It’s true that there are very obvious differences between the current policies towards disabled children in the United States and T4; the chief differences being that the U.S. is not Nazi Germany and this clearly isn’t 1939. Exaggerating the comparison would be to render it ridiculous:  the injuries and deaths to children with disabilities and those deemed “difficult” in today’s education system are not a stalking horse for organized, racist genocide, even considering our country’s shameful history of racism, eugenic sterilizations and the periodic “Black Stork” spates of post-natal euthanasia of “malformed” infants.
 In truth, though, the killing of the disabled in Nazi Germany wasn’t merely a prologue or “warm up” to the Final Solution either.  It was more a matter of “first things first”. The disabled, according to Nazi tenets of inequality, represented the ultimate and most critical “biologically inferior” target even before race.  As Rudolf Hess summed it up; “National Socialism is nothing more than applied biology”—or at least the Nazis’ bizarre conception of it. 

All the same, it’s clear that current abuse of disabled children in institutions doesn’t result from an organized, official policy to do harm, even if these current tragedies are, in an unconscious sense, perpetuated by an ideology which shares a few “chromosomes” with the “eugenetic” pseudoscience driving T4 medical atrocities. Maybe these differences could be summed up by saying the modern accidents too frequently befalling children with autism and similar disabilities aren’t exactly systematic but still systemic.

I think people within the education system can feel something negative afoot. The rate of career turnover for teachers is higher than it’s ever been and the increasingly challenged student population isn’t the only reason for this. As Phyllis Musumeci says, “I like to tell people that it’s not like everyone you meet working in a school is going to abuse your kid. But it happens more often than you know”. There are many good people working in schools and I can’t help but think that, depending on the school they’re working in, it’s got to suck being them and more than a few have reported symptoms of posttraumatic stress from witnessing abuse of disabled children.

As the rates of disabled students increase, so does the abuse and no one working in the system is ultimately out of earshot of the stories or sometimes the incidents themselves, creating an inquisitorial environment where one either remains collusively silent or faces the consequences of reporting. Anonymous Special Education teachers in the comments sections of articles on the subject of school restraint, amidst salvos of self pity and their complaints of how they are “abused” by autistic children, too often threaten that parents will be “sorry” the day that SpEd teachers leave the profession en masse because of being held to account.  I personally think this should be a goal—driving out those who defend abuse and making the system “unsafe” for abusers themselves, leaving the field open for those deserving to be vetted with the care of society’s most vulnerable individuals. How long could a sensitive, caring special education professional last in Stefan Ferrari’s school, moreover his school system (HERE), for instance?

During the rise of the T4 program in Nazi Germany, a similar thing happened to the professions of medicine, pediatrics and psychiatry—psychiatry particularly, since it was so much at the helm of creating and enforcing the eugenic selection criteria.  Young people were flocking away from the field.  Occupational therapy was actually invented during this period as an attempt to lure students back to the profession by offering “positivist” approaches.

“Special Treatment” for special students/Sonderbehandllung

One of the most jarring similarities between the current cases of abuse of disabled children in schools and the T4 euthanasia program in Nazi Germany is that the mechanisms of abuse and death are and were simply an excess of what were originally designed to be, for better or worse, “therapeutic” measures. The “therapeutic” means of killing provided cover along with the euphemized code for the mass killings—“Special Treatment”.

In the case of the children’s euthanasia program – because it was wildly unpopular in Germany and had to be conducted through bureaucratic subterfuge, front organizations and the use of euphemized medical language— causes of death of murdered children were usually listed as “cardiac insufficiency” or “pneumonia”. Of course it was never officially mentioned that pneumonia is an expected outcome of overdose with morphine compounds or the barbituate, Luminal— the most popular methods of killing before starvation, gassing, beating, medical neglect and the lethal use of “therapeutic” electroshock machines.  And it was never mentioned against what substance or treatment the heart was “deficient”.

Only the machinery for gassing—which was later disassembled and transferred to concentration camps, complete with medical staff—was specifically invented for the purpose of killing; all other murder methods simply arose from available medical practices. Even physical beatings and denial of rations were often viewed in German culture—as in many cultures at the time— as acceptable “moral” interventions to correct wayward youth.

