Alien to the Community

At ten past ten​ on the morning of 2 June 1948, Karl Brandt climbed on the black gallows in the courtyard of Landsberg Prison in Bavaria. An American military tribunal had sentenced him to death for crimes including ‘planning and performing the mass murder of prisoners of war and civilians of occupied countries, stigmatised as aged, insane, incurably ill, deformed and so on, by gas, lethal injections and diverse other means in nursing homes, hospitals and asylums during the Euthanasia Programme and participating in the mass murder of concentration camp inmates’.

As the executioner and his assistants completed their preparations, Brandt delivered an impassioned speech to the handful of journalists and officials standing in the courtyard. He had done nothing wrong, he declared. He had only done his best to help humanity – above all, German humanity. His death was an act of political murder. The Americans had no right to condemn him, least of all after they had killed nearly a quarter of a million people by dropping atom bombs on Hiroshima and Nagasaki. As he ranted on, the executioner, who had warned Brandt to keep his remarks short, lost patience, placed a hood over his head, took a step back and pulled the trapdoor lever, sending him plunging to his death.

Tall, good-looking and married to a glamorous swimming champion, Brandt had been appointed Hitler’s escort physician in 1934 after he had used the surgical skills honed on victims of mining accidents in the Ruhr to treat a Nazi official injured while driving in the Führer’s motorcade. A member of Hitler’s inner circle from then on, Brandt was in 1939 ordered by him to investigate a petition by the parents of a severely disabled child asking for the infant to be killed. Brandt approved the murder and supervised it himself. This led to his being appointed to run what was termed a ‘euthanasia’ programme, Aktion T4, carried out with Hitler’s authorisation under the cloak of the war. On Brandt’s advice, first children, then adults were rounded up from their homes and from institutions, taken to killing centres in mental hospitals and gassed with carbon monoxide.

In the summer of 1941, after Clemens von Galen, a Catholic bishop, condemned the murders in a series of public sermons, copies of which he distributed across the country, the gassing teams were transferred to new sites in Eastern Europe, where they set up the gas chambers in which millions of Jews were killed. But the ‘euthanasia’ programme continued in secret, by means of lethal injection, starvation and the denial of medical treatment. Up to three hundred thousand victims, most though not all of them German, had been killed by the end of the war.

The ‘euthanasia’ programme was preceded by an even more widespread programme of compulsory sterilisation. After attaining power Hitler lost no time in issuing a Law for the Prevention of Hereditarily Diseased Offspring: it came into effect on 1 January 1934. Four hundred thousand people were subjected to forcible sterilisation – a practice common in countries from Sweden to the US, and used in some places well after the end of the Second World War, but nowhere so widely as in Germany. Behind the programme lay a belief that the quality of the German race had been badly affected by the First World War, in which more than two million soldiers, thought to be the best and bravest of their generation, had lost their lives. It was urgently necessary to replenish and rebalance the race, a goal that for the Nazis involved not only encouraging the ‘fit’ and healthy to have more children but also preventing the ‘unfit’ and unhealthy from reproducing. In Hitler’s mind, this was part of Germany’s long-term preparation for victory in the struggle between races. The effects of Nazi eugenic policies would not be immediate, but no matter: he was planning the ‘thousand-year Reich’. Medical opinion in Germany was overwhelmingly in support of what doctors deemed to be a scientifically informed policy aimed at improving the quality of the population.

Not all Germans supported it. The American historian Dagmar Herzog points out in her new book that the Catholic Church, to which more than a third of Germans belonged, was opposed to eugenics and to ‘euthanasia’: ‘life was to be protected from the moment of conception through to a natural death.’ This was not entirely true, since the Church and its pre-1933 political wing, the Centre Party, had consistently supported the death penalty; priests attended executions and absolved malefactors of their sins. But since it was firmly opposed to contraception and abortion, the Church was not likely to approve of a law interfering with the God-given right of humans to reproduce.

The Protestant Church was a different matter. The main Protestant welfare organisation, the Inner Mission (so called to distinguish its work from that of overseas missionaries), was not opposed to compulsory sterilisation. Many pastors shared the anxieties that were driving the programme. Pastor Ernst Klessmann, an associate of the Inner Mission, articulated a widespread view when he declared in 1934 that ‘the continued existence of our Volk is lethally threatened by the strong expansion of the biologically inferior.’ There was, he added, ‘much common ground between National Socialism and the gospel’.

