United States of
America vs. Karl Brandt et al. IV. OPENING STATEMENT OF THE PROSECUTION Par 3 Part 1 GERMAN MEDICAL ORGANIZATION
Two years after the reconstitution of the German Reich, in 1871, the German Medical Association (Deutscher Aerztevereinsbund) was created, which tied together the older local medical associations. This society existed until it was abolished by the Nazi Government. Its structure was democratic, and its interests included problems of hygiene and public health, and to an increasing extent, socio-medical problems especially in the field of sickness and disability insurance. Bismarck's legislation of 1881 established compulsory sickness insurance for workmen. In the course of the ensuing years, the vast bulk of the workmen were insured, and consequently most of the ordinary physician's patients came to be insured patients. There were lists of physicians authorized to treat insured patients, and it was a matter of vital moment to every practicing physician to be listed. To protect their interest with respect to listing, fees, and other such problems, the German doctors founded a voluntary association for the defense of their economic interests known as the Hartmann Bund. Questions of professional ethics, medical malpractice, etc., were handled in Germany in two distinct sets of medical boards or "Courts." An entirely unofficial and voluntary system was established by the German Medical Association. The other, which was endowed with semiofficial status, was called the Reich Chamber of Physicians. These chambers were elected by vote of the members and were supported by an assessment. In addition to these organizations, there existed in Germany purely professional societies of doctors, where papers concerning scientific and practical problems were read and discussed, and which established connections with similar societies abroad. The German Government agencies which supervised the certification and licensing of physicians as well as their professional activities were the Ministry of Education and the Reich Health Office (Reichsgesundheitsamt) in the Ministry of the Interior. The latter supervised medical practice and licensing through the channels of the Ministries of the Interior of the various German states, although licensing was a federal function rather than a state function. Medical education and training were rather standardized but good. The students spent 5 or 6 years at one of several of the medical universities; they took a final examination covering their clinical studies and then spent a year at an authorized hospital under supervision. Thereafter the internes were licensed and permitted to establish a practice. After two more years they became eligible to treat insurance patients, and, after submitting a thesis, could obtain the degree of doctor from a university. Immediate Impact of Nazism on German Medicine In the years immediately preceding the Third Reich, physicians' organizations devoted to Party politics sprang up. One of these was the National Socialist Physicians' Society, founded in 1929, in which Conti played a leading role. There was a rival association of Social Democratic Physicians, and a Socialist Society of Physicians. These societies proposed candidates for election to the Physicians' Chambers, and thus the National Socialist Physicians Society and the Socialist associations came to compete with each other. The notorious "boycott day" in Berlin, 1 April 1933, was a day of disgrace for German medicine. Members of the National Socialist Physicians' Society, who knew the membership lists of the Socialist societies and the lists of Jewish physicians, broke into the apartments of their Socialist and Jewish colleagues in the early morning hours, pulled them out of their beds, beat them and brought them to the exhibition area near the Berlin Lehrter Station. There, all of them, including men up to 70 years old, were forced to run around the garden, as in a hippodrome, and they were shot at with pistols or beaten with sticks. There they had to stay for several days without sufficient food, and then were handed over to the SA which carried part of them to the cellars at the Hedemannstrasse jail for further tortures. Thereafter, the members of the Socialist Society of Physicians were barred from all insurance practice because of "Communist and subversive activities." In the subsequent listings of physicians issued by the insurance companies, the Jewish physicians were included in a separate list headed "Enemies of the State or Jews." Soon, the insurance companies, even private ones, were no longer permitted to pay fees to the Jewish physicians. Immediately thereafter, Jewish physicians were excluded from all professional and scientific societies. At first, those who were war veterans were nominally allowed to carry on their insurance practice, but patients who kept going to them were threatened and exposed to all kinds of unpleasantness on the part of the insurance officials. After the war began, certification and licensing were withdrawn from all Jewish physicians and they were degraded to the status of lay therapists. These physicians were forced to wear a blue shield with the Star of David and had to add a middle name such as "Sarah" or "Israel." Their prescriptions likewise had to bear the Star of David, which exposed their patients to all kinds of unpleasantness when filling them at pharmacies, most of which had signs in their windows reading "Jews not wanted." At first, the Aryan physicians were allowed to treat Jewish patients, but finally they were prohibited from doing so. Hospitals refused admission to Jewish patients, apart from a few courageous ones who admitted them in defiance of the law. Jews were admitted to mental institutions in separate wards, but usually were quickly transported elsewhere for extermination. In the early summer of 1943, Conti instigated and directed a wholesale persecution of doctors who were either foreigners or persons of so-called mixed blood and those related by marriage to Jews. At first, they were removed from their practice and sent off to posts under inferior Party doctors. In 1944, Conti went a step further and forbade these physicians to practice. They were drafted into the Speer organization, in which they were employed solely at manual labor, their living conditions being little better than those of concentration camp inmates. Prostitution of German Medicine Under National Socialism The totalitarian structure of the Nazi State demanded fundamental subordination of all
