Holocaust Education & Archive Research Team




  Nazi Eugenics & 


  T- 4 Staff

  T- 4  in Poland

  T - 4 in Germany &




14 [F] 13 


Death bed used in the T-4 Facilities

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.

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.

In addition, the SS camp physicians were apparently also instructed to include a large proportion of prisoners with criminal or antisocial records, since prior criminal charges and current behaviour had to be listed. In reality, however, the major criterion for selection was the prisoner's ability to do physical labour, but even there, the SS physicians picked their victims in the arbitrary manner common in the concentration camps. It was not in fact necessary for the condemned to be ailing, particularly if they were Jewish. It was sufficient if somebody in authority had decided to dispose of them. Physicians sometimes saw the victims, but examinations were cursory and essentially irrelevant. Decisions were indicated with a cross in a box on the form provided for the purpose. The SS spread the rumour in the camps that sick and weak prisoners could report for transfer to a sanatorium; to accept such a transfer was, of course, volunteering for death.

T4 assigned at least twelve physicians to visit the concentration camps. One of them was Dr Friedrich Mennecke, head of the Eichberg hospital and its children's ward, who wrote to his wife from Dachau on 3 September 1941: “There are only 2,000 men, who will be quickly done, as they can be examined only in assembly-line fashion.” So far as can be determined, Mennecke’s visit to KZ Sachsenhausen in early April 1941 marked the start 14 f 13, although preparatory work had commenced earlier. Questionnaires were transmitted to the camps prior to the physicians’ arrival and the SS had already filled in the obligatory information: name, date and place of birth, last residence, family status, citizenship, religion, race, and date of arrest.

Pages of the registry at Hadamar listing false causes of death

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.”. 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.

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.



Friedlander, Henry. The Origins of Nazi Genocide: From Euthanasia to the Final Solution, University of North Carolina Press, Chapel Hill, 1995.

Kogon, Eugen; Langbein, Hermann; Rückerl, Adalbert; eds. Nazi Mass Murder, Yale University Press, New Haven and London, 1993.

Lifton, Robert Jay. The Nazi Doctors – Medical Killing and the Psychology of Genocide, Papermac, London, 1990.

Sofsky, Wolfgang. The Order of Terror: The Concentration Camp, Princeton University Press, Princeton, 1997.




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