Then consider that modern use of the “face-down prone” restraint hold in American schools—a technique with the worst record for lethality— has been “therapeutically” permitted to “protect children from injury”; either to protect students and staff from an out of control peer or to protect rampaging students from themselves.  Generally, the cause of death resulting from this hold is “traumatic asphyxiation” and sometimes heart failure,  so it appears that far too many students have  “cardiac” and respiratory “insufficiency” against the hold—particularly when much larger adults lean or sit on them. This “insufficiency” among students to adapt to “therapeutic approaches” is to the point that even U.S. federal agency SAMHSA (Substance Abuse and Mental Health Services Administration) has questioned whether the restraint method should be legal in any situation, has identified it as unnecessary, has outlined safe alternatives and has worked to have it banned from use in residential facilities and institutions receiving federal funding.  But still, teachers’ unions and the Department of Education defend the use of these dangerous practices in “limited circumstances”.

Of course, the use of Luminal and morphine “in limited circumstances” was not always or immediately fatal either.  Neither are the drugs now being pushed on children with autism—in not so limited circumstances—always or immediately fatal, but they often are. Until changes to the Individuals with Disabilities Entitlement Act limited schools’ roles in influencing psychoactive drug treatment for students, many schools coercively directed families to drug their kids. Some continue to.

The use of the Rifton-type type restraint chair is another example of the perversion of therapeutic devices. The Rifton-type chair is designed as an aid to sitting erect for individuals with paralysis or neurological conditions which effect muscle control.  It isn’t designed as a device for restraint or punishment, which may be one of the reasons several children who did not need the chair for physical support have died in the chair while being restrained.  Then there’s the misuse of the “sensory diet” in many schools.  It seems particularly rape--like to use children’s sensory issues as a rationale to force illicit restraints. Children have died or been seriously injured under weighted blankets.
There’s no need to stretch an analogy for seclusion rooms in the T4 program. T4 physicians used them frequently. So do prisons.  One could argue that it’s all a matter of degree but the point is, that “degree” was passed a long time ago, after the first child died in any of these situations.

The T4 program was “eased into” prior to its enactment by a planned decrease in quality of care in institutions, withdrawal of disability compensation and resulting increase in mistreatment, abuse and neglect and narrowing choice of resources. Selecting patients for particularly brutal treatment or neglect was done under the justification of “incurability”—whether this distinction was accurate or not. Finding a modern parallel is easier than it should be, though I believe this is not part of a conscious grand killing scheme on the part of most participants: insurance blacklisting for autism, sleight of hand exclusions of children in state and military autism aid programs and the dearth of adult supports come to mind. 

“Wild” Euthanasia, “Wild” Theory

The next most disturbing similarity between current school abuse of the disabled and T4 is the lack of any official, publically accessible data resource tracking the abuses and the number of deaths, including the destruction and disappearance of documents and evidence. A further similarity is a bureaucracy which has become adept in self-exculpation, in hiding statistics and collusive distortion of facts involving individual cases.

Another relative overlap is the fact that teachers who abuse or even kill their disabled students are rarely brought to justice and this was also true of participants and engineers of the T4 program.  Nuremberg did conduct trials against T4 killers—the doctors, psychiatrists, nurses and others who collaborated in the medical murders of both adults and children—but only for a fraction of those involved. Some were even treated with professional deference by American court examiners, who asked if research performed on T4 victims had been “useful”. As an exercise, look up “Hallervorden Spatz syndrome” and see how many searches it takes to uncover the fact that Julius Hallervorden and Hugo Spatz had been involved with T4 and had even issued requests to the killing centers for the types of corpses of children they needed for research.

The most famous among the T4 killers to evade justice is Hans-Joachim Sewering who, as a physician, sent over 900 disabled children to Eglfing-Haar child killing center to be systematically murdered. Last year, at the age of 92, Sewering was awarded Germany’s highest medical honor, the Gunther Budelmann medal for service to public health.  Werner Catel, a pediatrician who directed the children’s killing program from its inception, went on to head the pediatrics department at Kiel after the war. Werner Hyde, the director of the adult euthanasia program, escaped justice and continued—with the full knowledge of his  colleagues— to work in medicine under an assumed name until he was finally caught fourteen years later.  And psychiatrist Franz Kallmann, an early collaborator in Hitler’s eugenic policy-building whose recommended approaches went too far even for the Nazis (Kallmann called for the sterilization of all family members of the mentally “deficient”), went on to perform his famous “twin studies”. Kallmann’s studies, despite being poorly researched and widely debunked,  are again being cited in American psychiatric textbooks to argue the genetic “foundations” of schizophrenia— theories which are today directly extrapolated to assumptions of autism’s “genetic etiology”. 

