This chapter contains references to the abuse and murder of people with disabilities, under the Nazi regime, that readers may find upsetting or disturbing.

What led to national socialist ‘Volkspflege’ (People's Care)?

Dividing the ‘worthy’ and ‘unworthy’ clients: a modern idea

Social work in Germany has emerged from Christian charity in the monasteries and hospitals of the Middle Ages with their doctrine of the duty to give alms to all who begged for it. Since about 1500 the new idea became established that poor people should be examined to see whether they were ‘worthy’ of support. Honorary municipal officials proved the willingness to work and the moral way of life of the poor. The ‘unworthy poor’ were locked up in poorhouses and penitentiaries in order to educate them to work (Kuhlmann, 2013, pp 21). The division into ‘worthy’ and ‘unworthy’ finally received a new, eugenic interpretation in the 19th century, and especially during the National Socialist era.

Eugenic thinking and its long tradition

The idea of improving humanity through ‘breeding’ emerged not only in Germany, but first in England (Francis Galton, 1822– 1911), and likewise throughout Europe, in the US, Canada and other immigration countries. Not only conservative or reactionary but also socialist and some feminist thinkers were impressed by the idea of combatting social problems by regulating reproduction. In Germany, the conviction arose, especially in psychiatric research, that criminality and other deviant behaviour could mainly be explained by hereditary diseases. Researchers referred to the examinations of the physique of people who had become criminals, as carried out by the Italian Cesare Lombroso (1876). As a result of the successful fight against cholera and tuberculosis through social hygiene measures, the view spread that hygienic concepts could also be successful in other areas. Thus, healthcare was already been oriented towards ‘racial hygiene’ from the turn of the 20th century (in marriage counselling centres or in sexual healthcare).

Around 1920, many psychiatrists in Germany were examining the residents of care institutions and categorising them, for example, as ‘libidinous, indifferent, brutal or morally inferior’. Most of them concluded that these people were more than 90 per cent hereditarily burdened because their parents and grandparents had already been labelled in a similar way (Kuhlmann, 1989, pp 79).