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Restricted Public Mental Health Practices in Germany Sterilization and Execution of Patients Suffering from Nervous or Mental Diesase Reported by Leo Alexander, Major, M.C., AUS CIOS Item 24 Combined Intelligence Objectives Sub-Committee Part III (2). Documents concerning expert opinions which Dr. Pfannmüller gave on patients selected for killing in other institutions These documents included letters of transmittal which accompanied the records which were sent from Professor Dr. Heyde to Dr. Pfannmüller for expert appraisal. Dr. Heyde’s letters of transmittal were written on stationery of the "Reichsasrbeitsgemeinschaft Heil- und Pflegeanstaltern" ("Realm Work Committee of Institutions for Cure and Care") Berlin, "9. Post Office Box 262 - another organization with high-sounding name, whose sole purpose was the killing of mental patients (Appendix 2, No.1). Dr. Pfannmüller returned the records with his expert appraisals by registered mail, accompanied by a letter of transmittal (Appendix 2, No.2) which sometimes contained comments, such as for instance, his comments on a group of 300 cases from the institution for the insane at Gütersloh, in which he sneered at the fact that the patients apparently had not benefited significantly from the results of work therapy which had first been initiated at the institution in Gütersloh (Appendix 2, Nos. 3 and 4). Sometimes Dr. Pfannmüller complained that the clinical abstracts submitted were not good enough to form a satisfactory expert opinion, such as in a group of 200 cases sent from the institutions at Langenhorn and Wiesengrund (Appendix 2 Nos, 5, 6 and 7). In the case of the patients from Langenhorn, however, he gave decisions just the same (Appendix 2, No.6), while in the case of the patients from Wiesengrund, he suggested to have the director submit new clinical abstracts (Appendix 2, No.7). More caustic were his comments concerning clinical abstracts of 300 cases which had been sent from the institution at Hildesheim (Appendix 2, Nos.8 and 9). He suspected the director of that institution of sabotaging the efforts of selection of patients for killing by making exaggerated claims concerning their occupational usefulness. Dr. Pfannmüller suspected that the director’s motives were purely egotistical ones: "he seemed to have heard some rumours about the dissolution of institutions and obviously did not want to help in sawing off the branch of the tree on which he was perched". Dr. Pfannmüller suggested sending an inspecting commission to the institution in Hildesheim to look into the true state of occupational usefulness of the patients. Altogether Dr. Pfannmüller submitted 5,475 expert appraisals during the period extending from 5 November 1940 to 3 May 1941. Unfortunately only the letters of transmittal and occasional comments are extant, the case histories and clinical abstracts themselves not having been retained in the file.
These activities were initiated by an order of the Ministry of the Interior for the Reich and Prussia, dated 26 June 1940 (Appendix 3, No.1). This order established compulsory registration by midwives, doctors and hospital personnel of all children who were suffering from severe congenital illness such as:- (I) idiocy and mongolism, especially cases associated with blindness and deafness; (2) microcephaly; (3) hydrocephalus of severe and progressive type; (4) malformations of every type, especially absence of limbs and severe cleft formations of the head or the spine; (5) palsies, including Little’s disease. Paragraph 4 of this order reads as follows:
Shortly after the issue of that order, a meeting of directors of institutions was held at the Ministry of the Interior in Munich, at which the Berlin representative of the committee, who was then a Dr. Wentzler (prior to Dr. von Hegener’s appointment to that position), addressed a select group of directors of institutions and apparently informed them of the true nature of the new type of "intensive treatment". Shortly after the meeting Dr. Pfannmüller sent a letter to Dr. Wentzler, dated 29 June 1940 (Appendix 3, No.2), in which he explained his contemplated participation in the program. The letter reads:
Heil Hitler". This letter was not initialled, but without doubt is the original carbon copy of Dr. Pfannmüller’s letter. A regulation from the Ministry of the Interior, dated 1.7.1940 (Appendix 3, No.3) regulated that the cost of the program should be defrayed from public welfare funds and in insured cases through sickness insurance. On 5 August 1940, Dr. Wentzler of the Realm Committee for Scientific Approach to severe illness due to Heredity and Constitution, replied to Dr. Pfannmüller and informed him that arrangements concerning selection of special institutions would soon be completed, at first in Vienna and in Gürden, and probably later in Dr. Pfannmüller’s institution in Munich. Dr. Wentzler suggested that Dr. Pfannmüller get in touch with the directors in Gürden and Vienna at a later date. His letter referred to Dr. Erwin Jekelius as the man in charge in Vienna (Appendix 3, No.4). There was apparently some delay in organization and it was not until 21 September 1940 that Dr. Pfannmüller reported to Dr. Von Hegener, who had in the meantime taken over in Berlin, that he had selected a Dr. Herbert Jung, who was a member of the Nazi party and politically reliable, as the man in charge of the new department, and stated that he would come to see Dr. von Hegener on 23 September 1940. The letter ends as follows:
On 11 October 1940 Dr. von Hegener sent Dr. Pfannmüller a special gasoline ration of 30 litres because "in view of the appointment of a new physician you will have to make an increased number of trips to Munich". (Appendix 3, No.6). On 2 November 1940 Dr. Von Hegener asked about a child who was supposed to be admitted to the new department (Appendix 3, No.7) and on 13 November 1940 he sent Dr. Pfannmüller another 30 litres of gasoline coupons "to be used for trips on behalf of the Realm Committee" (Appendix 3, No.8). On 30 November 1930 Dr. Pfannmüller submitted his first report on admissions and discharges to the new department. 11 children were admitted during that months, and 5 had already ‘died’. One child is described as having been taken home by the parents against medical advice: "it was handed to the parents upon their insightless urging. There were no legal means to retain it in the institution by force". (Appendix 3, No.9). On 26 November 1940 Dr. von Hegener invited Dr. Pfannmüller to a special discussion of the "physicians active on behalf of the Realm Committee in Berlin" (Appendix 3, No.10). Dr. Pfannmüller made the following notes about the meeting (Appendix 3, No.11):-
On 4 January 1941, Dr. Pfannmüller sent Dr. von Hegener a personal letter in which he expressed how much pleasure he derived from his cooperation with him, and also thanked him for the great help which he had given him by supplying him with extra gas coupons (Appendix 3, No.12). This obviously scrounging letter was followed by an award of 100 litres of gasoline to Dr. Pfannmüller on the part of Dr. von Hegener (Appendix 3, No.13). On 28 January 1941, Dr. von Hegener sent a letter to Dr. Pfannmüller in which he requested him to name pediatricians and gynaecologists with a National Socialist outlook on life in order to increase the scope of the new activities, presumably to step up the number of referrals (Appendix 3, No.14). In his reply of 8 February 1941 (Appendix 3, No.15), Dr. Pfannmüller stated that he had discussed Dr. von Hegener’s letter with Dr. Walter Schultze, Ministerial Director of the Ministry of the Interior. The letter went on to say
On 26 May 1941, Dr. Pfannmüller asked for 50 more beds for the children’s department, because it was overflowing with admissions (Appendix 3, No.16). On the same date Dr. Pfannmüller sent a letter to the Realm Committee in Berlin which indicated that there was some difficulty in obtaining payments from city welfare agencies for children which the Realm Committee referred to the special children’s department for "scientific investigation" and "treatment". (Appendix 3, No.17). At the same time Dr. Pfannmüller informed the juvenile department of the city welfare department of Kempten that the matter would be taken up with the Realm Committee for Scientific Approach to Severe Illness due to Heredity and Constitution (Appendix 3, No.18). Apparently there was some snag about disposing of the children quickly enough, because of the shortage of suitable poison. In his letter of 31 May 1940 (Appendix 3, No.19), addressed to Dr. von Hegener, Dr. Pfannmüller stated
Apparently Dr. Pfannmüller felt in need of some encouragement for his activities, because he kept a note of a conversation with the mother of a child by name of Lothar Hübsch. After a conversation during which the mother had expressed her solictude about her child’s comfort, she stated
The documents include lists of 275 children who passed through the children’s department between 1940 and 1943. "Authorization" was given in 213 of these cases. Sample sets of these lists are reproduced in Appendix 3, Nos. 21, 22, 23, 24 and 25. |