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Analyzing Economics and ''Ordinary Germans'' in the Nazi Euthanasia Program

Book Essay on: Michael Burleigh, Death and Deliverance: 'Euthanasia' in Germany,
c.1900 to 194
(New York: Cambridge University Press, 1991), 400 pages.
UCSB: R726.B87 1994

by Adam Wenger
March 13, 2009

for Prof. Marcuse's lecture course
Germany, 1900-1945
UC Santa Barbara, Spring 2009

About the Author
& Abstract
and Links
Plagiarism Warning & Links
Available at amazon

About Adam Wenger

I am a senior history major who has focused my studies on twentieth century European history. Growing up as a Jew, I have always held a keen interest in German history and society. Studying abroad in Italy in Spring 2008 was an amazing opportunity to live through and be surrounded by history. I've never known the details of the Nazi ''euthanasia'' program, and so I chose this book to get a better sense of how the program came to exist as well as how Germans could allow 200,000 psychiatric patients to be murdered in their own country.

Abstract (back to top)

In his book Death and Deliverance: ''Euthanasia'' in Germany 1900-1945, historian Michael Burleigh examines the inner workings of the Nazi euthanasia program. He pays special attention to the role played by all parties involved--from the nurses, doctors, and Nazi officials who facilitated the process, to the patients themselves. Why were ''ordinary'' people--agricultural laborers, builders, cooks, etc.--willing to look past individual rights and concern for the weak in favor of a strong Nazi party with its collectivist goals such as the good of the race, economy and nation? Ultimately troubled by a failing economy, and susceptible to propaganda which labeled these patients as ''life unworthy of life,'' many Germans were willing to accept, if not partake in, the murder of psychiatric patients for the betterment of their own as well as their nation's financial standing. And while there were those who spoke out against the program--Catholics who believed in the sanctity and value of all life were particularly troubled and eventually vocal in their rebuke--the euthanasia program continued on in its murderous course.

Essay (back to top)

From 1939 to 1945 the Nazis nefariously went through the process of murdering some 200,000 mentally ill and physically disabled people whom they had labeled “life unworthy of life.” The systematic murder of these people was known as the “euthanasia” program. Michael Burleigh examines and exposes in full, grim detail the workings of this program in his book Death and Deliverance: ‘Euthanasia’ in Germany 1900-1945. Burleigh pays special attention to the role played by all parties involved in the covert and complex series of operations that defined the euthanasia program--from the nurses, doctors, and Nazi officials who facilitated the process, to the patients themselves. Through extensive research into archival material, such as patient-relative letters of correspondence, asylum reports and medical files, interviews with former staff, and court documentation from the post-war trials, Burleigh shines light on the relationship between psychiatric reform, eugenics, and government cost-cutting policies during the Weimar Republic and Nazi periods.

Looking further, Burleigh seeks to explore the role ‘ordinary’ individuals played in this process. Why were ‘ordinary’ people--agricultural laborers, builders, cooks, etc.--willing to look past individual rights and concern for the weak in favor of a strong Nazi party with its collectivist goals such as the good of the race, economy and nation? Burleigh questions how far silent collusion went in facilitating the murders, and asks whether public acceptance of the ‘euthanasia’ program could have expedited the process (Burleigh, 4).

Through a close and compelling examination of all those involved in the euthanasia program--his attention to the victims is particularly fascinating and rich in detail--readers are left with a fuller understanding of how a nation could allow for the murder of over 200,000 mentally ill and physically disabled people. By personalizing the stories of the victims, Burleigh allows them to take a real form in the minds of historians and readers alike, rather than leaving them to become simple statistics.

Ultimately troubled by a failing economy, and susceptible to propaganda that labeled these patients as “life unworthy of life,” many Germans were willing to accept, if not partake in, the murder of psychiatric patients for the betterment of their own as well as their nation's financial standing. And while there were those who spoke out against the program--Catholics who believed in the sanctity and value of all life were particularly troubled and eventually vocal in their rebuke--the euthanasia program continued on in its murderous course.

Coming to Embrace Euthanasia

At the conclusion of World War I, Germany was in economic disarray. With people starving in the streets, many German professionals began mulling over different ways to alleviate the economy. Budget cuts were a main topic of discussion, and as Burleigh explains in the first section of his book, psychiatrists were deeply concerned over their expenses. Echoing the sentiments of many psychiatrists in the early part of the 1920s was Robert Gaupp, who felt wrong caring for “his patients, when people of ‘full value’ were starving to death in the world outside” (Burleigh, 20). It was in this period that the concept of the “destruction of life unworthy of life” came into existence, the term being coined in 1920 by authors Karl Binding and Alfred Hoche (Burleigh, 16). Writing in favor of involuntary euthanasia, Binding and Hoche found an audience with those who like themselves saw the mentally ill as a burden on German society.

