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| Amanda Achtman |
Today we might instinctively look at Nazi criteria for death as utterly baseless, but at the time seasoned medical professionals regarded them as reasonable. To have a sense of history is to grasp the arbitrariness of such criteria. When it comes to killing patients, there is no way to get the criteria just right because the stamp of medical approval sends a social message that there is a category of persons who should not exist.
On a visit to Hartheim Castle, a 400-year-old Renaissance fortress not far from Mauthausen concentration camp, I found myself examining a skull-measuring device from 1940. The sinister metal calipers and two measuring scales are on loan from Vienna’s Museum of Natural History; across from the glass display case is a 1930 poster from the UK Eugenics Society featuring a strong, tall man scattering seeds in a field. It reads: “Only Healthy Seed Must Be Sown: Check the Seeds of Hereditary Disease and Fitness by Eugenics.”
Nearby is a 1927 American movie poster: “Youth has its fling—and then comes the burning question—Are you fit to marry?”
In the spring of 2022, I visited one of eight former Nazi euthanasia centers—what Simon Wiesenthal called “regular schools of murder.” Five are in Germany: Brandenburg is just outside Berlin; Hadamar is between Cologne and Frankfurt; Sonnenstein is close to Dresden; Bernburg is in Saxony, and Grafeneck is near Stuttgart. The remaining three are in Austria; Hartheim Castle is in the small village of Alkoven, near Adolf Hitler’s childhood town of Linz.
All but one—Brandenburg—served as psychiatric hospitals or homes for persons with disabilities before being converted to euthanasia centers by the Nazis. Today, Hartheim houses an exhibit on modern eugenics alongside a memorial to the tens of thousands of people killed within its walls.
The link between Nazism and eugenics is often noted only in passing. But it was precisely this link that enabled Simon Wiesenthal to answer questions that bothered him for years. As he writes in his 1967 memoir, The Murderers Among Us:
How were people selected and trained to carry out the murder of 11 million people, and how did they keep their secrets so well that they were not known for years after the end of the war? Obviously, men assigned to the gas chambers, who had to watch the deaths of tens of thousands of people day after day and week after week, would have to be trained technically and psychologically, otherwise they might collapse under the continuous stress. . . . Machines broke down, but the people handling them never did.Wiesenthal wanted to understand how people could become so hardened to the cries of victims that they had less chance of cracking than even a machine. “Castle Hartheim and the other euthanasia centers were the answer,” he concluded.
“Hartheim was organized like a medical school—except that the ‘students’ were not taught to save human life but to destroy it as efficiently as possible,” Wiesenthal observed. Death was studied clinically, with a patina of medical authority; victims were “precisely photographed, scientifically perfected.” Before the death camps were established, euthanasia sites served as research facilities for what Nazis called Gnadentod, or mercy killings; physicians with stopwatches observed dying “patients” through a peephole in Hartheim’s cellar door and measured the length of the death struggle to one-tenth of a second. As Wiesenthal pointed out, “Nothing was left to chance.”
In a section of his memoir focused on his own visit to Hartheim, Wiesenthal pieced together a set of seemingly unrelated facts. Christian Wirth, the notorious leader of Operation Reinhard—the program to exterminate Polish Jewry—got his start supervising the Reich’s euthanasia program. Beginning in 1939, Wirth “troubleshot” extermination techniques at euthanasia centers. He would lure mentally ill or disabled “patients” to so-called showers or changing rooms, locking them in and exposing them to different fatal gas combinations in an attempt to observe which were most efficient. Following his tenure as chief of staff of Hartheim, Wirth went on to serve as commandant of the Belzec concentration camp, which became fully operational in March 1942.
Other SS officers followed suit; after a stint leading Hartheim, Franz Stangl became commandant of Treblinka. Gustav Wagner directed Hartheim before going on to lead Sobibor. A great many SS men who did technical work manning gas chambers and crematoria in the camps first worked at one or another euthanasia clinic. During his final weeks at Mauthausen, Wiesenthal recalled that “experts from Hartheim” were sent for to fix broken ovens or other machinery.
The questions that spurred me to visit were related to, but distinct from, Wiesenthal’s: how are victims of Nazi euthanasia remembered? How should we study and teach about their dehumanization, which differed from how Jews were dehumanized? For a time, Jews were formally banned from being “treated” at Nazi euthanasia sites. At least at first, it was understood that euthanasia was reserved not for Jewish enemies, but for German citizens whose death would be a mercy, both for them and for the country.
It is only recently that museums have been established at Nazi euthanasia sites. My work often takes me to Europe and, over the course of a couple of years, I went on solo trips to three: Hartheim, Hadamar, and Sonnenstein. What follows is not a thorough history of Nazi euthanasia under the Aktion T4 and Aktion 14f13 programs, but a travel diary of sorts, driven by questions that continue to trouble me.
The euthanasia memorials do not receive nearly the volume of visitors that flock to the more notorious death camps; most people are unaware of the links between them. But euthanasia victims often passed through multiple concentration camps before being deported and ultimately killed at euthanasia centers; and as noted, many euthanasia employees were later assigned to high positions within the death camps. How eugenics and euthanasia were both instrumental to and constitutive of the Nazis’ broader campaign of dehumanization deserves to be better understood.
The day I traveled to Hartheim Castle, I was struck by the juxtaposition of the bucolic setting and the site’s grim history. The castle seemed deserted, but fortunately, a receptionist at the front desk was on hand. She gave me a pamphlet explaining that chronically ill and disabled people—“useless eaters” in Nazi parlance—began arriving at Hartheim to be killed by the thousands in 1940. Later, from 1941 to 1944, thousands more prisoners and forced laborers from Mauthausen, Dachau, Ravensbruck, and Gusen were murdered there as well.
