The attack on handicapped patients in state hospitals and nursing homes had opened in 1933 with sterilization and a reduced standard of care. But this was only the beginning. In 1935 Adolf Hitler had told Gerhard Wagner, the Reich physician leader, that once war began he would implement euthanasia.1 He kept his word. When war started on 1 September 1939, the machinery to kill the handicapped was in place and the killings began. And just as the sterilization legislation enacted against the handicapped was followed by that enacted against Jews and Gypsies, the murder of the handicapped would be followed by the murder of Jews and Gypsies.
First came the murder of handicapped children. In 1938 the newly born infant of a family named Knauer served as the pretext for Hitler to set in motion the program of euthanasia he had intended to institute. The Knauer baby, sex unknown, was apparently born with severe handicaps. The exact nature of its affliction cannot be reconstructed with certainty, but testimony does seem to agree that it was born with a leg and part of an arm missing. Some evidence suggests that it was also blind, and the physicians also diagnosed it as an "idiot." But its blindness was not noted by all observers, and the diagnosis "idiot" was not definite. In addition, the baby apparently suffered from convulsions.2
The child's father consulted Werner Catel, the director of the Leipzig University Children's Clinic, and asked him to admit the infant. Catel, who admitted the child to the hospital, later claimed that the father requested that he kill the child and that he refused because this was against the law.3 Shortly thereafter, the Knauer family appealed to Hitler to grant permission to have the infant killed. Such appeals reached Hitler through his private chancellery, where similar appeals had already been collected. This Chancellery of the Führer (Kanzlei des Führers, or KdF), headed by Philipp Bouhler, prepared the information for Hitler, who decided to act in the Knauer case. He instructed his escorting physician (Begleitarzt), Karl Brandt, to visit the Knauer infant, consult with the Leipzig physicians, and kill the child if his diagnosis agreed with the conditions outlined in the appeal.4 In Leipzig, Brandt consulted with the attending physicians, confirmed the diagnosis, and authorized euthanasia; the baby was killed.5
After the killing of the Knauer infant, Hitler authorized Brandt and Bouhler to institute a program of killing children suffering from physical or mental defects. Hitler thus appointed Brandt and Bouhler as his plenipotentiaries for