As inflation rose and the economy continued to suffer in the early 1920s, asylums for the mentally ill began to close. Expenditure was cut in favor of areas of medicine where cures could be expected or where it seemed likely that a patient could be sent back into the work force (Burleigh, 25). Despite cuts in funding, the number of patients admitted to asylums rose steadily between 1924 and 1929 (Burleigh, 29). With more patients came added responsibility and a need to use more resources. This did not sit well with those in the Binding and Hoche camp. With the economy still floundering by the turn of the decade, a new sense of urgency arose in the psychiatric field, leaving several psychiatrists to discuss ideas of eugenic sterilization (Burleigh, 37). By 1932, eugenic sterilization had found popular support in Germany, leading the way for the signing of the Law for the Prevention of Hereditary Diseased Progeny on 14 July 1933 (Burleigh, 42). Involuntary sterilization was now legal. In the coming years, as the Nazi Party took control over the nation, the idea of killing the mentally ill would be discussed by senior officials responsible for the administration of Germany’s asylums (Burleigh, 47).

From Sterilization to Murder

Segueing into the Nazi period, Burleigh describes the introduction of the “Fuhrer principle,” under which asylums began to take new shape and find new personnel (Burleigh, 50). Non-Nazi doctors and nurses were replaced with SS doctors who were more willing than most to use drugs to kill patients (Burleigh, 53). As qualified personnel were replaced with unqualified members of the National Socialist party, asylums were losing those who had any concern for the sick. In turn, life inside the asylums became increasingly distressful for the patients. Then, in August of 1939, the Reich Committee made it mandatory for doctors and midwives to register all “'malformed’ newborn children” (Burleigh, 99). These children’s paperwork were to be examined by a team of “expert referees” who would determine whether or not each child should live or be killed (Burleigh, 101).

Readers can see both the bureaucratic process at work--one that is so indicative of Nazi Germany--as well as the large number of people involved in the early stages of the euthanasia program. Although the team of “referees” was ultimately responsible for the killing of the children, these men based their decisions on the registration forms that were filled out by midwives and nurses. Burleigh is interested in every person involved in this program, and thus convincingly highlights the role each person played, be it a midwife, a senior doctor, or Hitler himself. Of even greater concern to Burleigh, however, is the way in which the program’s participants dealt with the reality of their murderous job. Using nurses at the pediatric clinics as an example, Burleigh describes the mixed emotions that came with the job:

Although they sometimes requested transfers, and undoubtedly found the work disturbing, nonetheless they also regarded it as necessary to ‘release’ the ‘regrettable creatures’ in their care from their suffering. (Burleigh, 105)

Perhaps what tension did exist arose due to the fact that these nurses were assisting in the murder of children. Or maybe the nurses involved had some understanding of humanity. If it was difficult for some nurses to accept their “active,” role in the euthanasia program, Nazi propaganda that began before any patients were killed made it was far easier for the German public to later view the killings as beneficial to their nation. Films like “Victim of the Past,” released in 1937, painted psychiatric patients as a severe burden to Germany. Under Hitler’s orders, “Victim” was played in all German theaters, and warned of an “endless column of horror” that would infiltrate German society if the disabled were not dealt with (Burleigh, 191). These films were not only used to develop in Germans a “moral void,” but were also used by the organizers of Aktion T-4 to “induct their subordinates into the process of mass killing” (Burleigh, 195). Once Germany proceeded to a wartime economy in 1939, this “endless column of horror,” quickly became not only a threat to the German race, but also a detriment to the economy.

Meanwhile, the planned adult euthanasia program was labeled “Aktion T-4” and was put in place as specified in Hitler's secret memo dated September 1, 1939 (Burleigh, 112). With markedly angry undertones, Burleigh describes the “ordinary” people who worked for T-4 as brutal and insensitive working-class males, who would party and drink around dead corpses (Burleigh 127).