I made my way upstairs to Hartheim’s permanent “Value of Life” exhibit, which occupies much of the second floor. A sign at the entrance told an ugly story:
The next room in the Value of Life exhibit traces the rise of the modern eugenics movement. Pioneered by men like nineteenth-century scientists Charles Darwin and his cousin Francis Galton, eugenics quickly rose to prominence in highly developed countries including the U.S., Canada, and England. It took a variety of forms; on display, for example, are “Better Babies” medals. These were designed by famed American sculptor Laura Gardin Fraser and, beginning in 1913, were awarded at state fairs across the country to the most “scientific” babies, with an eye toward improving infant mortality and overall health among children. The national magazine Woman’s Home Companion explained the contests this way: “underneath the inviting charm of the idea is a serious scientific purpose—healthy babies, standardized babies, and always, year after year, Better Babies.”
Eventually, these gave rise to the 1920s “Fitter Family Contests,” which were more explicitly aimed at improving America’s gene pool. Also on display is a copy of Margaret Sanger’s 1929 work Motherhood in Bondage, a collection of letters from poor urban and rural mothers meant to illustrate the “socio-economic rationale for birth control.”
Around the corner was a large reproduction of a 1941 Nazi actuarial table detailing government savings should some number of people with disabilities be prevented from living ten years more. Daily and annual costs of caring for these citizens were meticulously calculated in Reichsmarks, making the case that the state would fare better if they did not exist. This type of formalized dehumanization of those living with disabilities and mental illness, under the guise of medical or actuarial science, contributed to the widespread desensitization and moral degradation of the “educated class.” By degrees, this emboldened people to dehumanize Jews under the pretext of racial hygiene.
The Value of Life exhibit underscores the “ordinariness” of the employees responsible for the sterilization and killing of those sent to Hartheim: kitchen and administrative staff, security guards, drivers, orderlies, technicians, and of course doctors and nurses. As far as we know, they generally worked for the euthanasia programs willingly and without compulsion. Once entrenched, however, they were sworn to secrecy and could not easily leave. But the pay was good, there were plenty of perks, and many were ideologically motivated to carry out their lethal work in the belief that it was beneficial.
It is also important to note that the Nazi euthanasia campaign involved multiple phases. First came the killing of children with physical and intellectual disabilities, then a wider range of patients with mental illnesses and, later, the so-called “Special Treatment” murder of political prisoners. Although Jews were initially kept away from the more “professional” environments of the euthanasia facilities, they were eventually included among the victims of Nazi euthanasia. At the Brandenburg euthanasia center, Jewish psychiatric patients were systematically killed. Some Jewish children were euthanized at Hadamar, and Jews were also among the prisoners euthanized under the “Special Treatment” campaign. The effort to distinguish medical euthanasia centers from the death camps became blurred.
In his memoir, Simon Wiesenthal quotes Bruno Bruckner, a photographer responsible for taking pictures of patients’ “death struggles” and autopsies. Bruckner candidly admitted that he enjoyed the food and abundant liquor at Hartheim and was glad to make “300 marks a month and . . . a little money on the side.” He also noted that “there were lots of parties. Everybody was sleeping with everybody else.”
Bruckner’s attitude seems to have been more the norm than the exception. Few in Germany or Austria resisted the Nazi euthanasia effort; as one plaque noted, “it took a long time for this resistance to be acknowledged in society. It was not until the 1990s when the history of Nazi euthanasia was researched in greater depth in Austria as well, that it found more widespread recognition.”
The main resistance figure recognized at Hartheim is Clemens von Galen, the Catholic bishop of Münster during the Nazi years. His resistance is also alluded to at Yad Vashem, where one display notes that Churches were instrumental in shutting down an early iteration of the program: “When the Euthanasia institutions were closed, their medical and operational personnel were sent to Poland, where they engaged in establishing and commanding the extermination camps for Jews.”
Another resistance figure commemorated at Hartheim is Franz Sitter, a nurse who left Hartheim almost immediately after being hired. He faced no repercussions for walking away, and his example damns all those who made a different choice. Sitter and a small handful of others are presented by the museum as ethical exemplars for visitors, inviting them to probe their own character and conscience as they reflect on what happened here.
The Value of Life exhibit concludes with a display titled “Breaks and Continuities,” containing items or images related to abortion, contraception, in vitro fertilization, surrogacy, genetic testing, disability aids, prosthetics, and more. These are presented without much commentary; it is left to viewers to consider the extent to which any of them relate to the ideology of eugenics and what that might mean for medical practice today.
I returned to the ground floor and Hartheim’s foundational exhibit, which includes the original “killing rooms.” I looked at photographs of victims and a selection of their belongings. When I walked into the gas chamber and crematorium, I felt the emptiness of a world in which so many innocents have been unjustly eliminated.
Later, just outside the castle’s courtyard, I started a conversation with a group of Austrian high school students during their lunch break. I asked if they thought there are ever circumstances in which euthanasia is appropriate. To general agreement, one student answered, “Only if the person asks for it.”
