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 Dr Robert Jay Lifton THE NAZI DOCTORS:
                        Medical Killing and the
                            Psychology of Genocide ©
 
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“Euthanasia”: Direct Medical Killing 
 
The decree itself was brief:  
 
Reich Leader Bouhler and Dr. Brandt* are charged with the responsibility for expanding the authority of physicians, to be designated by name, to the end that patients considered incurable according to the best available human judgment [menschlichem Ermessen] of their state of health, can be granted a mercy death [Gnadentod].35† 
 
Actually issued in October, the decree was backdated to 1 September, so that it could relate directly to the day of the outbreak of the Second World War. While the backdating is usually attributed to Hitler’s conviction that a wartime atmosphere would render the German population more amenable to such a project, there was a deeper psychological relationship between “euthanasia” and war. As the fanatical Dr. Pfannmüller in the Nazi program put it: “The idea is unbearable to me that the best, the flower of our youth must lose its life at the front in order that feebleminded and irresponsible asocial elements can have a secure existence in the asylum.”37

The Nazis viewed their biomedical vision as having a heroic status parallel to that of war. Hitler’s concept that the state in itself was nothing, and existed only to serve the well-being of the Volk and the race, applied also to the major enterprises of the state, especially its transcendent enterprise of war. Rather than medical killing being subsumed to war, the war itself was subsumed to the vast biomedical vision of which “euthanasia” was a part. Or, to put the matter another way, the deepest impulses behind the war had to do with the sequence of sterilization, direct medical killing, and genocide.

Yet Hitler and other Nazi leaders were aware that they were embarking on a draconian, though in their eyes necessary, measure for which the German public and even the official state bureaucracy were not quite ready. Hence, the decree was written on Hitler’s private stationery, as though he “considered the death of many thousands of sick persons as his private matter, not ... a decision of the head of state.”38 Or, we may say, he understood himself to be a prophet whose racial vision outdistanced the state’s structure, making it necessary for him to avoid the bureaucratic apparatus and proceed directly to the matter at hand.

His way of doing that was to go straight to the doctors. Inevitably, he ended up creating an elaborate new bureaucracy, one that was both medical and murderous. In his decision to turn the program over to Karl Brandt rather than to Conti (who, as health minister and Reich Health Leader, was the logical person to run it), Hitler was choosing his own
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* Conti and Lammers were soon replaced as heads of the “euthanasia” program by Philip Bouhler and Karl Brandt.

† There was apparently some disagreement about the wording. The final draft was probably written by Dr. Max de Crinis, whose role will be discussed later. Note the broadened “incurable” criteria in this decree: Brandt later claimed that Hitler substituted “best available human judgment” for “nearly certain possibility.” 36
 
 
THE NAZI DOCTORS:
Medical Killing and the
Psychology of Genocide

Robert J. Lifton
ISBN 0-465-09094
© 1986
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Last modified: July 23, 2005
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