One of these men whom Burleigh highlights is Kurt Eimann, whose utter commitment to the SS and total ruthlessness afforded him the ability to do whatever was asked of him: which in this case was the systematic murdering of over three thousand Polish psychiatric patients (Burleigh, 132). It is instances such as this one, where Burleigh’s tone becomes increasingly--albeit understandably--angry, that it becomes compelling to evaluate the criticisms of Michael Kater, of York University. Writing in the American Historical Review, Kater challenges Burleigh's position on these “ordinary” men and women, and challenges Burleigh over what he sees as the author’s “blanket treatment of ‘euthanasia’ killers as deranged or marginal people” (Kater, 865). Though, Kater’s belief that Burleigh depicts these “ordinary” people as marginal is completely misguided. While Burleigh offers more in depth insight into the lives of individual, “ordinary,” victims, he is equally interested in the minds of the perpetrators and their motivations. At the same time, knowing that an otherwise ordinary laborer such as Eimann could go on to be responsible for the killing of three thousand innocent people, makes it difficult for readers to sympathize in any way with these “ordinary” members of German society and the devastating role they played in the euthanasia program.

A Killing Apparatus

Once the T-4 program was conceived, its workings had to be established. Everything became embedded in the bureaucratic process as personnel had to be trained in the killing of thousands of people and ties had to be created between asylum officials--who were responsible for releasing patients to their death--and the T-4 doctors who would proceed with the actual murder. The doctors who turned the valves to the gas chambers showed no signs of concern for the victims (Burleigh, 134). But, before the valves could be turned, T-4 personnel had to make sure the asylum authorities were complicit in regards to the program. Authorities knew the patients they handed over to the T-4 personnel were being sent to their death, and in response, a certain number of them attempted to resist cooperation (Burleigh, 142). However, the clearing out of the asylums was ultimately inevitable, and Burleigh’s description of men and women being dragged from asylums to their certain deaths is chilling (Burleigh, 142).

The psychiatric patients could find no refuge in the institutions, but with thousands being killed, what response, if any, was there by the relatives of these victims? Burleigh describes the response as being mixed, as some relatives felt deeply saddened, while others welcomed the death of those who were otherwise a financial burden (Burleigh, 143). Here the idea of psychiatric patients as an unwanted cost comes back into play, which is important given its link to Burleigh’s thesis. As mentioned above, many Germans in the Weimar Republic worried that psychiatric patients were a financial burden to the state. Dr. Bodo Gorgass, a chief doctor among the T-4 personnel, went on record in 1947 reasoning that mentally ill people were a financial burden to their relatives and that the state should make the decision to kill for them (Burleigh, 152). This reasoning would seem outlandish had Burleigh not made it clear that some relatives did in fact accept the murders as a cost effective process. Burleigh in no way suggests that these sentiments were universal. However, by presenting them, readers can better gauge his assertion that economics played a crucial role in the development and implementation of the euthanasia program.

Reactions Against and an End to Euthanasia

While immense measures were taken to keep T-4’s operations covert--Burleigh describes the euthanasia program as one of “mass murder by stealth”--it was nevertheless impossible to hide from the public the murdering of hundreds of thousands of people (Burleigh, 162). With asylums constantly emptying in early 1941, community members were well aware of what was going on, leading many to openly express their anger towards a state that was now in “such a deleterious condition that it was having to kill the handicapped to fund its war effort” (Burleigh, 163). Families of victims who did accept the fate of their relatives also spoke out against the euthanasia program, placing insinuating death notices in local papers that exposed the public to the grim nature of the program (Burleigh, 165). The Catholic Church, which had been silent throughout the early stages of the euthanasia program, began limited protests in August 1941, despite the fact that--as Burleigh explicitly mentions--70,000 people had already been murdered (Burleigh, 173).

The timing of the Church’s response seems highly questionable, if not inexcusable, yet the actions of a few individuals within the Church cannot be ignored. Specifically, Burleigh introduces the bishop Clemens August Graf von Galen, who in August 1941 gave a damning indictment of the Nazis’ euthanasia program (Burleigh, 178). Galen’s sermon was a direct attack on the euthanasia program, the effects of which left Hitler and the Nazi authorities incensed. The Aktion T-4 would be halted soon after Galen’s sermon, making it appear that the Church’s response played a role in suppressing murder. However, Burleigh argues that by the summer of 1941, another, more important motivational factor was at hand:

The euthanasia programme was not halted because of some local difficulties with a handful of bishops, but because its team of practiced murderers was needed to carry out the infinitely vaster enormity in the East that the regime’s leaders were actively considering. (Burleigh, 180)

It was now time for the expertise and technical skills which were developed in Aktion T-4 to be put to use against Hitler’s primary enemy: the Jews.