I have continued to reflect on this and other persistent, uncomfortable questions. The students, I realized, freely agreed that no one is qualified to determine the value of anyone else’s life. Clearly the Nazis had profoundly failed to recognize the value of the lives of their neighbors. But do we run the risk of wrongly assessing the worth of our own lives, or becoming convinced our lives are less worthy due to some perceived deficit along medicalized or other standardized lines? If medical practitioners could err so profoundly in their judgments of life’s value, couldn’t I, couldn’t any of us, err similarly? Could “consent” merely corroborate an assessment of a life’s value that is fundamentally inaccurate or untrue? And might others who support a faulty assessment, perhaps out of a misguided sympathy, wrongly encourage people to end their own lives?
The doctors, nurses, and other staff at Hartheim Castle appear to have been driven by personal conviction; their views had become a matter of widespread professional consensus. For years, the judgment of assessors and providers of euthanasia were considered to be beyond reproach. Now, we recognize that their devaluation of human life was abhorrent and unjustifiable. But on what basis can we scrutinize this assessment of the value of life and deem it false?
I often think about how an estimated 30,000 persons were euthanized inside that elegant European castle. Many people participated out of a belief that this was for the good of the victims and for society at large. Hartheim Castle is a reminder that the insidious ideology of Nazism included a specific form of dehumanization that made it easier for modern, technocratic, and prosperous countries to do horrifying things.
Next, Hadamar
In February 2023, several months after my visit to Hartheim, I made my way to a second Nazi euthanasia memorial, Hadamar, located roughly between Cologne and Frankfurt. Usually, public museums are built in city centers for ease of access; concentration camps and euthanasia sites, of course, were deliberately out of the way.
Formerly an ordinary public psychiatric hospital, Hadamar was converted by the Nazis into their sixth euthanasia center as 1940 came to a close. Beginning in January 1941, patients with disabilities and mental illness were regularly bused to Hadamar, led into the main building, told to undress, registered by administrative staff, and then directed to the basement gas chamber, where they were killed. As at Hartheim, they were then incinerated; smoke could be seen from afar and locals reported smelling it. Some at Hadamar received lethal injections or were starved to death. Relatives of the euthanized were sent “comfort letters,” which included false information about the circumstances and time of death and, sometimes, the place of death. If the relatives so requested, they were sent urns containing ashes—though not the ashes of their loved ones.
Beginning in 1942, a more diverse array of “patients” was sent to Hadamar: forced laborers with tuberculosis, former SS soldiers suffering from shell shock, half-Jewish “mixed children.” More than 15,000 people were euthanized at Hadamar from 1941 to 1945, and many more had been sterilized there over the years.
Hadamar physicians were apparently enthusiastic about their work; staff celebrated the death of the 10,000th victim with beer and revelry, with one employee mockingly impersonating a priest. Hadamar staff received perks similar to those of Hartheim’s workers: excursions, concert tickets, even vacation homes. Eventually, it was the employees of Hadamar who went on to build the extermination camp, Treblinka.
The photos of victims especially drew me in. One young woman, identified as Selma K. [Klein], wore her short hair parted to the side, and faced the camera with a slight smile and her right arm folded over her left. According to the exhibit panel, Selma’s mother died when she was young, and she was raised in a Jewish girls’ home. At twenty-one, she got pregnant and, according to her medical records, was judged to be “destitute.” Despite an order banning Hadamar from receiving Jewish patients, Selma was sent there in 1936 and subjected to a sterilization order prior to Hadamar’s becoming a euthanasia center. After Selma was sterilized on the grounds of “not being able to satisfy expectations in life,” her father fought to no avail to get her released. Selma was later deported to Ravensbrück concentration camp, where she is likely to have died in 1942.
There was also Minna Heinze, an elegant-looking middle-aged mother of two, who had helped a Jewish family flee the country after Kristallnacht. Subjected to interrogation concerning her involvement with the Jewish refugees, Minna began to experience anxiety attacks and insomnia and was institutionalized. She was ultimately sent to Hadamar in 1943 and died in March 1944, at around the age of fifty, either from severe deprivation or lethal injection. Her family was prevented from visiting and received no news of her until her reported death from “influenza.” I thought about the Jewish family that fled and may have descendants living today because of Minna’s courage.
Despite Jews’ being occasionally banned from admission to Hadamar, there were exceptions. It was also at Hadamar that the Nazis designated “an Educational Home for Jewish half-breeds of minority age.” Children who had one Jewish parent were sent to Hadamar under the pretense of receiving social welfare education.
Among them were brothers Wolfgang and Günther. According to the boys’ medical files, they were deemed “incapable of being educated,” “inclined toward criminality,” and “morally neglected.” The boys had been growing up without their father; the Nazis had tortured and killed him for being half Jewish and alleged that he was communist. The brothers were admitted as “Jewish half-breeds” to Hadamar’s “educational institution.” They were both killed in the summer of 1943 and given false causes of death. About thirteen-year-old Wolfgang, the medical records said: “Skilled, can be used for domestic work and light gardening. Like his brother, he disturbs the sleeping hall at night and tells the most cock-and-bull stories.”
There is a photo on display of Wolfgang and Günther with their mother, Helene, whose protective expression reveals she knows something dreadful awaits her children. As usual, the doctor at Hadamar invented fictitious causes of death. But Helene also reported that the doctor told her directly: “Mrs. H. You have to accept that you will not see your children again, since Jewishness has to be eliminated.” Of the forty-three children enrolled in the “educational home,” thirty-eight were killed.
I descended to Hadamar’s former gas chamber with the somber realization that these walls were the last thing seen by the victims whose stories I had been learning upstairs.