During the 19th century a system of classification of mentally disabled people had emerged in Germany alongside the establishment of care institutions and the rise of the medical profession. The key criterion from the beginning was: could the disabled work? Care institutions generally welcomed inmates who could do menial domestic tasks or some kind of paid labour. As hereditarian thinking began to spread across the medical profession in the late 19th and early 20th centuries, however, anxieties emerged about the ‘feeble-minded’ passing on their ‘defects’ to future generations. It was claimed that mentally disabled people had a strong sexual drive and that it was better, therefore, to keep them confined in institutions or render them incapable of ‘infecting’ the body of the race.

The concept of ‘feeble-mindedness’ medicalised the consequences of social problems. One sub-category was ‘moral feeble-mindedness’, a diagnosis applied to social deviants like prostitutes and petty thieves. A growing body of pseudo-statistical literature was devoted to the supposedly hereditary effects of alcoholism, which, it was argued, led to generations of deviants and criminals, costing the state huge amounts of money. The overwhelming majority of intellectually impaired people were from a working-class background, but increasingly commentators ascribed their condition to hereditary rather than environmental factors. Three-quarters of all sterilisations under the Nazis were carried out for ‘congenital feeble-mindedness’, a definition so arbitrary that it was easy to apply it to individuals whose only crime was to be a member of the underclass or to deviate from bourgeois social norms.

As Herzog points out, the sterilised and the euthanised belonged to two distinct categories. Those diagnosed as suffering from inherited blindness or deafness, bipolar disorder, schizophrenia, ‘congenital feeble-mindedness’ or alcoholism, most of them living in the community, were earmarked by doctors for compulsory sterilisation by vasectomy or tubal ligation. The surgical procedures were often carried out clumsily and caused lifelong problems. Sterilisations became so common during the Third Reich that one Protestant care institution held a ‘sterilisation day’ every week. More than half the pupils in remedial schools were forcibly sterilised – the schools became popularly known as ‘eunuch institutions’.

The ‘euthanasia’ programme, by contrast, especially affected those who suffered from profound brain damage or a physical disability that rendered them unable to perform even simple physical tasks. These people were, in the words of an essay published in 1920 by the lawyer Karl Binding and the psychiatrist Alfred Hoche, ‘unworthy of life’ (the title of Herzog’s book fails to convey the full import of the term). The rationale was above all economic. These were what Hoche called ‘ballast existences’, weighing society down; they necessitated expenditure on care while bringing, in his view, no discernible benefit to the community. Nazi films and other propaganda justifying the killings during the war stressed above all the cost of care, while trying to arouse the public’s revulsion by portraying severely disabled people as monsters of deformity.

Unsurprisingly, this economic rationale wasn’t always adhered to. An ability to carry out ‘mechanical’ labour such as peeling potatoes or mopping floors or even weaving mats increasingly became regarded as insufficient to justify survival. In August 1940 the Catholic archbishop of Freiburg, Conrad Gröber, complained to the chief of the Reich Chancellery, Hans Lammers, that ‘euthanasia’ had claimed ‘a very large number of mentally ill and mentally weak individuals already’, though ‘many of those who died had been absolutely work-capable.’ Some decades after the war, an East German woman wrote in a collection of pieces by those whose family members were affected that her uncle, brain-damaged after a childhood infection, had been much loved by the family and a strong employee in a bakery, greatly appreciated especially after his fellow workers had been conscripted, but had nevertheless been consigned to an institution and murdered. There were many similar cases. A man about to be taken to the killing centre at Grafeneck, where more than ten thousand victims were gassed in 1940, was reprieved by the officiating doctor in his care home, who needed someone to polish his boots. An administrator at another care home, in Württemberg, tried and failed to prevent his cook, Lina L., from being taken to a killing centre in one of the grey buses used by the murder programme. He worried that if she was gassed it would be hard to find a replacement. Usefulness counted for little in the eyes of Nazis determined to eliminate anyone who was obviously gemeinschaftsfremd – alien to the community.

