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Euthanasia and Nazi Medicine

There is no denying that the Nazi Germany dead in the World War II will remain in the history books, particularly the holocaust stories. One of the most enduring questions about this regime is how the barbaric ideology became the reference point for a nation that had a rich history of scientific and historical accomplishments. In particular, how the physicians in the country completely subscribed to conducting some of the most barbaric atrocities of the Nazi regime is an issue not talked about enough. This matter has caught the interest of many people inside and outside Germany partly because doctors were Nazified much sooner than any other profession. Their complete subscription to Nazi ideologies made them do some of the most barbaric atrocities that will remain in the history books for many years to come (Lifton, 2017). To date, the question regarding how such an intelligent group embraced the Nazi ideology and practice continues to elicit debates, particularly in psychology. For this reason, this paper tells the story of euthanasia and Nazi medicine and the substantial psychological analysis of these atrocities based on Lifton’s (2017) and Burleigh and Boyd’s (1995) publications.


According to Burleigh and Boyd (1995), the term “euthanasia” maintained the classical and original meaning of “gentle” or “fine” until the late 19th century based on different accounts of Augustus’s death. This word has been through different modifications from as early as the 17th century during Latin transcriptions by Francis Bacon. During this, the term euthanasia was used to refer to deaths that alleviate suffering, according to doctors. However, this definition was not extended to the passive or active termination of an individual’s life. A number of German commentators, including Berlin physician Christoph Wilhelm Hufeland (Burleigh & Boyd, 1995), were aware of the moral responsibility of physicians to include euthanasia. This understanding increased the popularity of “the right to die”, that is, voluntary euthanasia. It was also meant to include the life-negating suffering of patients in palliative care and the consequential burdens to the community or close family members of mentally defective and incurably ill patients based on Adolf Jost’s account (Burleigh & Boyd, 1995, p. 12). Jost observed that patients who are mentally defective could be killed even without their consent because, after all, they lacked the intellectual capacity to make decisions about important things going on around them or in their lives. However, later developments were determined to remove the distinction between involuntary and voluntary euthanasia in what researchers such as Wilutsky refer to as “life unworthy of life” (Burleigh & Boyd, 1995, p. 13). Generally, euthanasia has been a subject of many debates over the years, with rigorous changes regarding its use and legality.

Perception of Mental Illness and Physical Handicap in Germany

In the Nazi Germany, psychiatry was treated with much disdain by the political class. Its already poor public image suffered from the gross Nazi propaganda and the overall fears originating from mental health collusion in the implementation of eugenic policies of the regime. For this reason, many individuals were afraid of being admitted to asylums. According to the documentary titled “Erhkrank,” made in 1936, there were many moves that were meant to criminalize, dehumanize, and degrade the physically and mentally handicapped population (Burleigh & Boyd, 1995, p. 183). This move was intended to justify numerous atrocities targeting such a population. Hitler himself liked such films to the extent of recommending them for viewership. He even went as far as to personally commission an elaborate sound sequel for the film “Erhkrank.” This movie shows the interest Nazi Germany had in the dehumanization of the mentally ill, considering that most films at the time did not have sound.

The sequel shows the true perception of Nazi Germany towards the mentally ill in the country and those who seek asylum. The documentary portrayed the mentally ill as people with a huge burden on society. They are fed artificially or spoon-fed and very few of them can actually train and be useful in society. The film further portrayed the majority of mentally ill persons as people who are not aware of what goes on around them and are only alive to pass the time (Burleigh & Boyd, 1995). One particular line in the film reads “Idiots are kept alive through medical science and the sacrifices of the nursing staff idiots who for the entire duration of their lives cannot be taught to speak or to make themselves understood” (Burleigh & Boyd, 1995, p. 185). The film also notes that mental health patients have to be given special clothing or protective gear, without which they can harm themselves or the people around them.

The documentary “Erhkrank” also implies that old people with mental illnesses reach that age because of the healthy environment and nitrous meals given to them. Without this support, they could not have lived longer and would have “become extinct at the start” (Burleigh & Boyd, 1995, p. 185). The film also attempted to convince the viewers that mental health patients are a burden to the young generation who dedicate the time that they would have used to do constructive things to care for this fragile population. The film suggested that the burden becomes even more when the patients have children, leaving all the burden to their descendants. The film did not leave the physically handicapped unscathed. For instance, the film portrays two young brothers with deformed hands as sexual offenders. The film laments that even though the brothers committed acts towards others, their “diminished responsibility” due to their physical illness helped them to evade punishment (Burleigh & Boyd, 1995, p. 185).

One would ask why the documentary “Erhkrank” is so important when talking about the history of Nazi Germany’s euthanasia and medical practice. Well, the film portrays the barbaric reason of the regime that sums up the main direction of the ideologies regarding the mentally ill, the physically disabled, the old, and minority populations such as the Jews. To summarize the source of their barbaric ideology, the film, whose sound was commissioned by Hitler himself, uses an example of a farmer weeding his farm. Such a farmer removes weeds sprouting to promote the well-being of the most valuable crop. This example was particularly used in the documentary to promote the “sterilization of the hereditarily ill” (Burleigh & Boyd, 1995, p. 185). To show their commitment to spreading their ideology to the public, the Racial and Political Office made other silent films such as “What You Have Inherited,” “Off the Path,” and “All Life is a Struggle between 1935 and 1837 to push similar agenda as “Erhkrank” documentary. As expected, all these films had one thing in common: to publicize propaganda against psychiatry and war crimes against the vulnerable in society.