The Hadamar memorial opened to the public in 1983. In 1991, they created a permanent exhibit. Gradually, the number of visitors, their countries of origin, and the languages in which the material is offered are increasing. The main visitors seem to be German students, but there are also professionals, such as nurses, doctors, and police officers.
According to a Hadamar pamphlet, “The Hadamar Memorial Museum is a place of remembrance, historical enlightenment, and political education and is aimed at children, young people, and adults. Its task is to provide visitors with information about the Nazi euthanasia crimes and to discuss current issues and political education.”
Though the causes of death were often fabricated, my visit made me realize the extent to which ostensibly scientific criteria and an air of medical authority had been wielded to rationalize ending the lives of “inconvenient” innocents. The unspoken logic of the criteria is that it qualified patients to be killed.
The medical records of the euthanasia victims list such things as: “congenital feeble-mindedness,” “social nonconformity,” “anxious relational psychosis,” “unable to work,” “incurable,” “danger to the public,” “unstable and dishonest,” “sullen and unapproachable,” “senile dementia,” etc., as conditions that obviously warranted death.
Ambiguous as these criteria are, they were used to reduce people to conditions that disqualified them from belonging in the world. The person with a name became the mere instance of a type. Doctors would refer to patients by their illness, disability, or inner struggle as a kind of shorthand that eclipsed the person. This is a particularly insidious form of dehumanization, when a person’s entire identity is reduced to a diagnosis, prognosis, or accessibility aid.
In short, a consensus arose around a social valuation of life, which became difficult to dispute. The rationale for killing people became entrenched under the guise of general agreement. The precedent became part of the argument. If the general presumption becomes that the rationale is logical, if there is a sense that fungible criteria are legitimate, then people are susceptible to being classified within them, regardless of whether they would have put themselves in that category.
Today we might instinctively look at Nazi criteria for death as utterly baseless, but at the time seasoned medical professionals regarded them as reasonable. To have a sense of history is to grasp the arbitrariness of such criteria. When it comes to killing patients, there is no way to get the criteria just right because the stamp of medical approval sends a social message that there is a category of persons who should not exist.
Finally, Sonnenstein
In December 2023, I visited a third Nazi euthanasia center: Sonnenstein, in eastern Germany, not far from Dresden in a little town called Pirna. Earlier that morning, I had taken a stroll nearby to the former home of Victor Klemperer, the Jewish chronicler of Dresden, who stored his diary at a home at Maxim Gorki Street No. 16. In the diary, he quotes a friend named Annemarie Kohler, a doctor from Pirna:
Among the more recent locations to become a memorial site, Sonnenstein was inaugurated as such in 2000. The site documents the ways in which the eugenics movement distorted the founding aims of the Sonnenstein Asylum, which once served as a model for the care and treatment of patients.
In the memorial exhibit, there is a first-edition copy of a 1920 book, The Destruction of Life Unworthy of Life, by the German professors and eugenicists Karl Binding and Alfred Hoche; a record of the Nazi-enacted Law for the Prevention of Hereditarily Diseased Offspring, also known as the Sterilization Law, from 1933; and a copy of the private letter signed by Hitler to his physician, Karl Brandt, triggering Aktion T4—the initial phase of the Nazi euthanasia project, authorizing the killing of those with disabilities.
The Sonnenstein memorial team put together a series called “Giving Victims Back their Names,” biographical portrait booklets commemorating some of those killed. Among these is a profile of the rabbi and academic Arnold Grünfeld, who was born in 1887 and killed at Sonnenstein in 1941. A concentration camp prisoner deported to Pirna to be euthanized, Arnold was one of eighty-five Jews from Buchenwald murdered on either July 14 or 15 in 1941.
Born in a Moravian town that had had a significant Jewish community since the fourteenth century, Arnold had lost both his parents by the age of fifteen. He is presumed to have lived with other family members until he finished school; there’s a record of a school trip he took to Vienna to meet Theodor Herzl, during which students gave Herzl donations they had collected.
Arnold served his community as a rabbi and wrote his doctorate on the divine will. His daughter Edith managed to flee Europe in a youth Aliyah. Arnold was deported first to Dachau and then to Buchenwald, before being brought before a medical commission and deported to Sonnenstein, where he was probably gassed on arrival.
After his murder, he was given a false cause of death, and his wife in Prague was told she could receive his urn for a fee.
Whether his ashes were actually in the urn is unknown, but the urn was buried in the Jewish cemetery in Prague. As at Hadamar, families were provided with ashes that could have belonged to anyone, and had no means of knowing whether they had been those of their loved ones. Reportedly, the only differentiation the Nazis made was the amount of ash put into an urn of a child versus that of an adult.
As for the fabricated causes of death, my guide informed me that relatives began to be suspicious upon, for example, receiving a death certificate listing the cause of death as appendicitis for a “patient” whose appendix had already been removed years before.
In a museum pamphlet, I read that about “one-third of those employed at the Sonnenstein killing center were later assigned, most in higher positions, to the extermination camps Belzec, Sobibor, and Treblinka in 1942 and 1943. Those camps were responsible for the murder of about 1.75 million Jews.”
The booklet also includes a photograph of two employees of the Sonnenstein killing center having a beer at the Belzec concentration camp. It is related as a historical fact that the ethical callousness of the euthanasia killings and the corresponding radical desensitization contributed to the mass murders in the concentration camps. But it was also noted that there were between sixty and seventy people on site at all times and that not all of them were ideological National Socialists. Other motivations for their participation included career aspirations, higher salaries, a sense of authority and prestige, and protection from being called up for frontline military service.