principles of medicine to National Socialist population policy and racial concepts. The
most emphatic and repelling expression of those new aims and goals came from the Nazi
Director of Public Health in the Ministry of the Interior, Dr. Arthur Guett, who took
office in 1933. In a book published in 1935 entitled "The Structure of Public Health
in the Third Reich," Guett announced that "the ill-conceived 'love of thy
neighbor' has to disappear, especially in relation to inferior or asocial creatures. It is
the supreme duty of a national state to grant life and livelihood only to the healthy and
hereditarily sound portion of the people in order to secure the maintenance of a
hereditarily sound and racially pure folk for all eternity. The life of an individual has
meaning only in the light of that ultimate aim, that is, in the light of his meaning to
his family and to his national state." All government-employed physicians had to take a special new course lasting 18 months and had to be Party members. The German Red Cross was likewise drawn into the orbit of the Nazi Party and the SS, in view of Dr. Grawitz' appointment as president of the Red Cross. In 1945, after Grawitz' suicide, the defendant Gebhardt succeeded him. The Third Reich also completely reorganized the professional medical societies. The German Medical Association and the Hartmann Bund were abolished. All German physicians were reorganized through an organization derived from the Reich Physicians' Chamber. This National Physicians' Chamber was placed directly under a medical "fuehrer" with the title of "Reichsaerztefuehrer." This position was also held by Conti. All doctors except those, on active military duty were subordinate to him. His regional deputies were selected from the ranks of active National Socialists who terrorized the district branch societies. These deputies, who usually strutted about in SA or SS uniforms, were recruited mainly from the early members of the National Socialist Medical Association. It was their job to bring pressure on physicians to join and take part in various party organizations, such as the SA and SS. A command performance, especially for younger physicians, was attendance at the so-called Fuehrer-School of German Physicians at Altrehse in Mecklenburg, which had been organized by the defendant Blome. There physicians were indoctrinated in the National Socialist point of view and way of life. The so-called comradely association and sports activity were merely window dressing for political spying. These courses finally became compulsory and had to be attended for several months annually. The general respect, in which doctors were held, sunk in view of the decreasing level of general education and ability of the doctors. This was partly due to the constant occupation of the physicians' time with Party functions, especially the time-consuming Party formations and marches which made it impossible for young physicians to develop scientific interests, so that recent graduates increasingly lost understanding and inclination for serious scientific study and long-range research. Medical School and Medical Training Under the Nazis On paper, medical training under the Nazis differed little from that of the pre-Nazi era. However, its fundamental spirit was ruinously distorted and medical standards suffered a dismal decline. Medical students had to be "Aryan," and were required to belong to the National Socialist Students' League. The students' entire course of studies was constantly interrupted by the demands of the various party organizations to which they were forced to belong. A student whose knowledge of the racial theories and Nuernberg laws was not sufficient would fail his medical examinations. Chairs in the universities were filled in many cases by Nazi so-called "professors" who might or might not have a scientific background. The true scientific societies under the Nazi regime became less and less active, and the Nazi professors in the universities devoted more time and interest to their SA or SS organizations than to the teaching of medicine. These Nazi professors would don their brown SA or black SS uniforms on all possible occasions, exchanging them proudly for their academic gowns at all academic celebrations and meetings. The worst Nazi politicians, like Streicher, were given the free run of university clinics, such as at Erlangen. This submissiveness to lay politicians led to a general decline of respect for German academic medicine not only on the part of their own public and abroad but even on the part of the very same politicians before whom they kowtowed. This went so far that Streicher, when addressing a full faculty meeting at the University of Erlangen in 1936, called the assembled professors "complete idiots" to their faces. This was by no means an isolated occurrence. Particularly deplorable was the degradation of psychiatry. Psychiatric university teaching declined to the level of a mere rehashing of the Nuernberg and sterilization laws. The modern techniques of psychotherapy had been abandoned, and treatment deteriorated to pep talks full of Nazi indoctrination admonitions and threats. No wonder that these methods backfired against the best interest of the German war effort which they were foolishly intended to serve. The lack of proper understanding and treatment of German soldiers who developed combat fatigue or neuroses, on the part of their own medical personnel, drove many of them to surrender to the enemy; efforts to rehabilitate them and restore them to duty were frustrated by the ruinous infusion of Nazi doctrine. Summary The general decline of German medical conduct and the poisoning of German medical ethics which the Nazis brought about laid the basis for the atrocious experiments of which the defendants are accused. Many of these were experiments in name only; we will show them to have been senseless and clumsy and of no real value to medicine as a healing art. The Nazi medical world was flooded with preposterous and wicked notions about superior and inferior races and developed a perverted moral outlook in which cruelty to subjugated races and peoples was praiseworthy. Training in SA and SS formations was hardly calculated to develop physicians who could comprehend even the bare elements of the doctor-patient relationship. In this noxious garden of lies, the seeds of the experiments were planted. In the climate of Nazi Germany, they grew with horrible rapidity. CRIMES OF MASS EXTERMINATION: MURDER OF POLISH NATIONALS