Aktion T4 killings of disabled patients

On 18 August 1939 the Reich Ministry of the Interior ordered physicians, nurses and midwives to report newborns and children under three with signs of severe mental or physical disability. From October, public health authorities urged parents to admit such children to designated pediatric clinics, which were killing wards: staff gave lethal overdoses of medication or starved the children. The age limit later rose to 17, and at least 10,000 children were killed.

In the autumn of 1939 Adolf Hitler signed a short authorization dated 1 September 1939, so that it would appear to be a wartime measure. It charged Philipp Bouhler, director of the Führer Chancellery, and Karl Brandt, Hitler's attending physician, with extending the powers of certain doctors so that patients judged incurable could be granted a "mercy death". It permitted killing without ordering it, and it protected participants from prosecution.

The adult program took its code name from its Berlin office at Tiergartenstrasse 4. Questionnaires went to hospitals, mental institutions and nursing homes, and secretly recruited physicians, many of them eminent, judged the returned forms in teams of three. Criteria included chronic psychiatric or neurological disorders such as schizophrenia and epilepsy, criminal commitment, more than five years in an institution, and not being of German or "related" blood. From January 1940 patients were taken to gas chambers at Brandenburg, Grafeneck, Hartheim, Sonnenstein, Bernburg and Hadamar. Psychiatrists reported their own patients, arranged the transfers and oversaw the gassing, first with carbon monoxide. Families received an urn and a death certificate with a false cause and date. T4's internal count reached 70,273 dead by August 1941.

After public and private protests, among them a sermon by Clemens August von Galen, bishop of Münster, on 3 August 1941, Hitler ordered a halt late that month. Child killings went on. From August 1942 medical staff again killed adults, by overdose, lethal injection and starvation, and the victims came to include geriatric patients, bombing victims and foreign forced laborers. The US Holocaust Memorial Museum cites an estimate of 250,000 killed in all phases.

Planners of the murder of Europe's Jews later adopted the gas chamber and crematorium designed for T4, and T4 staff served at the Belzec, Sobibor and Treblinka killing centers. A copy of Hitler's letter kept by Justice Minister Franz Gürtner survived and was entered as evidence at the International Military Tribunal and the Medical Case trial at Nuremberg.