From Action T4 to decentralized euthanasia in Lower Austria: The psychiatric hospitals of Gugging, Mauer-Öhling and Ybbs - PDF

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Herwig Czech From Action T4 to decentralized euthanasia in Lower Austria: The psychiatric hospitals of Gugging, Mauer-Öhling and Ybbs Introduction The history of psychiatry in Nazi Germany is inextricably

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Herwig Czech From Action T4 to decentralized euthanasia in Lower Austria: The psychiatric hospitals of Gugging, Mauer-Öhling and Ybbs Introduction The history of psychiatry in Nazi Germany is inextricably linked to the murder of tens of thousands of patients. There were three main complexes under which this was carried out, which were all organized differently, operated according to different time scales, and had different goals. The best known is the so-called Action T4, which ran from 1939 to 1941 and under which around 70,000 people were killed in six central extermination centres. Schloss Hartheim, near Linz, and the other extermination centres of T4 represent the first institutions in history set up to facilitate the mass destruction of people. They were a model and precursor for the death camps of Operation Reinhardt in occupied Poland, where murder would take place on an even bigger scale. After Hitler stopped T4 at the end of August 1941, the killings moved from the extermination centres to the psychiatric hospitals themselves, which resulted in significant regional differences, depending on specific circumstances and individual initiatives. For this second phase, the term decentralized euthanasia has become customary in the literature. The third programme was that of child euthanasia, by which the killing of children considered unworthy was intended to become a permanent part of the public health care system, as the example of the Viennese child euthanasia centre Am Spiegelgrund (where nearly 800 children died) shows. During the period between the cancellation of T4 in 1941 and the end of the war, some of the most gruesome medical crimes on Austrian territory took place in Gugging and Mauer-Öhling. The main perpetrator, Emil Gelny, murdered several hundred people with poison and a converted electroshock apparatus. In addition, many more patients died of hunger, infectious diseases or neglect, or were deported to institutions where they had little chance of survival something which until now has barely been acknowledged due to a narrow focus on Gelny s activities. As the following will show, this has led to a stark underestimation of the number of victims in the two Herwig Czech is a research fellow at the Documentation Centre of the Austrian Resistance (DÖW) and a lecturer at Vienna Medical University. Contact: 1 largest psychiatric hospitals in Lower Austria. The research data for these events is highly inconsistent. On the one hand, the Action T4 deportations and Gelny s murders were documented relatively early on. 1 The documents from the People s Court trials of 1946, against doctors and nursing staff from the two institutions, were the main source for later accounts, which however primarily focused on the Gugging institution. 2 When it comes to Mauer-Öhling, however, there is still no comprehensive account, particularly regarding an analysis of the institutions s medical records, which have since been taken over by the Lower Austrian State Archives. 3 The Ybbs institution was under the administrative control of the Vienna City Administration and served during the T4 transports as an intermediate institution for deportations from the psychiatric hospital Am Steinhof to Hartheim. Given its geographical position in Lower Austria, it too will be dealt with in this paper, albeit only at a cursory level. 4 After the war, the authorities focused on identifying those guilty of individual, direct acts of homicide, which could be punished by means of the criminal justice system. By contrast, the consequences of neglect and food deprivation were not even contemplated, although in many mental institutions they had been part of the repertoire of covert killing methods used during the war. It was only a few years ago that the Lower Austrian Provincial Government and the Institute of Science and Technology Austria (which now occupies the site belonging to the former Gugging psychiatric hospital) financed a project by this author which included an in-depth examination of Wolfgang Neugebauer, Euthanasie und Zwangssterilisierung, in: Dokumentationsarchiv des österreichischen Widerstandes (ed.), Widerstand und Verfolgung in Niederösterreich, Volume 3, Vienna 1987, Wolfgang Neugebauer, Zur Rolle der Psychiatrie im Nationalsozialismus (am Beispiel Gugging), in: Gemeindenahe Psychiatrie 17 (1996), ; as well as the articles in the anthology Reinelde Motz-Linhart (ed.), Psychiatrie ohne Menschlichkeit, Gugging , St. Pölten 2008 (especially those of Wolfgang Neugebauer, Gertrude Langer- Ostrawsky, Gerhard Fürstler and Claudia Spring) as well as Angela Danbauer s Angela Danbauer, Die Heil- und