Meeting with a young educator there, I asked her about the reactions of the students who visit. “What is it that really hits them?” I asked. My guide explained that what really gets to students is when they realize they could be selectively discarded. Oh wow, I could have been one of those ones who got killed.
When I heard this, I was pleased. I think it is a realization that makes a healthy presumption: that the world would be at a loss without you because the world is better with you in it. Whenever we discard someone, even in our minds, it unwittingly damages our own sense of self-worth because we will have made ourselves more precarious by their dismissal.
As noted, euthanasia, which is already a euphemism, was sometimes referred to by the Nazis as “mercy killings.” However, as with many things, the Nazis got this terribly wrong. Mercy is to be patient with ourselves and others in our weakness. Euthanasia ends a person’s life prematurely; it is an expression of impatience. Callousness can be shown quickly; expressing mercy takes time.
Having visited these three memorials, I am grateful that it is now possible to pay tribute to these lesser-known victims of Nazi euthanasia and eugenics. These sites are worth visiting; these victims deserve our remembrance and commemoration.
Exploring these memorial sites revealed to me the ways in which the euthanasia centers existed in a bizarre, liminal space: sometimes they were regarded as healthcare facilities, sometimes as killing centers. Jews were usually banned from them, but sometimes they got sent to them; many doctors and nurses were true believers in “mercy killing” but they also operated in top secrecy, falsifying death certificates and deceiving patients’ relatives; death was sometimes rationalized as being in the patient’s interest, other times it was a wartime necessity in the interest of the state; propaganda films and posters suggested that the public needed to be convinced, but the prevailing helplessness and fear experienced amid the war naturally limited pushback.
This fog of motivations and perceptions obscures the study of Nazi euthanasia and eugenics. And this is why this history is so crucial to confront: the Nazis surely hoped we would forget it, but the victims of Nazi euthanasia are not just a footnote; the dehumanization against which we need to be on guard is any instance in which a person is deemed “unworthy of life.” To study or visit these sites, I think, is to become responsible in this regard.
At the same time, my travel to these sites showed me that historical facts alone cannot teach us morality. Rather, these facts must be reckoned with and interpreted through a sincere wrestling with our own fears, insecurities, ideals, and hopes.
I made my way upstairs to Hartheim’s permanent “Value of Life” exhibit, which occupies much of the second floor. A sign at the entrance told an ugly story:
The murder of tens of thousands of people here, in this castle, during the National Socialist period formed the starting point for reflections on the value of life. This was narrowed to focus on the questions of how those deemed “useless” have been dealt with: What are the criteria used to define people as “useless”? Who sets the criteria? What have been the consequences of this judgment for those affected?The exhibit doesn’t definitively answer these questions, but begins with an interesting yet cursory history of ideas ranging from Christianity—the viewpoint of which is succinctly summarized as “no one is useless”—to industrial rationality, utilitarianism, and capitalism, with panels explaining how each ideology contributed to the poor, weak, and disabled being deemed useless.
The next room in the Value of Life exhibit traces the rise of the modern eugenics movement. Pioneered by men like nineteenth-century scientists Charles Darwin and his cousin Francis Galton, eugenics quickly rose to prominence in highly developed countries including the U.S., Canada, and England. It took a variety of forms; on display, for example, are “Better Babies” medals. These were designed by famed American sculptor Laura Gardin Fraser and, beginning in 1913, were awarded at state fairs across the country to the most “scientific” babies, with an eye toward improving infant mortality and overall health among children. The national magazine Woman’s Home Companion explained the contests this way: “underneath the inviting charm of the idea is a serious scientific purpose—healthy babies, standardized babies, and always, year after year, Better Babies.”
Eventually, these gave rise to the 1920s “Fitter Family Contests,” which were more explicitly aimed at improving America’s gene pool. Also on display is a copy of Margaret Sanger’s 1929 work Motherhood in Bondage, a collection of letters from poor urban and rural mothers meant to illustrate the “socio-economic rationale for birth control.”
Around the corner was a large reproduction of a 1941 Nazi actuarial table detailing government savings should some number of people with disabilities be prevented from living ten years more. Daily and annual costs of caring for these citizens were meticulously calculated in Reichsmarks, making the case that the state would fare better if they did not exist. This type of formalized dehumanization of those living with disabilities and mental illness, under the guise of medical or actuarial science, contributed to the widespread desensitization and moral degradation of the “educated class.” By degrees, this emboldened people to dehumanize Jews under the pretext of racial hygiene.
The Value of Life exhibit underscores the “ordinariness” of the employees responsible for the sterilization and killing of those sent to Hartheim: kitchen and administrative staff, security guards, drivers, orderlies, technicians, and of course doctors and nurses. As far as we know, they generally worked for the euthanasia programs willingly and without compulsion. Once entrenched, however, they were sworn to secrecy and could not easily leave. But the pay was good, there were plenty of perks, and many were ideologically motivated to carry out their lethal work in the belief that it was beneficial.
It is also important to note that the Nazi euthanasia campaign involved multiple phases. First came the killing of children with physical and intellectual disabilities, then a wider range of patients with mental illnesses and, later, the so-called “Special Treatment” murder of political prisoners. Although Jews were initially kept away from the more “professional” environments of the euthanasia facilities, they were eventually included among the victims of Nazi euthanasia. At the Brandenburg euthanasia center, Jewish psychiatric patients were systematically killed. Some Jewish children were euthanized at Hadamar, and Jews were also among the prisoners euthanized under the “Special Treatment” campaign. The effort to distinguish medical euthanasia centers from the death camps became blurred.
