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  • Writer's pictureIlka Knüppel

Why hasn't their story been told??

“The first group targeted were the handicapped. They were excluded by being institutionalized, but this was not enough...Excluded, incarcerated, sterilized, and neglected, the handicapped were viewed as expendable, and thus a logical progression led to the killing of the handicapped in the so-called euthanasia program.

Friedlander, Henry. The Origins of Nazi Genocide: From Euthanasia to the Final Solution, The University of North Carolina Press, Chapel Hill, NC, p. 21.

Ruth Rosa Luise Mühlmann, age 12 and a half, December 1932, during a visit home from Neinstedt Anstalten for the Christmas Holidays with her family.

Why hasn’t the story of the 300,000+ people killed by Hitler’s secret euthanasia programs been told? The number of Aktion T4 victims has steadily risen over the years as more scholarly research has been conducted. As researcher Melvin Conroy wrote “The more recent the research, the greater the evidence is uncovered of the true extent of the killings.” When Euthanasia Researchers Henry Friedlander and Götz Aly published their research, the documented number of deaths just at Bernburg Killing Centre was 8,601. In January 2020, when we visited Gedenkstätte für Opfer der NS-“Euthanasie” Bernburg (The Bernburg Memorial for the Victims of Nazi Euthanasia), the number had increased to 9,384 documented victims. As of May 2023, the number is 9,385.

“The at least 300,000 people who fell victim to this planned and organized mass murder were not an anonymous mass.” (Emphasis added.) Each of the victims had family. Many victims had relations still living, although the number decreases every year. As of 2014:

“One in eight contemporary Germans or Austrians who are older than 25 and had family roots in the former Reich territories that date back to 1900 is directly related to a person who was murdered between 1939-1945 as a useless eater.”

Many families in the Federal Republic do not know to this day that their ancestors were murdered in the National Socialist ‘euthanasia’. And, unlike those who were persecuted for antisemitic reasons and targeted to be destroyed as complete families, institutionalized disabled persons were targeted as individuals and murdered alone.

Furthermore, the victims of Aktion T4 belonged to groups which even after 1945, were still on the side-lines of society. Holocaust researcher Doris L. Bergen wrote what I have certainly found to be true in my research: there is much less scholarship published about disabled persons. Explanations are complex and varied but there seems to be three main reasons that the euthanasia victims have not had a great deal of scholarly research and/or family acknowledgement in the past.

  1. The euthanasia victims were German citizens.

After WWII, there was no sympathy internationally for Germans since they were viewed as responsible for starting two devastating world wars. German citizens, even if they had not served in the military or had any direct involvement in the euthanasia process, had to face the concept of collective guilt. Persons with disabilities had been slaughtered solely for the good of the German Reich. The suffering that had been meted out under the cover of war was not only of Jewish people, but also, the perpetration of a massacre of a target group of German citizens. This knowledge had to be faced by every citizen of the German Republic even though Aktion T-4 was well camouflaged behind charitable and public utility institutions.


"...those who were charged with writing the history of the euthanasia program were often personally implicated in it and hence had a vested interest in downplaying the widespread support and collaboration of the medical professions and presenting the killings as the aberrant deeds of a few criminals.”

Holocaust Researcher Dr. Susanne Knittel wrote there are legal, academic, and cultural reasons for silence on the Nazi euthanasia. Legal prosecution of its perpetrators was almost total failure.

Euthanasia victims were still not acknowledged in the 1950’s when Restitution Laws were written; “Because they were not considered victims of racial, religious, or political persecution, the victims of … Nazi euthanasia were not included in the 1953 Restitution Law.” The German Laws for compensation for National Socialist crimes did not include persons with disabilities even though their destruction of these persons was based on Aryan construct of “racial purity.”

The culture of contrition was nonexistent in the post war years. It wasn’t until 1977 when West German Chancellor Helmut Schmidt became the first chancellor to deliver a speech at Auschwitz-Birkenau that he acknowledged the Holocaust by stating: “We Germans of today are not guilty as individual persons, but we must bear the political legacy of those who were guilty. That is our responsibility.” But public acknowledgement of euthanasia victims remained a thorny situation.