Pflegeanstalt Gugging während der NS-Zeit (master s thesis), Vienna Gertrude Langer-Ostrawsky discusses the use of patient case files as sources in Medizingeschichtliche Quellen. Probleme und Methoden in der Bearbeitung der Akten der Niederösterreichischen Heil- und Pflegeanstalten Gugging und Mauer-Öhling , in: Sonia Horn/Peter Malina (ed.), Medizin im Nationalsozialismus. Wege der Aufarbeitung, Wien 2002, The focus of Gerhard Fürstler/Peter Malina s Ich tat nur meinen Dienst. Zur Geschichte der Krankenpflege in Österreich in der NS-Zeit, Vienna 2004, is on the nursing staff from both institutions. The mentioned files from the court case are located (as copies) in the Documentation Centre of the Austrian Resistance (DÖW /1-100). Since Michaela Gaunerstorfer s (unpublished) master s thesis, Michaela Gaunerstorfer, Die psychiatrische Heil- und Pflegeanstalt Mauer-Öhling , Vienna 1989, there has been no notable work on Mauer-Öhling, with the exception of the quoted publications from Fürstler and Malina. A research project on Mauer-Öhling during National Socialism is currently in preparation at the Institute for Jewish History in Austria. A brief overview of euthanasia in Lower Austria is also provided by Wolfgang Neugebauer, Die NS-Euthanasiemorde in Niederösterreich , in: Heinz Arnberger/Claudia Kuretsidis-Haider (ed.), Gedenken und Mahnen in Niederösterreich. Erinnerungszeichen zu Widerstand, Verfolgung, Exil und Befreiung, Wien 2011, Regarding the T4 transports from Steinhof and Ybbs, see Pia Schölnberger/Susanne Üblackner,...in eine nicht genannte Anstalt versetzt. Die T4 -Opfer der Wiener Anstalten Am Steinhof und Ybbs an der Donau. Eine Projektund Forschungsstandbeschreibung, in: Brigitte Kepplinger et al. (ed.), Tötungsanstalt Hartheim, Linz 2008, All three institutions in the focus of this paper continued functioning as psychiatric hospitals after The Gugging hospital was closed at its historic location and partly relocated in 2007; the premises became the ISTA campus. Mauer- Öhling and Ybbs are still in use in line with their original functions (Therapiezentrum Ybbs-Psychiatrisches Krankenhaus and Landesklinikum Mauer, Psychiatrische Abteilung). 2 the patients movements at the institution, and thus gives a more accurate insight into the true extent of how many died at the hospital during the war years. 5 In addition to a presentation of the key project results regarding the decentralized euthanasia in Gugging and a summary of the effects of the other euthanasia programs on the institution s patients, the following pages will also look at Ybbs and Mauer-Öhling, to give at least a provisional overall picture of the extermination of psychiatric patients in the Lower Danube Reichsgau (roughly today s province of Lower Austria). The focus on the provincial level is justified by the fact that especially in the second, decentralized phase of the euthanasia killings the Reichsgau s administrative authorities played a decisive role, which can also be demonstrated to be the case in Lower Austria. 6 Action T4 An oft quoted order of Hitler s from October 1939 to his personal physician Karl Brandt and the leader of the Fuhrer s Chancellery Philipp Bouhler is rightly considered a crucial step in the preparation of the euthanasia murders. 7 With the order, written on private stationary and intended above all to serve as an authorization for the proposed measures vis-à-vis the state administration and the judiciary, Hitler chose the most radical and far-reaching option, namely to organise secret patient killings within the Nazi state s zones of lawlessness. 8 It was only in the year that Poland was invaded that concrete preparations began as to the definition of responsibilities, the recruitment Nazi Medical Crimes in the former Gugging Psychiatric Hospital, research assignment for Herwig Czech from the I.S.T. Austria and the Lower Austrian Provincial Government, January 2008 until December The original German version of this paper has been published as Herwig Czech, Von der Aktion T4 zur dezentralen Euthanasie. Die niederösterreichischen Heil- und Pflegeanstalten Gugging, Mauer-Öhling und Ybbs, in: Jahrbuch des Dokumentationsarchivs des österreichischen Widerstandes (2016), Preliminary results of the project have previously been published in id., NS-Medizinverbrechen an Patienten der Heil- und Pflegeanstalt Gugging, in: Stadt Klosterneuburg (ed.), Von der Anstalt zum Campus. Geschichte und Architektur des Krankenhauses in Maria Gugging, Klosterneuburg 2009, 51-61; id., Nationalsozialistische Medizinverbrechen in der Heil- und Pflegeanstalt Gugging, in: Linda Erker et al. (ed.), Update! Perspektiven der Zeitgeschichte. Zeitgeschichtetage 2010, Innsbruck/Vienna/Bolzano 2012, The author wishes to thank Philipp Mettauer, Kamila Uzarczyk and Georg Maißer for their help with the data collection. Special thanks go to the I.S.T.A. and the Lower Austrian State Archive (NÖLA) for their cooperation, and to Rosie Waites for the translation of this text. For the importance of the regional authorities in carrying out decentralized