Medicine And Books

Die Totung Geisteskranker in Deutschland

BMJ 1995; 310 doi: (Published 04 February 1995) Cite this as: BMJ 1995;310:338
  1. Michael Burleigh

    Alice Platen-Hallermund, Psychiatrie Verlag, pp 131, ISBN 3 88414 149 X

    In postwar Germany, fitful attempts to publish books on medical criminality under the Nazis were dogged by misfortune. Manuscripts mysteriously disappeared doing the rounds of publishers or were neutralised after publication through purposive critical oblivion. Publications such as Alice Platen-Hallermund's 1948 book on Nazi “euthanasia” killings were studiously ignored by the West German medical profession, many of whose leading lights were erstwhile Nazis.

    Although based on an inevitably restricted range of source material (the records of the United States Nuremberg Doctors Trial), Platen-Hallermund's work anticipated most of the themes explored in the numerous studies of German medicine and psychiatry produced since the early 1980s. These themes include the rise of an anti-individualistic, biologistic collectivism, with doctors as eager “expert” sentinels watching over the fitness of “race” and nation, or the permeation of medicine with essentially utilitarian economic and political criteria at the expense of any received ethical or religious precepts.

    Platen-Hallermund was also the first to grasp how many of the psychiatric reforms of the Weimar period (including deinstitution-alisation, occupational therapies, or the new somatic therapies) simply served to create chronic subgroups within an already marginalised psychiatric population, which may have some direct bearing on why the later “euthanasia” murderers included so many of the most “progressive” psychiatrists of the day. Platen-Hallermund concisely charts the creation of a covert bureaucracy to organise these killings; the recruitment of suitably compliant doctors to carry out selections and mass murder; and the extension of the chosen victims to include the regime's political or “racial” opponents.

    The doctors smoothly crossed the thresholds of Buchenwald, Dachau, or Gross-Rosen, perfunctorily assessing “sick” prisoners and automatically including all Jews in what had become a mass extermination programme. Shocked by the zeal of his medical accomplices, the Reichsfuhrer-SS eventually insisted that as work could be found even for bedridden camp inmates, the doctors should confine their “selections” to the mad. The depths to which German medicine had sunk can only be imagined if Himmler was concerned about slipping standards.

    Despite attempts to keep “euthanasia” killings secret, knowledge of them rapidly became widespread both within and beyond the asylums. Children of 10 in Idstein were afraid of being confined in the sickbay, and apparently played a game based on the coffins with a hinged floor routinely used to economise on burial materials. Relatives who suspected that their loved ones had died in suspicious circumstances were not merely given the brush off by asylum authorities. One father, for example, who persisted in writing to Eichberg after the death of his son from “influenza” shortly after the asylum had written to say that the son was in good health, was threatened that he would be examined by an official doctor if he did not show greater circumspection.

    Although the details of the “euthanasia” programme have been elaborated in a huge number of publications over the past decade or so, Alice Platen-Hallermund grasped the essentials all too well, in a book that because of its economy and insights should now get the readership it was once deliberately denied.—MICHAEL BURLEIGH, reader in international history, London School of Economics and Political Science


    The former Samaritan Foundation for Cripples at Grafeneck, which became one of the main extermination centres in the Nazi “euthanasia” programme. In 1940 nearly 10000 people were gassed there

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