A “factor which greatly affected … Aktion T4 victims was the fact that the acknowledging of the German victim group also inherently points towards the acknowledgement of the German perpetrators, and raises questions of a political nervousness.” ‘Political nervousness’ is an excellent term used by Researcher Meaghan Ann Hepburn because it reflected the complex dichotomy of presenting German people as both victims and perpetrators within the same action and this led to the continued general avoidance of acknowledgement of victims.

It was not until 2011 that “the German parliament decided to grant the victims of Nazi euthanasia equal status with those of other Nazi crimes.”

2. Stigmas surrounding disabled persons in a family lingered for decades.

The stigma attached to families having physically or intellectually disabled family members existed for many years following the war. “To this day [2014], few families talk about missing relatives, often forgotten for a long time.” Knittel remarks that “[t]he topic of Nazi euthanasia was so inextricably bound up with stereotyping and taboo [that it] also discouraged the family members of euthanasia victims from lobbying for their acknowledgement.”

Irene Leiter, Director at Schloss Hartheim Memorial Centre, stated some families did not want their family member’s name included on the memorial boards - so strong was the negative connotation to admitting that they had someone with mental or physical disabilities in their families. The stigma surrounding mental illness in particular led to distancing acts. “According to Nazi ideology, descendants are ‘hereditarily ill’ and it would be foolish to presume that this ideology no longer carries weight.”

Günter Mühlmann, Ruth’s own brother, never told his own daughter about his sister with disabilites.

Heinz, Günter, and Ruth Mühlmann in December 1932. Ruth holds Günter’s hand in the photo.

Unfortunately, we were not able to find out his reasons for not speaking about his sister as Günter passed away in 2007, the only one of Emma and Paul’s children to survive the war. He would have been only 12 years old when Ruth was killed and she had been institutionalized since he was 2.5 years old. But Günter had mentioned his brother who is presumed to have died at the Battle of Stalingrad when Günter was 14 years old.

Ruth’s brothers Günter (left) und Heinz Mühlmann (right),in Herrenkrug Park, Magdeburg, Germany, 1935.

Another possibility is that the family felt shame about their family member with disabilities. After all, as Hugh Gallagher, Holocaust Researcher and Disability advocate, wrote, “There was something shameful about the disabled person – perhaps, if the scientists were right, something shameful about his family, too.”

Ableism has meant...that many families… with similar family histories have decided to remain silent about their murdered relatives….Victims of National Socialist ‘euthanasia’ have been rendered taboo in most German families, in public commemoration, and in memory politics, and their names kept secret since their murders.” (Emphasis added.)

Knittel describes the phenomenon that may be the root cause of the family not talking about Ruth as, : “having a euthanasia victim in the family was a source of stigma and shame, which resulted in the complete erasure of these victims and their memory.” Complete erasure of my great aunt’s memory would have been Ruth’s fate if not for her older half-sister, Elsbeth.

In addition, families were scared to speak out about the death of their family member with disabilities. Fear of reprisal against them, or their surviving family, was not unjustified. An example from a trial document from the War Crimes Trial:

War Crimes Trial document. Public Domain.

From the trial document: “I cannot give my name nor the institution where my son is, otherwise I, too, won’t live much longer.” This father was very suspicious about the circumstances of his son’s death but he feared repercussions to the rest of his family so he dared not sign his name to the letter he wrote.

3. No victims survived; therefore, there was no one to tell their story.

Since there were no survivors of the Aktion T-4, there can only be vicarious witnesses – giving voice to these silent and silenced victims.” Dr. Suzanne Knittel

The absence of survivor stories or of family documentation of victims’ lives and fates “led to de facto marginalization of these victims within the discipline of Holocaust… studies.” As for patients in the institutions who were aware of what happened to their fellow hospital patients, many of the people with disabilities were not in a position to leave written records.

There is only one euthanasia survivor autobiography, that of Elvira Hempel Manthey, a child at the time. Elvira wrote about her experience in her memoir, “Die Hempelsche: Das Schicksal eines deutschen Kindes, das 1940 vor der Gaskammer umkehren durfte. She was not disabled but was institutionalized due to her family situation and she was one of the child patients chosen for gassing. Through a series of fortunate circumstances, she ended up being sent back to an intermediate hospital. Her younger sister, institutionalized since birth, perished in the gas chamber.