From the preaching of Guett and others sprang the notions which underlie the crimes to which we will now turn. Here we leave behind all semblance, however fictitious, of science and research. Under these teachings, life and livelihood became the birthright of no one. The weak and the physically handicapped are in the way and must be pushed aside. Inferior peoples are born to be exterminated by the Herrenvolk. The charges in paragraphs 8 and 13 of the indictment concern the defendants Blome and Rudolf Brandt. The original impetus for this terrible mass murder came from a fiend named Greiser, who was the German Governor of the northwest portions of Poland, which had been absorbed into the Reich under the name "Wartheland." Early in 1942, Greiser was in the process of exterminating thousands of Jews in his territory, and he decided to turn his attention next to Poles infected with tuberculosis. I call the Tribunal's special attention to the German word "Sonderbehandlung." In the next document, as will be shown, it occurs frequently in Nazi correspondence and was used by them to mean extermination. In May 1942, Greiser wrote to Himmler as follows:
Greiser' s proposal was supported in a letter from one, Roppe, the SS and police leader
in that region, to the defendant Rudolf Brandt, to which Brandt replied stating that the
matter was under consideration and that the final decision would rest with Hitler. Late in
June, Himmler sent a "favorable" reply to Greiser cautioning him, however, that
the exterminations should be carried out inconspicuously. Thereafter, consultations as to
how to carry out the measure occurred between Greiser, Dr. Hohlfelder, and the defendant
Blome. The views of Blome are embodied in a letter from him to Greiser written in November
1942. This letter contains an indescribably brutal analysis of the situation, in which
Blome expresses agreement with the view that extermination of the tubercular Poles is the
simplest and most logical solution, and expresses doubt as to its desirability only in
that it would be difficult to keep such widespread slaughter secret, and that Hitler might
think the program politically inexpedient if the facts should ever come out.
The prosecution will introduce evidence to show that the program was in fact carried out at the end of 1942 and the beginning of 1943, and that as a result of the suggestions made by Blome and Greiser, many Poles were ruthlessly exterminated and that others were taken to isolated camps, utterly lacking in medical facilities, where thousands of them died. On 1 September 1939, the very day of the German attack on Poland, and after a great deal of discussion between Dr. Karl Brandt, Dr. Leonardo Conti, Philipp Bouhler, the Chief of the Chancellery of the Fuehrer, and others, Hitler issued the following authority to the defendant Karl Brandt:
After the receipt of this order, an organization was set up to execute this program, Karl Brandt headed the medical section and Philipp Bouhler, the administrative section. The defendant Hoven, as chief surgeon of the Buchenwald concentration camp, took part in the program and personally ordered the transfer of at least 300 to 400 Jewish inmates of different nationalities, mostly non-German, to their death in the euthanasia station at Bernburg. The defendants Brack and Blome participated in their capacities as assistants to Bouhler and Conti. Questionnaires were forwarded to the Ministry of the Interior from the various institutes and were then submitted to Karl Brandt and his staff for an expert opinion in order to determine the status of each patient. Then each of those experts indicated his opinion as to the eventual disposition of the patient; that is, whether or not the patient should be transferred to a killing station. The questionnaires were supposedly returned to the Ministry of the Interior, which, in turn, sent lists of the doomed patients to the different insane asylums, ordering the directors of the asylums to hand over the patients to a thing called the General Sick Transport Corporation for transfer to the particular stations where the killings took place. This Transport Corporation was not a real organization, but one of the code names used to disguise the true nature of the activities. The patients were then transferred to the station where they were immediately killed. This entire procedure took place without the consent of the relatives, but the relatives did receive a death certificate on which the cause of death was falsified. The Euthanasia Program was an open secret in top Nazi circles. However, every possible effort had been made to keep it from the public in order to avoid intervention by the churches. In spite of all these precautions, it became commonly known in Germany as early as the summer of 1940 that these killings were going on and church authorities, as well as various legal officials, tried in vain to stop the killings. Typical of the letters reaching the Minister of Justice and the Minister of Interior is the following : Addressed to The Reich Minister of Justice :
If this program had stayed within the bounds set forth in Hitler's letter to Karl
Brandt, it would have been bad enough. We may pass over as quite irrelevant any such
question as whether mercy killing may not in some circumstances be desirable, and whether
a statute authorizing mercy killings under proper safeguards would be valid. This is brought out very clearly in a letter from Himmler to the defendant Brack in December 1940:
But there are more fundamental matters here. The program did not stay even within the bounds of the secret Hitler authority. Euthanasia became merely a polite word for the systematic slaughter of Jews and many other categories of persons useless or unfriendly to the Nazi regime. The evidence before the International Military Tribunal proved this clearly, and the judgment states, and I quote :
I quote one more paragraph from the decision :
As stated in the indictment, the defendants involved in the euthanasia program sent their subordinates to the eastern occupied territories to assist in the mass extermination of Jews. This will be shown by abundant evidence, including the following excerpt from a letter from the defendant Brack to Himmler in 1942 from which I quote a paragraph :
Protesting the lawless slaughter which even Himmler sought to "camouflage", the Bishop of Limburg in 1941 foresaw that such insane carnage spelled the downfall of the Third Reich. He wrote :
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