Discussing the various degrees of opposition to, or reluctance to carry out, these policies, Herzog writes about Pastor Ludwig Schlaich, who ran an institution of the Inner Mission, where 323 out of 742 epileptic or ‘feeble-minded’ inmates were taken to Grafeneck to be gassed. Schlaich protested vigorously at the transports, and attempted to save patients by pleading with their families to take them back, or bargaining with the guards on the buses. Although he was an outspoken supporter of Nazi sterilisation policies, condemned ‘racial mixing’ and Jewish-Christian intermarriage, and lent his premises to the Hitler Youth for their meetings, he drew the line at murder. After the war, he published the testimonies of some victims and survivors in what Herzog calls an ‘anguished’ book-length confession of his failure. He remembered one wheelchair-bound inmate who was aware of his impending fate saying: ‘Who will hide me, who would be my advocate?’ The man survived, but another, who did not, shouted to his nurse as he was taken away: ‘We’ll see each other again in heaven!’ To the guards who had come for him, he screamed: ‘Our blood be upon you!’

After the war​ the Nazis’ eugenic policies continued to be implicitly or even explicitly condoned in West Germany. Courts accepted the excuse given by doctors accused of murdering the disabled that they hadn’t known their actions were illegal. The judges in one trial held in Hamburg in 1949 even declared that ‘the annihilation of the mentally completely dead’ was not a priori immoral, and cited in support Binding and Hoche’s tract, with its stigmatisation of the severely mentally impaired as ‘empty human shells’. The prison sentences meted out to a small number of doctors aroused widespread outrage, with petitions and newspaper articles demanding their release. The 1933 sterilisation law was not rescinded, unlike the Nuremberg race laws passed two years later, and compensation was refused to victims of the sterilisation programme, though many of them were still suffering from the effects of the surgical procedures they had been forced to undergo.

A few medical witnesses told the Federal Parliament’s reparations sub-committee in 1961 that supposedly hereditary conditions such as alcoholism, schizophrenia or ‘feeble-mindedness’ were nothing of the sort. But their voices were drowned out by the testimony of former members of the sterilisation tribunals who argued that eugenic sterilisation was an internationally accepted practice, and reminded the government that compensation for the victims would saddle it with a huge financial burden. A note made by an official in the Finance Ministry in 1962 claimed that 60 per cent of compensation would go to ‘psychotics, imbeciles and alcoholics’. Interviewed by Der Spiegel in 1964, Werner Catel, one of the ‘euthanasia’ doctors against whom charges had been dropped in the Hamburg case, reminded readers that ‘we are not talking about humans.’

In 1958 middle-class parents founded an organisation called Lebenshilfe (‘help with life’), calling for an end to the segregation of disabled children and their integration as far as possible into the mainstream state education system. While the movement, perhaps inevitably, did not meet with universal success, it made a start in overcoming social prejudice, provided disabled people with better public facilities and improved conditions in the surviving institutions. But it was not until the 1980s that the situation really began to change in West Germany, thanks largely to two people: the historian Gisela Bock, who in Zwangssterilisation im Nationalsozialismus, a major work of academic history, established that sterilisation and ‘euthanasia’ were part of the racist policies of the Nazis; and the campaigning journalist Ernst Klee, who wrote a series of popular books based on extensive research that detailed the horrors of the ‘euthanasia’ murders. Some members of the new generation of doctors and social workers employed Marxist theory to link the treatment of the disabled to social structures and processes. The Nazi sterilisation law wasn’t finally repealed until 2007, but by this time public attitudes towards disabled people had come a long way from the days of Binding and Hoche.

Herzog also points to the emergence of the so-called ‘cripple movement’, which demanded improved treatment for physically disabled people in the face of continuing discrimination. Prejudice against the disabled was still so widespread that in 1980 a Frankfurt court ordered the reimbursement of the cost of a hotel in Greece to a tourist who had been upset by the presence of a group of guests with cerebral palsy. The ‘cripple movement’ was founded at an outraged demonstration over the court’s decision.