There are three books of documented euthanasia victims that I came across in my research; all are published in German and all were written as a result of families researching what had become of their family members.

  1. Hans-Ulrich Dapp wrote “Emma Z.: Ein Opfer der Euthanasie'' in 1990.

  2. Sigrid Falkenstein wrote “Annas Spuren: Ein Opfer der NS->>Euthanasie<<” in 2012.

  3. Andres Hechler wrote of the murder of his great grandmother, Emilie Rau in Diagnoses that Matter: My Great-Grandmother’s Murder as One Deemed ‘Unworthy of Living” and its Impact on Our Family in 2015.

There are a number of other memoir books listed on Sigrid Falkenstein’s website , however, they are all written in the German language. My book will be the first euthanasia victim memoir which will written in the English language.

Knittel wrote “[i]n most cases, it is extremely difficult to find information about the victims’ lives”. I found this statement to be accurate. Luckily, through tenacity and research and Tante Helen’s oral history and pictures from her mother, we have been able to piece together enough of Ruth’s life to literally fill a book. Gedenkstätte für Opfer der NS-“Euthanasie” Bernburg assisted us greatly in our search for information and it ended up being a mutualistic relationship as we were able to provide them information about Ruth as well. With my permission, Ruth is included in their victims’ biographies which they use for the education of students and the public who visit the memorial.

Author’s photos of Bernburg display.

With this blog, and with my book, we will be giving voice to these silent and silenced victims.


Falkenstein, Sigrid. Annas Spuren, Ein Opfer der NS->>Euthanasie<<, F.A. Herbig Verlagsbuchhandlung GmBH, Stuttgart, Germany, 2012, p 10, [Author’s translation].

Aly, Götz, >Euthanasie< 1939-1945 Die Belasteten Eine Gesellschaftsgeschichte, Fischer Verlag GmbH, Frankfurt am Main, 2012, p. 15, [Author’s translation]

Hechler, Andreas. “Diagnoses That Matter: My Great Grandmother’s Murder as One Deemed ‘Unworthy of Living’ and its Impact on our Family”, Disability Studies Quarterly, Vol. 37, No. 2 (2017), p. 13. Diagnoses That Matter: My Great-Grandmother's Murder as One Deemed 'Unworthy of Living' and Its Impact on Our Family | Disability Studies Quarterly (

Loistl, Simone & Schwanninger, Florian. “Vestiges and Witnesses: Archaeological Finds from the Nazi Euthanasia Institution of Hartheim as Objects of Research and Education”. International Journal of Historical Archaeology. 22. 10.1007/s10761-017-0441-2. 2018. p. 8.

Bergen, Doris. L. War and Genocide: A Concise History of the Holocaust, Second Edition. Rowman & Littlefield Publishers, 2009, p. 15.

Hepburn, Meaghan Ann. Lives Worthy of Life and Remembrance: Memorialization of the National Socialist Aktion T4 Euthanasia Program. A thesis submitted in conformity with the requirements for the degree of Doctor of Philosophy Graduate Department of Germanic Languages and Literatures University of Toronto A thesis submitted in conformity with the requirements for the degree of Doctor of Philosophy Graduate Department of Germanic Languages and Literatures University of Toronto, 2014, p. 74. Hepburn_Meaghan_A_201406_PhD_thesis.pdf (

Knittel, Susanne, C. The Historical Uncanny: Disability, Ethnicity, and the Politics of Holocaust Memory. Fordham University Press, 2015, p. 297, Notes #21.

Aly, Götz, >Euthanasie< 1939-1945 Die Belasteten Eine Gesellschaftsgeschichte, Fischer Verlag GmbH, Frankfurt am Main, 2012, p. 15, [Author’s translation].

Gallagher, Hugh Gregory. By Trust Betrayed: Patients, Physicians, and the License to Kill in the Third Reich. Vandermeer Press, 1995, p. 39.

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