The Barbaric Atrocities

As Nazi Germany used films and all their propaganda machines to justify the mistreatment of particular proceeded with barbaric interventions that will forever remain in the history books. For instance, in 1941, Burleigh and Boyd (1995, 221) noted that a commission of physicians went to Dachau, Ravensbriick, Mauthausen, Neuengamme, Buchenwald, and Mossenburg where they randomly picked “sick” and “asocial” prisoners. They also picked Jews, political prisoners, and criminals to make full use of T4’s gassing facilities. As the war continued, the SS authorities would select the “sick” inmates, including those people who were troublesome in the concentration camps, and take them to “the final solution” (Burleigh & Boyd, 1995, p. 220). Often, the victims would be coaxed into developing a false sense of security. In prisons like Mauthausen, sick inmates were encouraged to take advantage of the limited transfer opportunity to Dachau, where they would be given a “recovery home” (Burleigh & Boyd, 1995, p. 220). At Auschwitz, ailing prisoners were told that they were transferred to Sonnenstein, where they would get a “rest home.” This mainly happened before the prison, as Auschwitz was turned into a mass extermination camp. The “sick” inmates were then forwarded to a commission of T-4 physicians. This act alone led to the death of about 20000 prisoners in gas chambers located in Sonnenstein, Hartheim, and Bernburg (Burleigh & Boyd, 1995, p. 221).

Unfortunately, many prominent physicians were involved in the ill-treatment of the selected population during Hitler’s regime. Some of the most famous names of doctors that took who orchestrated the barbaric deeds of Nazi Germany include “Werner Heyde, Paul Nitsche, Friedrich Mennecke, Horst Schumann, Kurt Schmalcnbach, Otto Heboid, Rudolf I, Chaucer, Robert Muller, Theodor Steinmeyer, Gerhard W Fischer, Viktor Ratka and Ilans-B(Klo Ciorgass” (Burleigh & Boyd, 1995, p. 221). These physicians commenced supporting the atrocities of the Nazi regime in Sachsenhausen and then extended their actions to Auschwitz, Buchenwald, and Mauthausen, looking for “asocial,” the “sick,” and the Jews. Interestingly, these physicians used every trick to lure their targets to their deaths. In one instance, Hans, a former prisoner, noted that Doctor Friedrich Mennecke and some of his peers once requested unfit and sick inmates to note their names down so that they would be transferred to a sanatorium.

About 200 to 300 prisoners registered for this relocation. However, the SS and the doctors considered this number too low. They, therefore proceeded to select individuals in dire physical disadvantage. At the end of this process, about 700 inmates were loaded in tracks. About eight days later, another 650 inmates were transferred in a similar manner. Hans noted that their clothes were returned back to the camp. He would later read in a newspaper that one of his friends who he witnessed register with physicians succumbed to a hand injury. The prisoners connected the dots often advised people against registering with physicians and the SS regardless of how sweet the deals they were offered sounded. A similar advice was extended to the inmates with physical issues including those with walking limbs, armbands, and glasses. Those with glasses were advised to take them off and walk past physician with confidence. What surprised Hans H. and colleagues is that when those that registered to go to better places were urged to leave their spectacles, trusses, and artificial limbs. This only meant one thing: they did not need them because they were going to be killed.

Such atrocities coincided with Germany’s invasion of the Soviet Union, a war also driven by race. The different army groups were under strict orders to terminate the undesirable people, which basically meant the Jewish people. They were also under orders to destroy psychiatric clinics, gassing or poisoning the patients they found. They also used starvation as a significant tool to kill the “undesirable” people. Other patients were hunted by soldiers on horses or left outside to die. As if this was not enough, the mentally ill patients were also used in experiments. In one event, about 20 mentally ill patients were locked in bunkers under which an experimentation of explosive performance was done (Burleigh & Boyd, 1995). However, the first attempt to blow them was not successful. The commander, Arthur Nebe then ordered the wounded in the first attempt to be picked and placed in arranged in the bunkers again for the second wave of trial. About 100 kilograms of explosives were further added in the second attempt which was so “successful” according to Burleigh and Boyd (1995, 230) based on the amount of time used by the captured Jews to pick the scattered body parts the following day. This is one example of the lengths that the army and other professionals were willing to go to exterminate the “undesirable” population.