In this book, Michael Burleigh does an excellent job of presenting a subject that is as profoundly disturbing as it is rich in historical evidence. From the start, Burleigh establishes the questions he hopes to resolve and proceeds like a skilled tactician to evaluate and procure the answers he set out to find. His examination of the role economics played in allowing for a manipulative propaganda campaign, as well as the weakening of the minds of those involved in the euthanasia program--the majority of whom believed that what they were doing was beneficial to Germany--is chilling. His description of the relative ease with which many of the men and women responsible for these murders came back into German society after the war--Eimann for example, who oversaw the death of at least 3,000 people was sentenced to merely four years in jail--is as sobering as it is infuriating. Finally, Burleigh’s assertion that the technical expertise acquired in the euthanasia program “would eventually be brought to bear on annihilating the Jewish population of occupied Europe” (Burleigh, 133) is immensely significant in that it contributes to a better, fuller understanding of the Holocaust and its evolution.

Bibliography and Links (back to top)(links last checked 3/13/09)

Book Reviews:

Duncan Forrest of the Medical Foundation for the Care of Victims of Torture, London. From the Journal of Medical Ethics, v.22(1); pp. 59-60. February 1996. <http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1376870&pageindex=2#page>
Duncan Forrest commends Burleigh for writing about a Nazi and German subject that has not been exhausted. He summarizes the book and highlights the good use of quotations that he says helps in painting a better image of the times and of an ongoing debate that deserves more attention from scholars. He calls the book a “gripping read.”

Sheila Faith Weis, review in the Journal Isis, Vol. 86, No. 4 (Dec., 1995), pp. 680-681 Published by: The University of Chicago Press on behalf of The History of Science Society.
Weis lauds what she calls a “superb book” for being the first full scale examination of such an important subject and enjoys the dedication to individuals. Says that is both detailed enough and historical but also accessible to a broader public, which is important. Concludes it is “profoundly humane and moving.”

Michael H. Kater, review in The American Historical Review, Vol. 101, No. 3 (Jun., 1996), pp. 865-866.
Kater Finds book disappointing in that it is poorly edited and for its “blanket treatment of ‘euthanasia’ killers as deranged people.” In contrast, he views the euthanasia doctors as conditioned, not just crazy.

Web Sites:

  • T.D. Hall, “The Scientific Background of The Nazi ‘Race Purification’ Program, US & German Eugenics, Ethnic Cleansing, Genocide and Population Control…” (last revised April 2004), <http://www.trufax.org/avoid/nazi.html>
    T.D. Hall gives a thorough and insightful overview of the origins of euthanasia and how Nazi Germany came to embrace the idea of racial cleansing and eugenics. He pays particularly close attention to Social Darwinism and the affects of this doctrine on Nazi ideology.
  • United States Holocaust Memorial Museum, “Euthanasia Program,” (last revised Oct. 2008), <http://www.ushmm.org/wlc/article.php?lang=en&ModuleId=10005200>
    An in depth survey of the Nazi euthanasia program that covers the programs beginnings in 1939 and the child euthanasia program, to its later stages in East Europe, and finally to its end in 1941. It includes links to riveting personal testimony from survivors.
  • Wikipedia, “Aktion-T4,” (accessed March 5, 2009), <http://en.wikipedia.org/wiki/Action_T4>
    The most complete and comprehensive overview of the euthanasia program available online. Of particular interest is its overview of public and private opposition to the euthanasia program. Conveniently divided into subtopics, it provides myriad links and references that allow for further exploration of the topic.

Books and Articles:

  • Sheila Weiss, The Race Hygiene Movement in Germany, Isis, Vol. 86, No. 4 (1987), pages 193-236. Published by The University of Chicago Press on behalf of The History of Science Society.
    Weiss argues that the German eugenics movement was heterogeneous in its politics and ideology, and discusses to what degree German eugenics promoted racist ideologies.
  • Robert Proctor, Racial Hygiene. (Harvard University Press, 1988) 414 pages. <http://books.google.com/books?id=hogbxS2Gp1QC>
    Proctor examines how Nazis and “fine” scientific minds became perverted Nazism and eugenics. His book explores how the finest and wisest of men can go on to commit unspeakable crimes.

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Any student tempted to use this paper for an assignment in another course or school should be aware of the serious consequences for plagiarism. Here is what I write in my syllabi:

Plagiarism—presenting someone else's work as your own, or deliberately failing to credit or attribute the work of others on whom you draw (including materials found on the web)—is a serious academic offense, punishable by dismissal from the university. It hurts the one who commits it most of all, by cheating them out of an education. I report offenses to the Office of the Dean of Students for disciplinary action.

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