “special pediatric units”52 of the child “euthanasia” program. At each of these facilities, “euthanasia” operatives, functioning through a fictive organization, the Reich Committee for the Scientific Registration of Severe Hereditary and Congenital Disorders, arranged the transfer of disabled children from the parental home or from another pediatric institution to a participating T4 facility for killing. One of their victims was four-year-old Anita Hart.53
52. The German Kinderfachabteilungen, literally meaning “children’s wards,” is translated in this context as “special pediatric units” to denote a killing center of the child “euthanasia” program.
53. This individual’s surname has been changed to protect her privacy and that of her family.
Anita Rosemarie Hart was born into a Catholic family in Ludwigsburg, near Stuttgart in southwestern Germany, on September 1, 1938. The infant girl was healthy, and Albert Hart, a skilled metalworker, and his wife, Erika, happily welcomed their first child. In early childhood, however, Anita contracted meningitis, a life-threatening infection that causes an inflammation of the protective membranes surrounding the brain and spinal cord. The toddler recovered from the disease, but the resulting encephalitis54 had caused blindness and permanent brain damage.
54. This is an acute inflammation of the brain.
As the child grew, medical professionals advised the Harts that severe cognitive impairment would likely leave her uneducable and that the youngster would probably require institutionalization. Yet, as with many young children with disabilities, Anita remained with her parents until she approached school age. At this time, Albert Hart had been drafted into military service and was serving with Wehrmacht forces at the front. Erika Hart was in the early stages of a new pregnancy. Alarmed by the prospect of caring as a single parent for a newborn and a severely disabled child, she yielded to the pressure of local public health authorities and agreed to place Anita in a pediatric institution. Representatives of the Reich Committee for the Scientific Registration of Severe Hereditary and Congenital Disorders—in reality operatives of the child “euthanasia” program—arranged Anita Hart’s committal to the Kaufbeuren Sanatorium and Nursing Home (Heil- und Pflegeanstalt Kaufbeuren) on March 30, 1943. The facility’s chief medical director, Valentin Faltlhauser,55 informed the Harts that their daughter’s prognosis for recovery was “extraordinarily bleak” but indicated that the child was “trusting and good-natured” and presented few difficulties for the nurses who managed her care. Anita lived at the facility for three months, during which time her mother, despite wartime travel restrictions, journeyed the 140 kilometers (89 miles) from Ludwigsburg to visit her child. Abruptly, on June 22, 1943, Erika Hart received a telegram that her daughter had died of pneumonia. In reality, Anita Hart, aged four years and nine months, had been murdered with a lethal overdose of medication. She is one of 209 infants, toddlers, and juveniles who perished at the Kaufbeuren “euthanasia” facility between December 1941 and May 1945.56
55. Valentin Faltlhauser (1876–1961) served as the medical director for the Kaufbeuren institution from 1929. He not only directed both the adult and child “euthanasia” programs at the facility but also served as a consultant who selected adult patients for the “euthanasia” effort. Arrested in 1945 and tried by an Augsburg court in 1949, Faltlhauser was convicted on the relatively minor charge of abetting manslaughter and sentenced to three years in prison. For the fate of “euthanasia” perpetrators in the postwar period, see Ernst Klee, Was sie taten—was sie wurden: Ärzte, Juristen und andere Beteiligte am Kranken- und Judenmord (Frankfurt am Main: Fischer Taschenbuch Verlag, 1986), 198–99.
56. Michael von Cranach, Martin Schmidt, and Robert Kuhlmann, “Heil- und Pflegeanstalt K
aufbeuren,” in Psychiatrie im Nationalsozialismus: Die Bayerischen Heil- und Pflegeanstalten zwischen 1933 und 1945, ed. Michael von Cranach and Hans-Ludwig Siemen (Munich: R. Oldenbourg Verlag, 1999), 295. Approximately 1,350 adult patients were also murdered at the facility during the war years.
Document 6-8. Excerpts from the patient file of Anita Hart, March 30, 1943, to June 22, 1943, File No. 13029, USHMMA, RG-14.030M, Bezirkskrankenhaus Kaufbeuren (translated from the German).
Kreis Association Ludwigsburg (Württemberg)Mathildenstrasse 8
Telefon 4857–4859
February 12, 1943
Juvenile Office
Re: Accommodations for the child Anita Hart, born September 1, 1938, from Ludwigsburg, Wernerstrasse 62.
The Reich Committee for the Scientific Registration of Severe Hereditary and Congenital Disorders in Berlin W9 reported to me in a letter of October 19, 1942, that admittance of the above mentioned child to your institution has come into question. Because her mother is five months pregnant, time is of an essence in placing this child.
I therefore ask a response at your earliest convenience as to when and under what conditions this child can be admitted there. What must be sent with [the child] in terms of clothing? The cost of care and lodging will be undertaken by the City Office for Family Support in Ludwigsburg, as the father at this time has been inducted into the army.
[signature]
Mr. Albert Hart
Ludwigsburg/Württemberg
Dear Mr. Hart!April 8, 1943
Your child Anita has adjusted very well to the pediatric unit. She is causing no trouble. The condition of the child remains the same as before, as you are already aware.
The planned eye examination here has shown that at least in the right eye, some vision has been retained. In the left eye, the optic nerve has completely disappeared, while in the case of the right eye, some of the nerve has been left intact.
Children during the Holocaust Page 32