Hitler met with Conti, Hans Heinrich Lammers, the chief of the Reich Chancellery with the title of Reich minister, and Martin Bormann, the chief of the Nazi Party Chancellery.7 At the meeting, Hitler told them "that he considered it appropriate that life unfit for living of severely insane patients should be ended by intervention that would result in death." Like numerous others who advocated the killing of the handicapped, Hitler used as an example the hypothetical case of patients so incapacitated that they could not keep themselves clean and "took their own excrement as food"--an example used extensively by the killers at their postwar trials, although none of the murdered patients probably exhibited this aberrational behavior.8 As an additional argument to convince the bureaucrats, Hitler added that killing adult patients would also produce "a certain saving in hospitals, physicians, and nursing personnel."
Conti accepted the assignment, but he did not remain in charge long; within a few weeks, Hitler replaced him.9 Apparently, a power struggle developed within the Nazi leadership over control of adult euthanasia. Philipp Bouhler, in charge of children's euthanasia, convinced Hitler that the KdF should undertake the killing of handicapped adults as well. Bouhler was probably urged to embark on this jurisdictional struggle by Viktor Brack and the KdF staff. In addition, Bouhler feared that the appointment of Conti, who headed the party office for national health in the Nazi Party Chancellery, would ensure Martin Bormann's control over the euthanasia operation; in his intrigue against Bormann and Conti, Bouhler apparently allied himself with Hermann Göring, Heinrich Himmler, and Wilhelm Frick.10
Hitler granted Bouhler's request and informed Karl Brandt of his decision. Brandt and Bouhler, already in charge of children's euthanasia and now also appointed plenipotentiaries for the killing of handicapped adults, accepted the new commission and began to confer on how to implement it.11 No doubt, considerations of secrecy also prompted Hitler to substitute Brandt and Bouhler for Conti. As in children's euthanasia, administrative direction by the KdF ensured that neither the party, through its visible SS formations, nor the state, subject to budgetary controls, would be openly involved. And once again, Hitler "desired a non-bureaucratic solution."12
When did Hitler make these decisions and appointments? It is impossible to fix the time with absolute certainty. At Nuremberg, both Brandt and Lammers placed Hitler's appointment of Conti in the early period of the war, September or early October 1939, and the change to Brandt and Bouhler several weeks later.13 But Brack at Nuremberg, and other witnesses interrogated by German prosecutors years later, placed these events several months earlier.14 Evidence does support the earlier date; thus it seems likely that the KdF called its first planning session for adult euthanasia before the start of the war.15 We