In general, “euthanasia” and the role played by physicians in committing the atrocities that were committed towards the mentally ill and the “undesirable” population were perfectly planned before they even happened. The perpetrators particularly used starvation as one of their “euthanasia” (Burleigh & Boyd, 1995). The deliberate starvation approach was used in asylums throughout the length of World War II. Instance, when patients were received in asylums, they were categorized into two groups, those who cannot work and those who can work. Those who were able to work ate while those who could not work were given “stinging nettle soup three times a week and died” (Burleigh & Boyd, 1995, 242). Other patients wrote placards to their family members desperately asking for food. One some relatives complained about the conditions of the patients, one physician patronisingly and cynically replied that mentally ill people lived boring lives that left them with only food issues to discuss. The main reason behind patient starvation was because Schmidt and Mennecke wanted it to be so. Another reason is because the food were stored for “more deserving causes” (Burleigh & Boyd, 1995, 245). However, it was then discovered that starving patients was a slow process. This is the reason why deaths were accelerated using dangerous quantities of sedatives mixed on drinks and food. In worst cases, doctors would use lethal injections to end the lives of patients quickly. These atrocities, together with many others, call for an analysis of the psychology behind “Euthanasia” and Nazi medicine, and in particular, the psychology of genocidal interventions.

Psychology Analysis of Euthanasia and Nazi Medicine

How the Nazi doctors behaved a few years into World War II and through the war undoubtedly calls for the analysis of the psychology of genocide, as observed by Lifton (2017). One of the essential parameters of looking at the Nazi doctor’s actions in Auschwitz is a psychological principle referred to as “doubling” (Lifton, 2017, 418). In simple terms, Lifton (2017, 418) defined doubling as “the division of the self into two functioning wholes, so that a part-self acts as an entire self.” A perfect example of this phenomenon is a doctor in Auschwitz who could facilitate killing or kill and also went an extra mile to do so silently on behalf of the barbaric program. Such people could also encompass all aspects of their behaviors. This tool was used by the Nazi doctors to adapt to a diabolical environment as they took part in mass killing in the name of racial cure. Often, doubling happens outside individual’s awareness.

According to Lifton, (2017), doubling can perfectly be described by five main characteristics. One of these characteristics is the holistic principles of the subject. The Auschwitz doctor’s behavior perfectly matched the whole Auschwitz and its surroundings leading to a connection lured the doctors into committing the atrocities they did. Second, the dialectic between the two selves in the form of connection and autonomy is also another significant characteristics involved in doubling. Doctor in the Nazi regime only required their Auschwitz selves to psychologically function in a surrounding and change their previous ethical standards of practice. Such doctors also depended on their previous selves to continually portray themselves humane people. In this regard, their new Auschwitz selves had to connect autonomously with their previous selves that made them who they are. The third characteristics of the Nazi doctors based on doubling was the life-death dimension. According to Lifton (2017), the doctors’ Auschwitz selves were viewed by the perpetrators as their own route to psychological well-being in a society that is dominated by deaths. The fourth characteristics of doubling that was also evident in Nazi doctors’ behavior is the constant guilt avoidance. Often, the second self is the one that is often engaged when committing the atrocities that the Nazi regime and their doctors did to the population they termed as undesirable. Lastly, and equally important, Nazi doctors doubling was due to their considerable change of moral consciousness and the unconscious dimension often occurring without the subject’s awareness (Lifton, 2017). These characteristics of doubling may be used to further explain how many people, including doctors, went to on subscribe to the ideologies of the Nazi Germany, leaving their ethical consciousness behind them.

In general, doubling may be regarded as the continued process where an individual adopts to extreme behaviors. Such an adaptation demands the perpetrator to dissolve “psychic glue” as another way of radicalizing self. For instance, in Auschwitz, such a sequence was formed under the duress of a period a physician’s took to transform. A physician would experience period of stasis, separation, or disintegration depending on their anxiety to death. For the anxiety of such a doctor to reduce, he required functional Auschwitz that assumed the hegemony each day while significantly cutting off prior odd moments. The doctors were also required to reduce contact outside the camp especially with their families and friends. Most of them welcomed this approach as the only way they could function psychologically. In other words, Lifton (2017, 422) observed that “if an environment is sufficiently extreme, and one chooses to remain in it, one may be able to do so only by means of doubling.” This explanation may be used to get some answers about doctor’s involvement in “euthanasia” and atrocities committed to the mentally ill patients and the entire “undesirable” population during the Nazi regime.


In summary, the Nazi Germany committed some atrocities towards particular groups that they deemed “undesirable” that will forever remain in the history books. More than eight decades have passed since the World War II began but some of the crimes committed would still terrify people in modern day society as if they were seeing the atrocities committed live. While this is true, one question that has often been the subject of debates is how the doctors were convinced to forget about their ethical duties and be a significant orchestrators of the suffering that befell many people; Jews, prisoners, the old, and the mentally and physically ill person as observed by Burleigh and Boyd (1995). Based on research conducted by Lifton (2017), doubling could be the main psychological explanation of this total switch from ethical practices based on principles of medicine as a profession to barbaric acts and mass murder.


Burleigh, M., & Boyd, C. E. (1995). Death and deliverance:”Euthanasia” in Germany, 1900–1945.  History: Reviews of New Books24(1), 36-36.

Lifton, R. J. (2017). The Nazi doctors: Medical killing and the psychology of genocide.


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