euthanasia see, among others, Brigitte Kepplinger, Regionalisierter Krankenmord. Voraussetzungen und Strukturen der nationalsozialistischen Patiententötungen außerhalb der zentral gesteuerten Programme, in: Bertrand Perz et al. (ed.), Schlussbericht der Kommission zur Untersuchung der Vorgänge um den Anstaltsfriedhof des Psychiatrischen Krankenhauses in Hall in Tirol in den Jahren 1942 bis 1945, Innsbruck, 2014, Kepplinger describes the four states or provinces of Saxony, Bavaria, Hesse-Nassau and Pomerania as the main regions for the decentralized patient killings in pre-anschluss Germany, and in Austria only the Upper Danube (Upper Austria) and Carinthia, but not the Lower Danube or Vienna. For example, Ernst Klee, Euthanasie im Dritten Reich. Die Vernichtung lebensunwerten Lebens, Frankfurt am Main 2010, Winfried Süss, Krankenmord. Forschungsstand und Forschungsfragen zur Geschichte der nationalsozialistischen Euthanasie, in: Theresia Bauer/Winfried Süss (ed.), NS-Diktatur, DDR, Bundesrepublik. Drei Zeitgeschichten des vereinigten Deutschland. Werkstattberichte, Neuried 2000, 47-86, 48. 3 of staff and the construction of a secret, special bureaucracy to enforce the programme. 9 For this purpose the Fuhrer s Chancellery (Kanzlei des Führers or KdF) set up several front organisations, which later became known as T4 because of their location in Berlin s Tiergartenstrasse Without the active cooperation of public authorities the KdF (a Nazi party office without any formal powers) would never have been able to realize its far-reaching plans. This applies in particular to the Interior Ministry and its Department of Public Health. In September 1939 it began to collect information on potential victims for the euthanasia programme. 11 The registration forms compiled during this process were used a short while later by specially designated experts (Gutachter) as the basis for their decisions on who to kill. In order to murder the selected victims, T4 established six extermination centres, of which up to four were in operation simultaneously. In annexed Austria the T4 organisation leased Schloss Hartheim in Alkoven, near Linz. In the winter of 1939/40 it was modified for its new purpose. After the necessary staff had been recruited, the first psychiatric hospital patients died in the gas chamber in May There is ample literature on the mass killings at Hartheim, the findings of which need not be repeated here in detail. 13 Diverging from the established practice in the Old Reich (pre-anschluss Germany), in the Ostmark the registration forms were not completed by the staff of the psychiatric hospitals but by special commissions sent by T4. This method of selection turned out to be far more radical than that used in the Old Reich. Within a short time large psychiatric institutions were totally or partially evacuated, their inhabitants were gassed in Hartheim and the corpses were burnt. In this way 62.4 per cent of all patients in public psychiatric hospitals (based on the number of existing beds) were killed in Ostmark, under T4. Using this method of calculation, 63.5 per cent were killed in Mauer-Öhling and 82.7 per cent in Ybbs. 14 In the Vienna psychiatric Ulf Schmidt, Kriegsausbruch und Euthanasie. Neue Forschungsergebnisse zum Knauer Kind im Jahre 1939, in: Andreas Frewer/Clemens Eickhoff (ed.) Euthanasie und die aktuelle Sterbehilfe-Debatte. Die historischen Hintergründe medizinischer Ethik, Frankfurt am Main/New York 2000, ; Udo Benzenhöfer, Bemerkungen zur Planung bei der NS- Euthanasie, in: Arbeitskreis zur Erforschung der nationalsozialistischen Euthanasie und Zwangssterilisation (ed.), Der sächsische Sonderweg bei der NS- Euthanasie, Ulm 2001, 21-53; Süss, Krankenmord. For the organizational structure of T4, see Henry Friedlander, Der Weg zum NS-Genozid. Von der Euthanasie zur Endlösung, Berlin 1997, Instructions from the Reich Interior Ministry for filling out the T4 registration form, cited by Jochen-Christoph Kaiser et al., Eugenik, Sterilisation, Euthanasie. Politische Biologie in Deutschland Eine Dokumentation, Berlin 1992, 251. Henry Friedlander, Damals in der Ostmark. Die Mordanstalten in und bei Linz, in: Fritz Mayrhofer/Walter Schuster (ed.), Nationalsozialismus in Linz. Volume 2, Linz 2001, , For example ibid.; Brigitte Kepplinger, Die Tötungsanstalt Hartheim , in: Institut für Gesellschafts- und Sozialpolitik an der Johannes Kepler-Universität Linz u. a. (ed.), Der Wert des Lebens: Gedenken/Lernen/Begreifen, Linz 2003, Brigitte Kepplinger, NS-Euthanasie in Österreich: Die Aktion T4 - Struktur und Ablauf, in: Brigitte Kepplinger et al. (ed.), Tötungsanstalt Hartheim, Linz 2008, 35-62, hospital Am Steinhof, around 3,200 people two thirds of patients fell victim to Action T4. 15 In Gugging, 50.5 per cent of patients were transported to Hartheim (based on the actual number of patients on 1 st November 1940, shortly before the first transport). 