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Killing While Caring Nursing in the Nazi “Euthanasia” Program Susan Benedict, CRNA, DSN, FAAN Medical University of South Carolina.

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Presentation on theme: "Killing While Caring Nursing in the Nazi “Euthanasia” Program Susan Benedict, CRNA, DSN, FAAN Medical University of South Carolina."— Presentation transcript:

1 Killing While Caring Nursing in the Nazi “Euthanasia” Program Susan Benedict, CRNA, DSN, FAAN Medical University of South Carolina

2 First, the language of disability: People with disabilities… People with disabilities… People with developmental disabilities… People with developmental disabilities… Many terms used are those of the time and are not acceptable today. Many terms used are those of the time and are not acceptable today.

3 “A history of mental illness”… is as non-specific as “a history of physical illness”. is as non-specific as “a history of physical illness”.

4 Anna G: Accused of killing 150 patients… “When giving the [lethal] medicine, I proceeded with a lot of compassion. I took them lovingly and stroked them when I gave the medicine. They were not to be tortured more than necessary.”

5 Steps to the “Final Solution” Devaluation and generalization Devaluation and generalization Sterilization Sterilization Euthanasia Euthanasia Concentration camps Concentration camps

6 How could this happen? Eugenics Eugenics

7 Passed in 1922, the US Model Eugenical Sterilization Law applied to Feeble-minded Insane (including the psychopathic) Criminalistic (including the delinquent and wayward) Epileptic Inebriate (including drug users) Diseased (including the tuberculosis, the syphilitic, the leprous, and others with chronic, infections, and legally segregable diseases Blind (including those with seriously impaired vision) Deformed (including the crippled) Dependent (including orphans, ne’er-do-wells, the homeless, tramps and paupers.

8 Eugenics also popular in US Courses taught at Courses taught at Columbia University Columbia University Brown University Brown University Northwestern University Northwestern University Harvard University Harvard University Cornell University Cornell University University of Wisconsin University of Wisconsin

9 In 1925, in “Mein Kampf” Hitler wrote… “Those who are physically and mentally unhealthy and unworthy must not perpetuate their suffering in the body of their children.” “Those who are physically and mentally unhealthy and unworthy must not perpetuate their suffering in the body of their children.”

10 July 1933: Germany’s sterilization law passed Hereditary epilepsy Schizophrenia Mental deficiency Huntington’s chorea Hereditary blindness and deafness Certain malformations Severe alcoholism

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12 More than 350,000 people were sterilized in Germany More than 350,000 people were sterilized in Germany

13 Examples in textbooks Examples in textbooks Courses in nursing and medical schools Courses in nursing and medical schools Racial hygiene a component of all education Racial hygiene a component of all education Education

14 1935 Textbook Problem 95 Problem 95 The construction of an insane asylum requires 6 million RM. How many housing 15,000 RM could be built for the amount spent on insane asylums?

15 Socialization Posters depicting people with handicaps Posters depicting people with handicaps Movies Movies

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19 Sterilizaton to “Euthanasia” Binding and Hoche, 1920: Binding and Hoche, 1920: The right to live must be earned. The right to live must be earned. Destroying “lives not worth living” would be humane. Destroying “lives not worth living” would be humane. Elimination not a crime but permissible and beneficial Elimination not a crime but permissible and beneficial

20 Applied to People with terminal illnesses People with terminal illnesses “Incurable lunatics” “Incurable lunatics” Those who had sustained an illness or injury and would awaken to a “nameless misery” Those who had sustained an illness or injury and would awaken to a “nameless misery”

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22 Three phases of killing The children’s “euthanasia” program The children’s “euthanasia” program The T4 “euthanasia program The T4 “euthanasia program “Wild euthanasia” “Wild euthanasia”

23 The Children’s “euthanasia” program 1939 – – ,000 – 7,000 children killed 5,000 – 7,000 children killed

24 All children with the following had to be reported: Idiocy and Mongolism (particularly if blindness or deafness were also present Microcephalie [sic] Hydrocephalus Deformities of every kind, in particular the absence of limbs, spina bifida, etc. Paralysis including Little’s disease (Spastics)

25 The midwife Received a fee of 2 Reichsmark “in return for her trouble” Received a fee of 2 Reichsmark “in return for her trouble”

26 3,000 – 5,000 children were murdered

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28 T-4 “Euthanasia” Program Grafeneck Grafeneck Brandenburg Brandenburg Hartheim Hartheim Sonnenstein Bernburg Hadamar

29 T-4 “Euthanasia” Program Began with this letter: 1 September 1939 Began with this letter: 1 September 1939 Reichleiter Bouhler and Reichleiter Bouhler and Dr. med Brandt Dr. med Brandt are charged with the responsibility to extend the authorization of certain physicians designated by name in order that patients who must be considered incurable on the basis of human judgment be granted the mercy death after a critical evaluation of their illness. Adolf Hitler are charged with the responsibility to extend the authorization of certain physicians designated by name in order that patients who must be considered incurable on the basis of human judgment be granted the mercy death after a critical evaluation of their illness. Adolf Hitler

