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 Dr Robert Jay Lifton THE NAZI DOCTORS:
                        Medical Killing and the
                            Psychology of Genocide ©
 
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“Euthanasia”: Direct Medical Killing  
 
[seventeen-] day period, Pfannmüller was required to complete 2,109 such evaluations. And once more they did no examinations, had no access to medical histories, and made their decision solely on the basis of the questionnaire. Their occasional disagreements had only to do with definitions and policy principles, and the pressure was always toward death. One expert remembered the general principle that “in doubtful or borderline cases ... action should be requested,” and recalled that official injunctions “exceeded the ... medically defensible standpoint.” Another expert recalled the similar principle that “one should not be petty ... but instead, liberal in the sense of a positive [killing] judgment.”48 These same “experts” served at times on special Physicians’ Commissions, which had the ostensible purpose of providing further medical control but tended to be a medical cover for pressing ahead with the legal machinery of the project, especially where there had been any suggestion of recalcitrance or resistance or even pleas of insufficient time and personnel for the paperwork.

For example, there was the case of the Neuendettelsauer Nursing Homes in Bavaria, a scattered group of institutions asked to fill out fifteen hundred forms in four weeks. After the denial of a request for a delay to permit the chief doctor of the hospital to return from a trip, the commission appeared on less than a day’s notice; it consisted of one expert and sixteen young men and women, about half of whom were medical students and the other half typists. The medical students filled in the forms, making use of material from the files to dig out damning information, even when no longer applicable, and working entirely independently of the institutional doctors. These students sometimes questioned nurses about patients in a perfunctory way, ignoring answers that conveyed favorable information and sometimes reversing in their report what was actually told them by the nurses. When it was pointed out to the “commissioner” (the expert) that the students had assumed that all cases of mental impairment were equally severe because all were listed in the files as “idiocy” (according to an earlier terminology), he agreed to take account of the fact in the future — but several hundred questionnaires had already been filled out in accordance with the students’ misconception. It is estimated that during the week the commission members spent at the hospital, they brought about the death of more than a thousand patients.49

The marked questionnaires were then sent for a final review by a “senior expert” (Obergutachter), a function served at first only by Heyde but later by Nitsche and possibly Linden as well. At this level, there was no “?”; nor was this ultimate expert bound in any way by the earlier judgments. While this signature was pro forma, it carried with it the full authority not only of the project but usually of German academic psychiatry as well, since the signatory tended to be a distinguished professor. As far as is known, no formal written guidelines were provided for either level of these “expert reviews.” 50  
 
THE NAZI DOCTORS:
Medical Killing and the
Psychology of Genocide

Robert J. Lifton
ISBN 0-465-09094
© 1986
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