In his memoir, Simon Wiesenthal quotes Bruno Bruckner, a photographer responsible for taking pictures of patients’ “death struggles” and autopsies. Bruckner candidly admitted that he enjoyed the food and abundant liquor at Hartheim and was glad to make “300 marks a month and . . . a little money on the side.” He also noted that “there were lots of parties. Everybody was sleeping with everybody else.”
Bruckner’s attitude seems to have been more the norm than the exception. Few in Germany or Austria resisted the Nazi euthanasia effort; as one plaque noted, “it took a long time for this resistance to be acknowledged in society. It was not until the 1990s when the history of Nazi euthanasia was researched in greater depth in Austria as well, that it found more widespread recognition.”
The main resistance figure recognized at Hartheim is Clemens von Galen, the Catholic bishop of Münster during the Nazi years. His resistance is also alluded to at Yad Vashem, where one display notes that Churches were instrumental in shutting down an early iteration of the program: “When the Euthanasia institutions were closed, their medical and operational personnel were sent to Poland, where they engaged in establishing and commanding the extermination camps for Jews.”
Another resistance figure commemorated at Hartheim is Franz Sitter, a nurse who left Hartheim almost immediately after being hired. He faced no repercussions for walking away, and his example damns all those who made a different choice. Sitter and a small handful of others are presented by the museum as ethical exemplars for visitors, inviting them to probe their own character and conscience as they reflect on what happened here.
The Value of Life exhibit concludes with a display titled “Breaks and Continuities,” containing items or images related to abortion, contraception, in vitro fertilization, surrogacy, genetic testing, disability aids, prosthetics, and more. These are presented without much commentary; it is left to viewers to consider the extent to which any of them relate to the ideology of eugenics and what that might mean for medical practice today.
I returned to the ground floor and Hartheim’s foundational exhibit, which includes the original “killing rooms.” I looked at photographs of victims and a selection of their belongings. When I walked into the gas chamber and crematorium, I felt the emptiness of a world in which so many innocents have been unjustly eliminated.
Later, just outside the castle’s courtyard, I started a conversation with a group of Austrian high school students during their lunch break. I asked if they thought there are ever circumstances in which euthanasia is appropriate. To general agreement, one student answered, “Only if the person asks for it.”
I have continued to reflect on this and other persistent, uncomfortable questions. The students, I realized, freely agreed that no one is qualified to determine the value of anyone else’s life. Clearly the Nazis had profoundly failed to recognize the value of the lives of their neighbors. But do we run the risk of wrongly assessing the worth of our own lives, or becoming convinced our lives are less worthy due to some perceived deficit along medicalized or other standardized lines? If medical practitioners could err so profoundly in their judgments of life’s value, couldn’t I, couldn’t any of us, err similarly? Could “consent” merely corroborate an assessment of a life’s value that is fundamentally inaccurate or untrue? And might others who support a faulty assessment, perhaps out of a misguided sympathy, wrongly encourage people to end their own lives?
The doctors, nurses, and other staff at Hartheim Castle appear to have been driven by personal conviction; their views had become a matter of widespread professional consensus. For years, the judgment of assessors and providers of euthanasia were considered to be beyond reproach. Now, we recognize that their devaluation of human life was abhorrent and unjustifiable. But on what basis can we scrutinize this assessment of the value of life and deem it false?
I often think about how an estimated 30,000 persons were euthanized inside that elegant European castle. Many people participated out of a belief that this was for the good of the victims and for society at large. Hartheim Castle is a reminder that the insidious ideology of Nazism included a specific form of dehumanization that made it easier for modern, technocratic, and prosperous countries to do horrifying things.
In February 2023, several months after my visit to Hartheim, I made my way to a second Nazi euthanasia memorial, Hadamar, located roughly between Cologne and Frankfurt. Usually, public museums are built in city centers for ease of access; concentration camps and euthanasia sites, of course, were deliberately out of the way.
Formerly an ordinary public psychiatric hospital, Hadamar was converted by the Nazis into their sixth euthanasia center as 1940 came to a close. Beginning in January 1941, patients with disabilities and mental illness were regularly bused to Hadamar, led into the main building, told to undress, registered by administrative staff, and then directed to the basement gas chamber, where they were killed. As at Hartheim, they were then incinerated; smoke could be seen from afar and locals reported smelling it. Some at Hadamar received lethal injections or were starved to death. Relatives of the euthanized were sent “comfort letters,” which included false information about the circumstances and time of death and, sometimes, the place of death. If the relatives so requested, they were sent urns containing ashes—though not the ashes of their loved ones.
Beginning in 1942, a more diverse array of “patients” was sent to Hadamar: forced laborers with tuberculosis, former SS soldiers suffering from shell shock, half-Jewish “mixed children.” More than 15,000 people were euthanized at Hadamar from 1941 to 1945, and many more had been sterilized there over the years.
Hadamar physicians were apparently enthusiastic about their work; staff celebrated the death of the 10,000th victim with beer and revelry, with one employee mockingly impersonating a priest. Hadamar staff received perks similar to those of Hartheim’s workers: excursions, concert tickets, even vacation homes. Eventually, it was the employees of Hadamar who went on to build the extermination camp, Treblinka.
