The Euthanasia Program & Nurses' Participation

by Joseph Cohen-Arazi, 11/20/03 [source link updated 1/12/2011]


Joseph Cohen-Arazi, a junior History and Religious Studies Major, examines the Euthanasia Programs in Nazi Germany during World War II, and has a particular interest in the Holocaust. Based on several euthanasia websites and particularly Susan Benedict's work, Joseph examines the Nurses Participation in the Euthanasia Programs and evaluates whether or not they should be blamed for committing murder


Wartime, Adolf Hitler suggested, "was the best time for the elimination of the incurably ill." Many Germans did not want to be reminded of individuals who did not measure up to their concept of a "master race." The physically and mentally handicapped were viewed as "useless" to society, a threat to Aryan genetic purity, and, ultimately, unworthy of life. At the beginning of World War II, individuals who were mentally retarded, physically handicapped, or mentally ill were targeted for murder in what the Nazis called the "T-4," or "euthanasia," program.

The "euthanasia" program required the cooperation of many German doctors and nurses, who reviewed the medical files of patients in institutions to determine which handicapped or mentally ill individuals should be killed. The doctors also supervised the actual killings. Doomed patients were transferred to six institutions in Germany and Austria, where they were killed in gas chambers. Handicapped infants and small children were also killed by injection with a deadly dose of drugs or by starvation. An estimated 5,000 children were killed during the so-called children's euthanasia program. The bodies of the victims were burned in large ovens called crematoria.

Despite public protests in 1941, the Nazi leadership continued this program in secret throughout the war. Anywhere from 30,000 to 200,000 handicapped people were murdered between 1940 and 1945.

The T-4 program became the model for the mass murder of Jews and other "inferior" people in camps equipped with gas chambers that the Nazis would open in 1941 and 1942.

(source for the text above: Susan Benedict:
[NOTE Jan. 2011: Since 2004 this link has changed to:])

In 1935, Hitler told the Reich physician leader, Dr. Gerhard Wagner, that he would implement euthanasia once war began. After Hitler decided to proceed with the euthanasia plans, he put together a committee of three individuals with medical and psychiatric expertise which was called "Reich Committee for the scientific registering of serious hereditary and congenital illnesses". It was decided that the killings of these "unworthy" individuals, would start with handicapped and acutely ill children. In 1939, Hitler issued an order to expand the euthanasia program to include adults. A number of academics and asylum directors were added to the original three of the Reich Committee. Although the children were killed with injections or starvation, these methods were not efficient for the large number of adults at the killing centers. In these locations, gas was used. Overall there were six killing centers that were set up in Graf neck, Brandenburg, Hartley, Sonnenstein, Bernburg, and Hadamar.

(source for the text above: Link:

In the euthanasia programs, physicians and nurses contributed a major role in the killings. In 1939, only nine percent of the nurses were members of the Nazi sisterhood. The main employment of the Nazi nurses was in community health nursing because this area could provide the greatest opportunity for influencing the population. It was not, therefore, only the Nazi nurses who were involved in the euthanasia programs. Obedience was greatly valued in Germany and nurses were to be obedient to their senior ranking nurses as well as to physicians. They would follow their orders without questioning them, because if they did not, they believed that they would be punished. One former nurse said, "I only did my duty and I did everything on order of my superiors. The Director Grabowski always warned us of the Gestapo. He said he would inform the Gestapo if we didn't do what he ordered". Also, some of the nurses saw the killings as an act of mercy and release for the patients. Former nurse Luise Erdmann said, "I was used to obey strictly the orders of the physicians. I was brought up and instructed to do so. I was aware of the fact that a person was killed but I didn't see it as a murder but as a release." Martha W. said, "I didn't have enough time to think about it at that time because the nurses were put under a lot of stress".

The nursing staffs of the euthanasia centers were often forced to swear an oath of loyalty, pledging eternal silence regarding what went on in the clinic, under pain of death. One nurse described the process of what happened once the patients arrived at the center.

"The adult patients were transported by bus or train from local and regional hospitals to the killing centers. At the killing center, the arriving patients were met by the staff and led to the reception room by a male or female nurse, who might have accompanied them on their trip. Patients were examined individually by a physician, photographed, and measured. They were then taken to gas chambers which were disguised as shower rooms. The patients were already prepared for the showers because, while they were undressing, the nurses had told them that they would be bathed. Most patients accepted the nurses' explanation that they were going to the showers..." (Friedlander, 1995, p. 95)

During this period in Germany, the public was made aware of the euthanasia through posters, movies, and books supporting the destruction of "lives not worth living".

This notion of "keeping seriously ill people alive was against the basic principles of nature," became widely popular in Germany. Because of the negative attitude of the public toward the handicapped and seriously ill, "parents were made to feel shame and embarrassment at having to raise an abnormal or malformed child". Due to public protest in August 1941, Hitler ordered the organized euthanasia program for the adults to end, however, the children's euthanasia program continued without interruption. In 1941 there was a stop order which applied only to the killings in the gas chambers of the killing centers. As with the children, after the stop order, physicians and nurses killed handicapped adults with tablets, injections, and starvation. In fact, more victims of euthanasia perished after the stop order was issued than before.


In my opinion, the nurses who participated in the euthanasia programs did not commit murder, on the contrary I think that they were humane and easily convincible people. The nurses followed the orders of their superiors and could not even imagine that they were doing something illegal. As supporting evidence, we saw in the Milgram experiment that people are easily persuadable and obedient to order, no matter how bad the circumstances and how bad it hurts the recipient. Personally, I could not imagine disobeying the order of my superior in that situation, firstly because he is more experienced, and secondly because if I do not do what is ordered he can report me to the Gestapo. Although the nurses were active participants who killed over 10,000 people in these involuntary "euthanasia programs" it is hard to put the blame on them. After the war was over, most of the nurses were never punished for these crimes although some were tried along with the physicians they assisted.


    The American-Israeli cooperative enterprise was established in 1933in order to strengthen the U.S.-Israel relationship by emphasizing the fundamentals of the alliance. Website last updated in 2003(no specific date).
    These documents of the Holocaust was compiled by Dr. S D Stien who teaches Comparative Genocide, Social Psychology, and the Holocaust's War Crimes and Criminals. Website last updated 6/24/02
  3. (site not available in Dec. 2003)
    This project is the result of a fellowship for research on medical ethics and the Holocaust granted to Susan Benedict by the Research Institute of the U.S. Holocaust Memorial Museum. Susan is a professor at the College of Nursing; Medical University of South Carolina, Charleston. Website update is unknown.

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