Chapter 3 Killing Handicapped Children

Policy Origin: Adolf Hitler planned euthanasia as early as $1935$ , informing Reich physician leader Gerhard Wagner that implementation would coincide with the start of war.
The Pretext: In $1938$ , the case of the Knauer infant—born with severe physical defects and blindness in Leipzig—provided the justification for Hitler to authorize the first state-sanctioned mercy killing.
Authorization: Hitler appointed Karl Brandt (his escorting physician) and Philipp Bouhler (head of the Chancellery of the Führer) as plenipotentiaries for the children's euthanasia program.
Secret Directorate: The Chancellery of the Führer (Kanzlei des Führers, or KdF) directed the operation to avoid the public scrutiny and legal requirements of standard government departments like the Reich Ministry of Interior (RMdI).

Administrative Management: Viktor Brack (head of KdF Central Office II) served as the day-to-day manager, with Hans Hefelmann and Richard von Hegener coordinating the specific "children's euthanasia" program in Office IIb.
The Reich Committee: To maintain secrecy, the KdF used a fictitious front called the "Reich Committee for the Scientific Registration of Severe Hereditary Ailments" (Reichsausschuß zur wissenschaftlichen Erfassung von erb- und anlagebedingten schweren Leiden).
Institutional Cooperation: The RMdI Department IV, led by Arthur Gütt and later Herbert Linden, provided the necessary civil service infrastructure to enforce reporting across the Reich.

Mandatory Reporting: An August $18, 1939$ decree required midwives and physicians to report newborns and children under age $3$ with conditions including idiocy, mongolism, microcephaly, hydrocephalus, and physical deformities.
The Meldebogen (Reporting Form): Health officers transmitted single-page forms to Post Office Box $101$ , Berlin $W 9$ .
Expert Evaluators: Forms were reviewed by three physicians: Werner Catel, Hans Heinze, and Ernst Wentzler. Decisions were made solely on paperwork, without clinical examination:
- $+$ : Marked for killing.
- $-$ : Exclusion from the program.
- "Observation": Postponed decision.

Kinderfachabteilungen: Approximately $22$ killing wards were established within existing state hospitals and clinics.
Key Facilities:
- Brandenburg-Görden: The first ward, directed by Hans Heinze; served as a training center and research site for medical experiments.
- Am Steinhof (Vienna): The "Am Spiegelgrund" ward served as the killing center for Austria under Erwin Jekelius and Ernst Illing.
- Eglfing-Haar (Munich): Directed by Hermann Pfannmüller, an early advocate of euthanasia.
- Eichberg: Directed by Friedrich Mennecke and Walter Eugen Schmidt.
- Kaufbeuren-Irsee: Directed by Valentin Faltlhauser; killings continued here until May $29, 1945$ , after Germany's surrender.

Starvation: Hermann Pfannmüller notoriously utilized a slow reduction of food rations to induce death naturally as a result of starvation.
Medication Overdose: The preferred method was the administration of barbiturates like Luminal and Veronal, or Morphine-scopolamine. These caused medical complications, such as pneumonia, allowing physicians to record a "natural death."
The Supply Chain: Because the KdF could not legally purchase lethal quantities of drugs, the Kriminalpolizei (Kripo) acted as intermediaries. The Technical Institute for the Detection of Crime (KTI), specifically the chemistry section under Albert Widmann, provided the poisons.

Parental Deception: The RMdI and local health authorities used "advanced therapeutic interventions" as a pretext to convince parents to commit children to the wards.
Coercive Measures: Parents who resisted were threatened with the loss of custodial rights. Mothers of soldiers were sometimes threatened with assignment to contractual labor.
Expansion of Scope: Initially limited to children under $3$ , the program eventually expanded to include older children and teenagers.
Total Mortality: It is estimated that at least $5,000$ children were murdered during the program.

U.S. Prosecutor's Cross-Examination of Hermann Pfannmüller at Nuremberg:

Question: When you decided that children should be subjected to euthanasia to relieve them from their suffering, did you then notify the parents or guardian of the children concerned?
Response: Pfannmüller claimed they were told ahead of time by departmental physicians and invited to visit because the child was "sick."
Question: Did you instruct the parents and guardian that you were going to administer Luminal treatment to the child?
Response: Pfannmüller admitted he did not, stating "No, no, that was a top secret matter."