Maybe in this sense more than in any other, T4 is quite literally the thing that wouldn’t die. Very few members of the modern medical establishment, much less the public, are even aware that certain prevalent scientific and medical concepts had their roots in T4.

Diminished Capacity

Once their children had been killed, some families made trouble for the T4 bureaucrats (known as “desk-killers”) over the mysterious and inadequately explained deaths. This was particularly true if the family saw the state of their loved one’s bruised and skeletal remains in the early days of the killing program, before killing centers were attached to the high capacity crematoria which were developed specifically for T4. In these cases, families might be threatened with a particularly “genomic” form of coercion: they were reminded that their child or relative was institutionalized for a “hereditary” condition and that the “unreasonable” nature of the family’s complaints was arousing medical suspicions that surviving family might be similarly afflicted.  Any parent complaining about the circumstances of their child’s death might also be barraged with T4 physicians’ incensed self-pity, reminders of what great sacrifices staff had made on behalf of their defective offspring, how no resource or inconvenience was spared to improve the quality of their child’s unbearable life which, in ending, had spared the individual the suffering of a life not worth living.

The parallel here goes back to the remarks that my friend the attorney-advocate overheard from staff of the schools she worked with—that autism parents are all “crazy”— as well as the endless stream of modern throwaway studies on “stress”, “depression”, “personality disorders” and “mental illness” in the families of autistic children.  There have been cases of parents of autistic children forced to submit to mental health assessments and investigations by child protection agencies as a result of conflict with schools over drugging or the use of restraint. 

Among other relevant similarities is that, in the years leading up to WWII, the rate of so-called mental disability had risen in Germany and other developed countries.  German eugenicists, prior to adopting anti-Semitic policies, were at first mostly concerned with overflowing German psychiatric institutions. In Britain in 1919 for instance, as the eugenics movement there ramped up, the rate of mental disability had in fact grown many fold in just seventy years, from an estimated .2 per 1000 in the population to almost 3.5 in 1000 or roughly 120,000 out of about 35 million British citizens.  The increasing burden on Britain’s welfare system, which had been under state control and monitoring since Henry XVIII, led Winston Churchill to announce that the growing population of individuals with “mental defect” needed a “eugenic solution”.  

It was of no more concern to British eugenicists than it would be to German biological “hygienists” that a large percentage of the mentally “defective” population wasn’t afflicted by hereditary conditions even within the era’s limited understanding of heredity.  Most of these conditions for which the disabled were condemned under T4 to this day have not been determined to be genetic, despite more than 100 years and billions of dollars spent trying to “prove” genetic components to such things as alcoholism, “susceptibility” to post-traumatic stress among war veterans, depression, “criminality” and even schizophrenia.  Furthermore, the use of mutagenic mustard gas and other biological weapons during World War I, as well as Germany’s position as a leader in the chemical industry at the time, could conceivably have contributed to a number of birth defects. Some of these birth defects were first discovered between the two world wars and several were later identified as “de novo” or nonheritable gene mutations. 

Sociological studies have been performed which attempted to determined the reason that so many doctors, psychiatrists and scientists willingly participated in the T4 program. Though the program was sometimes rationalized as economic, it apparently had more to do with disgust towards the rising tide of those deemed “genetically unfit” which was set aflame by Nazi scientific propaganda.
 The disabled have always lived tenuously in almost every culture on earth, but what was peculiar to the Nazi eugenic philosophy was the determination to reverse a widely established disability support system.  What’s also peculiar is that it seems almost to the very degree that some conditions were not, in fact, genetic but environmental (and could therefore happen to anyone)— and even perhaps the fault of science and society— that determined the degree of clinical hostility towards the afflicted.   Enough said. I don’t need to mention the modern parallel for this.
Accounting

The final similarity seems a bit arbitrary and simply has to do with numbers of victims. 

