Operation T4

Prior to World War II, Germany enacted Operation T4—a program through which mentally and physically disabled individuals were euthanized in mass numbers. Upon the recommendation of Alfred Hoche, a noted psychiatrist, and Karl Binding, a prominent scholar of criminal law (who together wrote Allowing the Destruction of Life Unworthy of Living), Hitler started the implementation of Operation T4.  Between 1940 and 1941, doctors systematically killed 70,293 individuals who were determined to be “life unworthy of living.”  

Hitler chose not to present a euthanasia law, for he feared that the public would not accept such a program.  He decided to carry out this project in secret, which is why it required a code name of Operation T4.  
Doctors carried out virtually all aspects of the T4 program.  The Interior Ministry told all government- or church-run asylums and nursing homes to complete surveys about each of their patients.  The questionnaires were then sent back to the assessors, who then acted as the review commissions.  These commissions would determine who was worthy of living.  Based on the questions from the surveys, they would mark a “+” for each patient who would die, a “-” for each patient who would live, and a “?” for each patient who would require further investigation.  
Those determined to be “life unworthy of living” would then be bussed to killing facilities.  At first, they were killed by lethal injection.  When this method became impractical, the program started using gas chambers disguised as showers (which were later used in the WWII extermination camps).  The bodies were placed in mass crematoria, and doctors sent death certificates with fake causes of death and letters of condolence to the victims’ families.  They also prepared urns with random ashes to present to families upon request.
Eventually, this program became public as the doctors involved made more mistakes.  For example, a family member would be sent a death certificate indicating that the patient died from a burst appendix, when that patient’s appendix had been removed years ago.  There were also instances where a family would receive an urn of ashes for their male relative that contained bobby pins.
Church leaders, local judges, and families of victims soon were revolting against this hideous program.  Hitler did finally end the program in 1941.  However, the euthanasia killings continued, just in a more decentralized manner.  During this same time, a movie entitled Ich klage an (“I Accuse”) was released in which a professor killed his incurably ill wife.  The movie was viewed by 18 million people.  Hitler promoted the idea that mental patients were “useless eaters” and “life unworthy of life.”  He also encouraged doctors to determine which patients were worthy of living or not.  The killing resulted in the deaths of 200,000 to 250,000 mentally and physically handicapped people between 1939 and 1945.
Between 1940 and 1941, Nazi doctors systematically killed 70,293 mentally and physically disabled individuals who were determined to be “life unworthy of living.”