16 The claim that Action T4 was aimed solely at the destruction of the mentally dead was, from the beginning, a euphemistic lie. By 1941 at the latest, it was dropped from the internal discourse of the killing bureaucracy as shown by the following statement: The elimination of all those who are unable, even within institutions, to carry out productive work, not only the mentally dead. 17 As a quantitative analysis of a large sample of the T4 medical records held in the German Federal Archives demonstrated, there was no significant correlation between the factors of inherited disease and social deviance on the one hand, and selection for the gas chamber on the other. The most important factor for selection was first and foremost a negative evaluation of work performance. Another significant factor when it came to being selected for the T4 killing programme was a stay of more than four years within an institution, and a negative appraisal of behaviour (seen as increasing the cost of care). Women were also in significantly greater danger of being selected for killing. 18 Action T4 in the Lower Austrian Mental Hospitals In the Gau Lower Danube (formerly Lower Austria), as was the case in other provinces, the Gauleiter was informed by an official from Berlin of the impending patient killings. The head of the Gau administration Sepp Mayer testified before the People s Court after the war that in 1939 or 1940 he learnt through Gauleiter Hugo Jury that Leonardo Conti, the Reich health leader, had visited Jury and told him that euthanasia will soon be carried out in the Gau. 19 From 1939 patients Wilhelm Podhajsky, Speech by Director Primarius Dr. Wilhelm Podhajsky, held in celebration of the 50 th anniversary of the founding of Am Steinhof psychiatric hospital on October 8 th 1957, in: Wiener Zeitschrift für Nervenheilkunde und deren Grenzgebiete 14 (1959), As part of the aforementioned research project (see footnote 5), information on patient movements (of children and adults) between 1937 and 1946 was recorded in a database, using the following documents: NÖLA, Heil- und Pflegeanstalt Gugging, patient admissions, departures and death registers, circa 1895 until The data was supplemented with information on the fate of the Gugging patients who were sent to Spiegelgrund and Steinhof, as well as a request to the archive at the Mauer-Öhling institution. The records of the T4 victims were kindly made available by the Hartheim Memorial. Decision of the two euthanasia representatives [Bouhler und Brandt] regarding the assessment (considering the results of the meeting in Berchtesgaden on ), quoted by Ernst Klee, Dokumente zur Euthanasie, Frankfurt am Main 1985, 100. Gerrit Hohendorf et al., Krankenmord im Nationalsozialismus - Ergebnisse eines Projektes zu den psychiatrischen Patientenakten von den Opfern der Aktion T4, in: W. E. Platz/V. Schneider (ed.), Todesurteil per Meldebogen. Ärztlicher Krankenmord im NS-Staat. Beiträge zur Aktion T4, Berlin 2006, DÖW 18860/1-100, LG Wien, Vg 8a Vr 455/46, Case against Dr. Josef Mayer and others (subsequently quoted under the respective DÖW signature). Here: DÖW 18860/35, statement Dr. Josef Mayer, ; DÖW 18860/3, Trial, 5 were not allowed to leave Gugging (this was probably also the case in Mauer-Öhling), so the hospitals became veritable traps, even for patients who were eligible for release. 20 Also, according to a statement from the hospital doctor Koloman Nagy, medical officers received the order in 1941 or 1942 to place all people with hereditary defects and those not able to work who have already been in institutional care back into an institution again. 21 The director of the Gugging psychiatric hospital, Josef Schicker, told the People s Court after the war that he was notified in 1940 by the Gau Physician Leader, Richard Eisenmenger, he was responsible for hospitals and nursing homes in the Lower Danube Gau administration, 22 that measures to empty the wards had to be taken. At this time killing was not explicitly mentioned, rather the euphemistic phrases which were common in the euthanasia apparatus were used. Erwin Jekelius (who at the time was also the director at Spiegelgrund) was named as the liaison; he acted as a coordinator for the euthanasia programme within the Vienna area. In the same year, 1940, Schicker said that nine medical students appeared at Gugging, who under Jekelius s orders were responsible for sifting through patient s medical records and completing registration forms. This statement is remarkable, as in other institutions within Ostmark this task was done by a high level commission under the personal guidance of the medical director of T4, Prof. Werner Heyde. The hospital doctor Koloman Nagy spoke before the same court of a commission of 18 to 24-year-old Baltic Germans. 23 In Mauer-Öhling, a commission was also at work probably already in May 1940 but its composition was markedly different. 24 According to a statement from the former director of the hospital Michael Scharpf (who stood as one of the accused before the People s Court) it was directed by Professor Nitsche and consisted also of Prof. Reimers, two faculty members of the medical departments of Graz and Inn
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