Action 14f13- The killing of the sick

Hartheim Castle

It is hard to say which crime committed during the Holocaust was the most gruesome, but along with the Action T4 program, the Action 14f13 is equally horrific. Not because they were worse then all the other atrocities but because elements of both programs are slowly sneaking in by stealth in a number of European countries.

Action 14f13, also called “Sonderbehandlung (“special treatment”) 14f13″, was a campaign of the Third Reich to murder Nazi concentration camp prisoners. Also called “invalid” or “prisoner euthanasia”, the campaign culled the sick, elderly and those deemed no longer fit for work from the rest of the prisoners in a selection process, after which they were killed. The Nazi campaign was in operation from 1941 to 1944 and later covered other groups of concentration camp prisoners, as well.

A coded language was used to record the death of the inmates of concentration camps. “14 f 1” signified natural death, “14 f 2” – suicide or accidental death, “14 f 3” – shot while trying to escape, “14 f I” – execution. By Himmler’s order, in April 1941, “Special Treatment (Sonderbehandlung) 14 f 13”, the “euthanasia” of sick or infirm prisoners was instituted.  From inception, T4 sent medical personnel to the camps to select and list prisoners for liquidation.

Collaboration between the Inspectorate of the Concentration Camps (a department of the SS) and the T4 administrators did not require extensive negotiations. Himmler had provided some support services for T4 killing operations which were organized by Viktor Brack, an active member of the SS who had a close relationship with Himmler. Once Himmler and Bouhler had reached an agreement on the killing of concentration camp prisoners, Brack simply coordinated the joint killing operation. This SS-T4 collaboration included both the process of selecting the victims and the actual killing operation. Prisoners from all camps administered by the Inspectorate, except Natzweiler, which was established too late to be included, were selected for 14 f 13.

Philipp Bouhler (11 September 1899 – 19 May 1945) was a senior Nazi Party official who was both a Reichsleiter  andChief of the Chancellery of the Führer of the NSDAP. He was also an SS-Obergruppenführer in the Allgemeine SS who was responsible for the Nazi Aktion T4 and Action 14f13 euthanasia program that killed more than 70,000 handicapped adults and children in Nazi Germany.


Today is the 71st anniversary of his suicide.

The selection process involved a two-tier approach. SS camp physicians pre-selected a pool of potential victims, and T4 physicians then picked the actual victims from this pool. Officially, the Inspectorate apparently directed SS camp physicians to select those suffering from incurable physical diseases who were permanently unable to undertake physical labour. In addition to personal data, the reason for arrest, and the date of incarceration, SS camp physicians had to provide details about physical ailments but not about the disabilities that had been used to evaluate the handicapped. Unofficially, the Inspectorate applied other criteria, which were not transmitted in writing. The unofficial instructions covered racial and eugenic criteria for selection.

The operation began in April 1941. A panel of doctors began visiting concentration camps to select sick and incapacitated prisoners for “elimination”. This panel included those already experienced from Aktion T4, such as professors Werner Heyde and Hermann Paul Nitsche, and doctors Friedrich Mennecke, Curt Schmalenbach, Horst Schumann, Otto Hebold, Rudolf Lonauer, Robert Müller, Theodor Steinmeyer, Gerhard Wischer, Viktor Ratka and Hans Bodo Gorgaß.


(There are no pictures of Curt Schmalenbach,  Robert Müller, Theodor Steinmeyer, Gerhard Wischer and  Hans Bodo Gorgaß. available)

To speed up the process, camp commandants made a preliminary selection list, as they had done in the T4 operation.


This left just a few questions to be answered, such as personal information, date of admission to the camp, diagnosis of incurable disease, war injuries, criminal referral based on the criminal code of the Third Reich and any previous offenses. Under the operation’s guidelines, names of ballastexistenzen (“dead weight” prisoners) were to be compiled and presented to the medical doctors for “withdrawal from service”. This included any prisoner who had been unable to work for a long time or was substantially incapacitated and would not be able to return to work.