The photos of victims especially drew me in. One young woman, identified as Selma K. [Klein], wore her short hair parted to the side, and faced the camera with a slight smile and her right arm folded over her left. According to the exhibit panel, Selma’s mother died when she was young, and she was raised in a Jewish girls’ home. At twenty-one, she got pregnant and, according to her medical records, was judged to be “destitute.” Despite an order banning Hadamar from receiving Jewish patients, Selma was sent there in 1936 and subjected to a sterilization order prior to Hadamar’s becoming a euthanasia center. After Selma was sterilized on the grounds of “not being able to satisfy expectations in life,” her father fought to no avail to get her released. Selma was later deported to Ravensbrück concentration camp, where she is likely to have died in 1942.
There was also Minna Heinze, an elegant-looking middle-aged mother of two, who had helped a Jewish family flee the country after Kristallnacht. Subjected to interrogation concerning her involvement with the Jewish refugees, Minna began to experience anxiety attacks and insomnia and was institutionalized. She was ultimately sent to Hadamar in 1943 and died in March 1944, at around the age of fifty, either from severe deprivation or lethal injection. Her family was prevented from visiting and received no news of her until her reported death from “influenza.” I thought about the Jewish family that fled and may have descendants living today because of Minna’s courage.
Despite Jews’ being occasionally banned from admission to Hadamar, there were exceptions. It was also at Hadamar that the Nazis designated “an Educational Home for Jewish half-breeds of minority age.” Children who had one Jewish parent were sent to Hadamar under the pretense of receiving social welfare education.
Among them were brothers Wolfgang and Günther. According to the boys’ medical files, they were deemed “incapable of being educated,” “inclined toward criminality,” and “morally neglected.” The boys had been growing up without their father; the Nazis had tortured and killed him for being half Jewish and alleged that he was communist. The brothers were admitted as “Jewish half-breeds” to Hadamar’s “educational institution.” They were both killed in the summer of 1943 and given false causes of death. About thirteen-year-old Wolfgang, the medical records said: “Skilled, can be used for domestic work and light gardening. Like his brother, he disturbs the sleeping hall at night and tells the most cock-and-bull stories.”
There is a photo on display of Wolfgang and Günther with their mother, Helene, whose protective expression reveals she knows something dreadful awaits her children. As usual, the doctor at Hadamar invented fictitious causes of death. But Helene also reported that the doctor told her directly: “Mrs. H. You have to accept that you will not see your children again, since Jewishness has to be eliminated.” Of the forty-three children enrolled in the “educational home,” thirty-eight were killed.
I descended to Hadamar’s former gas chamber with the somber realization that these walls were the last thing seen by the victims whose stories I had been learning upstairs.
The Hadamar memorial opened to the public in 1983. In 1991, they created a permanent exhibit. Gradually, the number of visitors, their countries of origin, and the languages in which the material is offered are increasing. The main visitors seem to be German students, but there are also professionals, such as nurses, doctors, and police officers.
According to a Hadamar pamphlet, “The Hadamar Memorial Museum is a place of remembrance, historical enlightenment, and political education and is aimed at children, young people, and adults. Its task is to provide visitors with information about the Nazi euthanasia crimes and to discuss current issues and political education.”
Though the causes of death were often fabricated, my visit made me realize the extent to which ostensibly scientific criteria and an air of medical authority had been wielded to rationalize ending the lives of “inconvenient” innocents. The unspoken logic of the criteria is that it qualified patients to be killed.
The medical records of the euthanasia victims list such things as: “congenital feeble-mindedness,” “social nonconformity,” “anxious relational psychosis,” “unable to work,” “incurable,” “danger to the public,” “unstable and dishonest,” “sullen and unapproachable,” “senile dementia,” etc., as conditions that obviously warranted death.
Ambiguous as these criteria are, they were used to reduce people to conditions that disqualified them from belonging in the world. The person with a name became the mere instance of a type. Doctors would refer to patients by their illness, disability, or inner struggle as a kind of shorthand that eclipsed the person. This is a particularly insidious form of dehumanization, when a person’s entire identity is reduced to a diagnosis, prognosis, or accessibility aid.
In short, a consensus arose around a social valuation of life, which became difficult to dispute. The rationale for killing people became entrenched under the guise of general agreement. The precedent became part of the argument. If the general presumption becomes that the rationale is logical, if there is a sense that fungible criteria are legitimate, then people are susceptible to being classified within them, regardless of whether they would have put themselves in that category.
Today we might instinctively look at Nazi criteria for death as utterly baseless, but at the time seasoned medical professionals regarded them as reasonable. To have a sense of history is to grasp the arbitrariness of such criteria. When it comes to killing patients, there is no way to get the criteria just right because the stamp of medical approval sends a social message that there is a category of persons who should not exist.
In December 2023, I visited a third Nazi euthanasia center: Sonnenstein, in eastern Germany, not far from Dresden in a little town called Pirna. Earlier that morning, I had taken a stroll nearby to the former home of Victor Klemperer, the Jewish chronicler of Dresden, who stored his diary at a home at Maxim Gorki Street No. 16. In the diary, he quotes a friend named Annemarie Kohler, a doctor from Pirna:
The Sonnenstein is no longer the state mental asylum. The SS has it. They built their own crematorium. Disagreeable people are brought here in a kind of police car. Here it is generally called the “whisper carriage.” The relatives then receive the urn. Recently a family received two urns at once.The euthanasia center at Pirna was located on the grounds of the Sonnenstein Castle. As with Hadamar, the site had been an ordinary psychiatric hospital since 1811, before being converted by the Nazis. There, an estimated 13,720 persons living with disabilities and mental illness were euthanized under Aktion T4. In 1941, more than a thousand concentration camp prisoners from Auschwitz, Buchenwald, and Sachsenhausen were killed there.