Between 100,000 and 200,000 individuals of varying disabilities were systematically slaughtered under the Nazi T4 killing program.  Among the victims, it’s generally estimated that about 5,000 disabled children lost their lives between October, 1939 and the end of WWII in 1945, when four year old Richard Jenne became the last victim of children’s euthanasia. This final murder occurred three weeks after Germany’s unconditional surrender, as T4 operatives continued killing victims until Allied soldiers were literally storming the gates of facilities.  The disparity between the numbers of adult and child victims may have had to do with which “excluded” conditions were recognizable among children under 17 (mental retardation, physical defects, epilepsy, visual and hearing impairment, etc.) and which tend to have later onset among adults (alcoholism, “criminal psychosis” , depression, schizophrenia, dementia, combat injuries, etc.).

It’s grotesque to say it, but 5,000 children out of the population of Germany and the combined populations of Reich-occupied territories—about 87 million in 1939— from which victims were drawn seems a very low number by today’s child-disability standards. Yet German pediatric clinics and institutions were virtually emptied out in France, Poland, Germany, Austria and some parts of Russia during the course of the war, to the extent that T4 physicians and psychiatrists began to worry that they might soon run out of victims altogether.  Even considering that Hans Asperger managed to spare the lives of a handful of children diagnosed with his new, namesake discovery, not an enormous number of families managed to hide their disabled offspring in order to save them.  There simply were not the per capita rates of disability among children as there are today.  In order to wipe out almost an entire population of children with disabilities in occupied Europe, the rate of killing of disabled children in the Reich would have averaged out to roughly 1,000 per year.

In 1998, as Spectrum Magazine recently reported, the Harvard Center for Risk Analysis estimated that about 150 individuals a year are killed due to restraint and seclusion in the U.S. The estimate included all facilities and schools and it was admitted to be a “tip of the iceberg” statistic.  This was several years before the epidemic had landed on public schools with its current force and numbers.  This might seem to be just playing around with statistics to foist some significance, but I find it chilling to think of how the public and government health agencies collectively shrugged when the numbers “150” and “1,000” were exchanged, as when the rate of autism went from 1/1,000 to 1/150. 

Since 1998, how many more than “150” individual are being killed yearly by seclusion, restraint and abuse now that some “snake pit” institutional practices have entered the realm of schools? And what will the public and the government do if, say, that number became “1,000” a year? Would it no longer be considered genocide if the same numbers of disabled children are killed per year in the US as were murdered during the Nazi reign simply because there are now so many more disabled children? 

Does a dying child suffer less because their individual death is diminished relative to a per capita count? 

No Schindler for the Disabled

Very few disabled children managed to escape their fate in the killing centers once drawn into the children’s euthanasia program in Nazi Germany, since their only champions might be their parents. Like today’s parent advocates for children with autism, parents of disabled patients under Nazi rule—no matter their affiliations— were put in a weakened position to advocate for their children, not simply because their objections threatened authority and threatened the system but simply because they were biologically related to victims of the deadly caste system.  As my friend Cassandra told me, not even wealthy families have much clout regarding school policies, arrests of children with autism who “act out”, seclusion, restraint and other abuses. Dr. Kamat, for instance, wasn’t able to prevent his son from being initially abused (notice the other child in a wheelchair left confined in a darkened room with the “dangerous” autistic child at the beginning of the video, here http://tinyurl.com/qdqdmv ). 

Thank God we aren’t living in Nazi Germany. Thank God we can still make ourselves heard and that advocacy organizations exist. But we had better take advantage of the freedoms we now possess and keep from “falling asleep in the snow” before this kind of corruption spreads further.  It’s still going to be mainly parent-run organizations and parents such as Lori McIlwain, Phyllis Musumeci  and others who burn the midnight oil to enforce change and we would do well to join them for the sake of our children.  Once an abusive machine like this gains momentum, it takes coalitions to stop it. I can only hope that what’s happening now and what happened in the past century is not a match, though to the children who died, what’s the difference?  

Adriana Gamondes lives in Massachusetts with her husband and is the mother of twins who are currently recovering from vaccine-induced GI disorders.