30 The plan to kill 60, ,000 to kill 60, ,000

31 The victims of T-4 Persons with developmental disabilities Persons with developmental disabilities Psychiatric patients Psychiatric patients Epileptics Epileptics Persons with inherited diseases or conditions Persons with inherited diseases or conditions Persons with family histories of disease, alcoholism, antisocial behaviors Persons with family histories of disease, alcoholism, antisocial behaviors

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36 Hadamar

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43 T4 ended August 1941 August 1941 Killings had become public knowledge Killings had become public knowledge Churches objected Churches objected No objections from nursing or medical organizations No objections from nursing or medical organizations

44 70,273 adults were killed in the T4 program

45 “Wild euthanasia”

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47 Roles of nurses in the “euthanasia” programs Reported newborns and children with disabilities Reported newborns and children with disabilities Selected patients for killing Selected patients for killing Accompanied the transports Accompanied the transports Killed patients Killed patients Aktion Reinhard Aktion Reinhard

48 Consequences for the nurses

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50 Why did nurses participate? Belief in National Socialism and its goals: Belief in National Socialism and its goals: “I swear to Adolf Hitler, my Führer [leader], unswerving loyalty and obedience. I commit myself to every assignment that I am placed in and to fulfill my task as a National Socialistic nurse, loyal and conscientious in the service for the people, so help me God.”

51 Obedience To government To government To administrators To administrators To physicians To physicians To superior ranking nurses To superior ranking nurses

52 Lack of support From colleagues From colleagues From professional organizations From professional organizations

53 Duress? Some were sworn to secrecy. Some were sworn to secrecy. Some were threatened verbally. Some were threatened verbally. In over 50 years of post-war testimony, no instance has been found of anyone being shot, harmed, or sent to a concentration camp for refusing. In over 50 years of post-war testimony, no instance has been found of anyone being shot, harmed, or sent to a concentration camp for refusing.

54 Economics Housing was tied to the job. Housing was tied to the job. Jobs were hard to find. Jobs were hard to find. Bonuses were paid for working in the killing units. Bonuses were paid for working in the killing units.

55 In their words: Helene W. (killed several hundred): Helene W. (killed several hundred): “I only did my duty, and I did everything on the order of my superiors.

56 Luise E. (210) “I would consider it a release if a physician or a person acting on direction of a physician would give me a dose releasing me from my suffering…I didn’t do it with a light heart but only after serious inner fights I obeyed the orders.” “I would consider it a release if a physician or a person acting on direction of a physician would give me a dose releasing me from my suffering…I didn’t do it with a light heart but only after serious inner fights I obeyed the orders.”

57 Anna G.: (150) “I would never have committed a theft because I know one isn’t allowed to.” “I would never have committed a theft because I know one isn’t allowed to.”

58 Martha W. (150): “The only explanation I can give is that I didn’t have enough time to think about it at that time because the nurses were put under a lot of stress.” “The only explanation I can give is that I didn’t have enough time to think about it at that time because the nurses were put under a lot of stress.”

59 Erna D.: “I can’t say why I didn’t refuse.” “I can’t say why I didn’t refuse.”

60 Margarete T. (150): “I saw the act of giving medicine, even in order to kill mentally handicapped persons, as an obligation I wasn’t allowed to refuse. In case of refusal, I always imagined my dismissal from the job of nurse and civil servant, which is why I didn’t refuse.” “I saw the act of giving medicine, even in order to kill mentally handicapped persons, as an obligation I wasn’t allowed to refuse. In case of refusal, I always imagined my dismissal from the job of nurse and civil servant, which is why I didn’t refuse.”

61 Meta P. “Among the nurses, there was strict discipline and every subordinate nurse was obliged to strictly execute the orders of the superior.” “Among the nurses, there was strict discipline and every subordinate nurse was obliged to strictly execute the orders of the superior.”

62 Edith B.: “I didn’t see anything wrong with it.” “I didn’t see anything wrong with it.”

63 Margarete Maria M.: “If I had refused to execute her [another nurse’s] orders, I would have been dismissed. I could have quit the job, but at that time I was obliged to support my grandparents in Mesertiz.” “If I had refused to execute her [another nurse’s] orders, I would have been dismissed. I could have quit the job, but at that time I was obliged to support my grandparents in Mesertiz.”

64 Gertrude F.: “I was the youngest nurse on our ward. Still today, I haven’t completely become aware of my wrongdoing.” “I was the youngest nurse on our ward. Still today, I haven’t completely become aware of my wrongdoing.”

65 The killings of the “euthanasia” programs led to the murders in the concentration camps.

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68 Lessons for today: Remember the victims. Remember the victims. Be vigilant against marginalization. Be vigilant against marginalization. Avoid generalizations about groups; i.e., the “mentally ill”, the “disabled”. Avoid generalizations about groups; i.e., the “mentally ill”, the “disabled”. Consider the “slippery slope” of assisted suicide and euthanasia. Consider the “slippery slope” of assisted suicide and euthanasia.


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