Among the more recent locations to become a memorial site, Sonnenstein was inaugurated as such in 2000. The site documents the ways in which the eugenics movement distorted the founding aims of the Sonnenstein Asylum, which once served as a model for the care and treatment of patients.
In the memorial exhibit, there is a first-edition copy of a 1920 book, The Destruction of Life Unworthy of Life, by the German professors and eugenicists Karl Binding and Alfred Hoche; a record of the Nazi-enacted Law for the Prevention of Hereditarily Diseased Offspring, also known as the Sterilization Law, from 1933; and a copy of the private letter signed by Hitler to his physician, Karl Brandt, triggering Aktion T4—the initial phase of the Nazi euthanasia project, authorizing the killing of those with disabilities.
The Sonnenstein memorial team put together a series called “Giving Victims Back their Names,” biographical portrait booklets commemorating some of those killed. Among these is a profile of the rabbi and academic Arnold Grünfeld, who was born in 1887 and killed at Sonnenstein in 1941. A concentration camp prisoner deported to Pirna to be euthanized, Arnold was one of eighty-five Jews from Buchenwald murdered on either July 14 or 15 in 1941.
Born in a Moravian town that had had a significant Jewish community since the fourteenth century, Arnold had lost both his parents by the age of fifteen. He is presumed to have lived with other family members until he finished school; there’s a record of a school trip he took to Vienna to meet Theodor Herzl, during which students gave Herzl donations they had collected.
Arnold served his community as a rabbi and wrote his doctorate on the divine will. His daughter Edith managed to flee Europe in a youth Aliyah. Arnold was deported first to Dachau and then to Buchenwald, before being brought before a medical commission and deported to Sonnenstein, where he was probably gassed on arrival.
After his murder, he was given a false cause of death, and his wife in Prague was told she could receive his urn for a fee.
Whether his ashes were actually in the urn is unknown, but the urn was buried in the Jewish cemetery in Prague. As at Hadamar, families were provided with ashes that could have belonged to anyone, and had no means of knowing whether they had been those of their loved ones. Reportedly, the only differentiation the Nazis made was the amount of ash put into an urn of a child versus that of an adult.
As for the fabricated causes of death, my guide informed me that relatives began to be suspicious upon, for example, receiving a death certificate listing the cause of death as appendicitis for a “patient” whose appendix had already been removed years before.
In a museum pamphlet, I read that about “one-third of those employed at the Sonnenstein killing center were later assigned, most in higher positions, to the extermination camps Belzec, Sobibor, and Treblinka in 1942 and 1943. Those camps were responsible for the murder of about 1.75 million Jews.”
The booklet also includes a photograph of two employees of the Sonnenstein killing center having a beer at the Belzec concentration camp. It is related as a historical fact that the ethical callousness of the euthanasia killings and the corresponding radical desensitization contributed to the mass murders in the concentration camps. But it was also noted that there were between sixty and seventy people on site at all times and that not all of them were ideological National Socialists. Other motivations for their participation included career aspirations, higher salaries, a sense of authority and prestige, and protection from being called up for frontline military service.
Meeting with a young educator there, I asked her about the reactions of the students who visit. “What is it that really hits them?” I asked. My guide explained that what really gets to students is when they realize they could be selectively discarded. Oh wow, I could have been one of those ones who got killed.
When I heard this, I was pleased. I think it is a realization that makes a healthy presumption: that the world would be at a loss without you because the world is better with you in it. Whenever we discard someone, even in our minds, it unwittingly damages our own sense of self-worth because we will have made ourselves more precarious by their dismissal.
As noted, euthanasia, which is already a euphemism, was sometimes referred to by the Nazis as “mercy killings.” However, as with many things, the Nazis got this terribly wrong. Mercy is to be patient with ourselves and others in our weakness. Euthanasia ends a person’s life prematurely; it is an expression of impatience. Callousness can be shown quickly; expressing mercy takes time.
Having visited these three memorials, I am grateful that it is now possible to pay tribute to these lesser-known victims of Nazi euthanasia and eugenics. These sites are worth visiting; these victims deserve our remembrance and commemoration.
Exploring these memorial sites revealed to me the ways in which the euthanasia centers existed in a bizarre, liminal space: sometimes they were regarded as healthcare facilities, sometimes as killing centers. Jews were usually banned from them, but sometimes they got sent to them; many doctors and nurses were true believers in “mercy killing” but they also operated in top secrecy, falsifying death certificates and deceiving patients’ relatives; death was sometimes rationalized as being in the patient’s interest, other times it was a wartime necessity in the interest of the state; propaganda films and posters suggested that the public needed to be convinced, but the prevailing helplessness and fear experienced amid the war naturally limited pushback.
This fog of motivations and perceptions obscures the study of Nazi euthanasia and eugenics. And this is why this history is so crucial to confront: the Nazis surely hoped we would forget it, but the victims of Nazi euthanasia are not just a footnote; the dehumanization against which we need to be on guard is any instance in which a person is deemed “unworthy of life.” To study or visit these sites, I think, is to become responsible in this regard.
At the same time, my travel to these sites showed me that historical facts alone cannot teach us morality. Rather, these facts must be reckoned with and interpreted through a sincere wrestling with our own fears, insecurities, ideals, and hopes.
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1 comment:
I recently visited Dachau concentration camp. Its mention in this article made me visualize again the horrors that went on there. Everyone should tour such camps and extermination camps to realize how people can be brainwashed and desensitized into committing such atrocities, not only in the past but now!
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