The prisoners were transported in so called ‘charitable ambulances’


The T4 physicians thus only needed to check the completed information, enter the diagnosis, and make the final decision. Thereafter, the questionnaires were delivered to T4 headquarters in Berlin. Mennecke admitted: “This did not involve medical evaluations, because in the concentration camps I only had the assignment to fill out questionnaires.”.

Two pages of the death registry at Hadamar listing false causes of death

For Jews, the physicians did not even bother to enact the pretence of a physical examination. In one of his letters to his wife, Mennecke described the procedure: “As a second allotment there then followed altogether 1,200 Jews, who did not first have to be ‘examined,’ but where it is sufficient to extract from the files the reasons for their arrest (often very extensive!) and to record them on the questionnaires.” Unlike T4, the deaths were recorded by the registry office responsible for each concentration camp. The camp was noted as the place of death and a fictitious cause of death created, although from early 1942 death notices were no longer sent to the next-of-kin of the deceased.

Personally responsible for selecting 2,000-3,000 “euthanasia” victims, Mennecke’s motives for participating in the killing operation could be considered typical of the T4 physicians: a mixture of ideology, careerism, and greed. He accepted and affirmed the principles of Nazi ideology, especially as it corresponded to the theories espoused by his senior professional colleagues. He also wanted to advance his career. He obtained specialty certification for his “work”, and like many other perpetrators, he enjoyed the privileges and the money T4 distributed.

Only three Nazi killing centers (NS-Tötungsanstalt) were used for the gassing of the “invalided” prisoners: Bernburg Euthanasia Centre (headed by Irmfried Eberl), Sonnenstein Euthanasia Centre (headed by Horst Schumann) and Hartheim Euthanasia Centre (headed by Rudolf Lonauer and Georg Renno).


As the shortage of manpower became critical, 14 f 13 policy changed.  On 28 March 1942, the office of the Inspectorate of the Concentration Camps wrote to all camp commandants:

“A camp commandant’s report has made it known that of 51 prisoners selected for special treatment 14 f 13, 42 had `again become fit for work’ after a certain time, so that it was no longer necessary to apply special treatment to them. This case clearly shows that the regulations were not observed at the time of the prisoner’s selection. Only those categories of prisoner referred to in the regulations should be brought before the medical commission, particularly those who are no longer fit for work.”

By April 1943, an order from Himmler further reduced the application of 14 f 13: “…Only mentally ill prisoners should be selected by the competent medical commissions for operation 14 f 13. All other prisoners who are unfit for work…are definitely to be excluded from this operation. Bedridden patients should be given suitable work that can be performed in bed.” This order did not prevent camp physicians continuing to kill prisoners unfit for work on their own initiative. Prisoners were now either killed at the camp itself or sent to a camp equipped with gas chambers.

As a result of this further change of policy, all of the T4 killing centres were closed down, other than Hartheim. But on 11 April 1944, a new order was issued: “euthanasia” for prisoners was reinstituted. Now the selections were not made by T4 personnel, but by the camp physicians. At Mauthausen and its sub-camp, Gusen, for example, normally the day before a transfer the camp physician informed the block leader (Blockältester)  that there would be a transport to a “convalescent camp” the following day, and specified the number of prisoners to be conveyed. During this last phase of 14 f 13, 3,228 prisoners from Mauthausen and Gusen were killed at Hartheim.

The total number of victims of 14 f 13 is uncertain, but is thought to exceed 20,000. The 14 f 13 program was relatively small in scope in comparison to the killings in the death camps, but it provided an important link between the “euthanasia” of mental patients in the T4 program and the subsequent mass murder of Aktion Reinhard, Auschwitz, and elsewhere. 14 f 13 transferred the practices of the “euthanasia” program to the concentration camps, thereby helping to create the dual purpose labour and extermination camps. Moreover, to some extent, 14 f 13 provided the model for future methods, particularly insofar as the “selection” of victims was concerned.

Post war photo of the cemetery at Hadamar where victims of the euthanasia killings were buried.


This is just the tip of the iceberg when it comes to the Nazi regime’s medicine programs. I will do a follow up on both T4 and 14f13 projects in the future.




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