This was not the first German organisation to campaign on behalf of physically disabled people. Herzog doesn’t mention that in 1919 the writer Otto Perl, prompted by the plight of men wounded in the First World War, founded the Self-Help League of the Physically Handicapped (Selbsthilfebund der Körperbehinderten). Perl, who suffered from a stiffness of the limbs bordering on paralysis, was confined to a series of institutions but still managed in 1926 to publish a history of disabled people. Pointing out that those who suffered only from physical problems were mostly still able to work, Perl included younger civilians as well as the war-wounded in his movement. He influenced the Nazi regime’s decision to redesignate what were referred to as ‘cripples’ (Krüppel) in official documents as ‘physically handicapped’ (Körperbehinderte). In 1934, Perl’s organisation was incorporated into the National Socialist People’s Welfare and given the task of integrating physically disabled people into the economy. Those who couldn’t easily work (such as haemophiliacs, or sufferers from severe rheumatoid arthritis or deformities of the hands or spine) were, however, ordered to be confined in institutions, and Perl and his movement had no problem with the Nazi stigmatisation of the mentally disabled.

The war-wounded continued to have higher status than disabled civilians. Until the emergence of the disability rights movement in the 1980s, West German society did little to provide facilities such as wheelchair lifts and wheelchair-friendly kerbs. Disabled children still had to contend with patronising and discriminatory behaviour from teachers and doctors. All too frequently they were confined to special schools and institutions in which, Herzog writes, ‘the climate was infantilising, claustrophobic and repressive.’

At least physically disabled people could organise and campaign for better treatment; it was more difficult for the mentally disabled. Behind the scenes, as two members of the ‘cripple movement’, Nati Radtke and Udo Sierck, discovered in 1984, forced sterilisations had continued. In a sensational exposé of the practices of doctors, charity workers and teachers at special schools, they showed that, as Der Spiegel put it, every year ‘hundreds, potentially thousands, of girls and women are being sterilised in the Federal Republic,’ 80 per cent of them without informed consent. A loophole in the law allowed doctors to sterilise teenage girls with mental disabilities if they secured consent from parents or guardians. Teachers in special schools encouraged this practice, and as a consequence ‘often a third and sometimes even fully half of the females had been made infertile.’ The same was true in Protestant welfare institutions. The practice was frequently justified with the spurious argument that sterilisation would liberate the girls to engage in sexual encounters and romantic relationships. In 1984 the German TV news programme Panorama interlaced a report on the scandal with clips from Nazi propaganda films. The result was a national debate that led to a new law banning the sterilisation of anyone under eighteen.

On the other side of the Iron Curtain, the GDR recognised the eugenic policies of the Nazis as anti-proletarian and repudiated them from the start. Its attitude to disabled people was governed by its emphasis on labour as the source of value. The state suffered from a chronic labour shortage, caused in part by the flight to the West of more than two and a half million people (out of 18.4 million in 1950). The communist regime needed those with mild intellectual difficulties to become part of the labour force; the care of more severely disabled people was handed over to the churches, above all the Inner Mission. So great was the need for labour that the regime tried to pressurise mothers into going to work by sending their disabled children to institutions.

The valorisation of work led to a widespread contempt for the disabled. The GDR relied heavily on the Protestant Church and its Inner Mission, but as an atheistic state left them chronically underfunded. State institutions became dumping grounds for the unwanted. The regime and the state-run media did their best to conceal the conditions in these homes. After the fall of the Berlin Wall and the reunification of Germany in 1990, however, Western journalists were able to gain access to these places and expose the atrocious conditions inside them. As Herzog writes, children ‘were systematically neglected, tied down to beds, in some cases literally caged (in dog cages) and with no professionally trained, therapeutically encouraging or engaging staff anywhere in sight’. The immediate reaction to the exposure was outrage, not at the conditions in the institutions, but at the reporters, against whom charges of libel were brought (they were eventually dropped in 1994). After all, it was said, similar conditions had obtained in the West not long before. It was another decade or more before disability rights were generally accepted in the reunited Germany.

Herzog has written an important book, valuable especially for its detailed coverage of the postwar decades, but it is written in an indigestible, convoluted style, with sentences crammed with long subordinate clauses, parenthetical remarks and unhelpful neologisms such as ‘Antipostfascism’. The optimism with which she ends her account may also be misplaced. The far-right Alternative für Deutschland, now the second largest party in the Bundestag after doubling its seats at this year’s election, is attempting to revive the stigmatisation of the disabled, on the basis of the populist fantasy that they are the product of incestuous unions between immigrants. Prejudice against disabled people and racial minorities is being whipped up once more.