Disabled People under fascist rule. The first shows disabled people being collected to be driven to a gas chamber equipped killing facility. The bus type seen in the picture was commonly used for this kind of job. The second picture shows a poster which says "this person who has a hereditary disease is costing the community 60.000 RM (the former currency) throughout his life-time. Comrade, this is your money too. Read NEW PEOPLE, monthly journal of the office for racial policy of the NSDAP (the Nazi party)."

It is commonly assumed that Europe´s fascist governments of the first half of the 20th pursued inhumane policies against disabled people. What do we know about disability policies in Nazi Germany and Fascist Italy?

By Florian Sanden, florian.sanden@enil.eu and Francesca Spanghero, esc.volunteer@enil.eu

From 1933 to 1945 the Nationalsocialist Party, lead by Adolf Hitler, ruled Germany. From 1922 to 1945 Italy was under fascist rule, lead by Benito Mussolini. How did both regimes, each a variant of fascism, treat disabled people?

This poster says “this person who has a hereditary disease is costing the community 60.000 RM (the former currency) throughout his life-time. Comrade, this is your money too. Read NEW PEOPLE, monthly journal of the office for racial policy of the NSDAP (the Nazi party).”

Nazi Germany

A key feature of the Nazi ideology was the view that only humans which corresponded to a narrow ideal of ethnicity and of physical and mental disposition were deemed worthy of existing. Those who were not deemed worthy, were subjected to intense scapegoating for the problems of society and increasing exclusion. Step by step exclusion turned into persecution and assassination. Disabled people were regarded as unworthy and seen as damaging for the hygene of the arian race. Steps were taken. From 1939 to 1945 200.000 to 300.000 disabled people in Germany and the occupied territories were eliminated during the so called “T 4 action”.

The almost continuous economic crisis of the 1930s had led to rigid austerity measures and cuts to the budgets for the care of chronically sick people (Hohendorf et al. 2002). Disabled people were increasingly branded as anti-social and as burdens (Wild 2012).  

In 1932, the psychiatrist Khin published an influential paper on the euthanasia and eradication of undesirable hereditary dispositions and the elimination of people of inferior value.

In July 1933, a law on the prevention of newborn children with hereditary diseases was introduced and legalised forced sterilisation. The objective was to prevent people who did not correspond to the national socialist ideal of how a person should be like from producing offspring. Between 350.000 and 400.000 people with psychosocial, physical or mental impairments were forcedly sterilised (BPB 2019).

After forced sterilisations had been legalised, more and more voices demanded the killing of disabled people.

Allegedly parents started to ask Hitler for the permission to kill their disabled children. Hitler who publicly mocked “the humanitarian befuddlement of modern society” gave his permission.

An order of the ministry of the interior from 1939 obliged doctors and nurses to enter children and babies with congenital impairments into a central register. The infants were subsequently brought to “specialists units” in hospitals were they were abused in medical experiments and killed through injections and starvation. According to estimates, 5000 children disabled children died that way (Wildt 2012).

In 1939 government representatives presented plans for a new euthanasia programme to influential psychiatrists who voiced their agreement and pledged their support. All patients who had been residing in institutions for more than 5 years were to be added to a central register. All people who had a diagnosis of schizophrenia, feeble mindedness, epilepsy or another neurological condition had to be registered too (Hohendorf et al. 2002).

The nationalsocialist government formed a special office for the euthanasia of disabled people which launched a campaign named T 4 after its address in Berlin at Tiergartenstraße 4.

From spring 1940 jewish patients were gathered in collection institutions and killed.

The selection of other victims to be euthanised took place through registration forms which had to filled in by two psychiatrists from the institution were the disabled person resided. The final decision was taken by a head assessor. Patients were gathered with grey buses and brought to the killing facilities. Once there a medical evaluation took place to identify a plausible cause of death. Subsequently, the disabled people were brought into gas chambers and suffocated with carbon monoxide. Family members received falsified notifications, giving the cause of death identified before the assassination (Hohendorf et al. 2002).

The mass killing of disabled people started to cause disquiet in the population and was officially stopped by Hitler in 1941. In truth, the T 4 action continued clandestinely. The circle of victims was widened to older people in nursing homes and to young non-disabled people regarded as ineducable.

In the occupied territories in eastern Europe, residents of institutions were shot by SS unites.

On this photo, Disabled People are being collected to be driven to a gas chamber equipped killing facility. The bus type seen in the picture was commonly used for this kind of job.

Fascist Italy

In Italy, persecutions of disabled people were not comparable to the ones taking place in Germany, but the wide and acritical acceptance of Fascist ideology by the Italian Society of Psychiatry resulted in an increase of hospitalisation and mortality rates in mental health institutions (Milano 2019).

Between 1943 and 1945, with the support of the Italian Society of Psychiatry, on several occasions jewish patients were taken from psychiatric facilities in north-eastern Italy to be transferred to concentration camps and killed. It is important to note that the areas in question were under direct control by Nazi Germany (Disabili 2019, Schneider et al 2017).

Disabled people had access to pensions, although the regime used social security resources for other, unrelated, projects, such as industrial development and colonisation (Quine 2002, Giorgi 2019). According to Quine (2002), fascist authorities often rejected disability pensions claims, and could do so on medical grounds, as claimants wer required to be examined by doctors of the National Institute for Social Security (INPS). Claimants had no right to appeal against such decisions. According to Giorgi (2019), concessions of disability pensions happened fairly easily (as demonstrated by their increase throughout the 1930s), and were granted especially through pressure from Fascist Party officials, often in contrast with health assessments. Access to social security was bound by the opinion of Fascist authorities (p. 925). A precondition to any NGO’s existence (including DPOs) was their alignment to Fascism (Schianchi 2020).


BPB 2019. Vor 80 Jahren: Beginn der NS-“Euthanasie”-Programme. https://www.bpb.de/kurz-knapp/hintergrund-aktuell/295244/vor-80-jahren-beginn-der-ns-euthanasie-programme/

Disabili 2019. https://www.disabili.com/amici-e-incontri/articoli-amici/schedati-perseguitati-sterminati-i-malati-psichici-e-disabili-durante-nazionalsocialismo-e-fascismo  

Giorgi 2019. Social Policies in Italian Fascism. Authoritarian strategies and social integration.

Hohendorf et al. 2002. Die Opfer der nationalsozialistischen „Euthanasie-Aktion T4“. https://www.klinikum.uni-heidelberg.de/fileadmin/zpm/psychatrie/projekte/pdf/hohendorf_2002.pdf

Milano 2019. https://www.ilsole24ore.com/art/geneticamente-inferiori-sterminio-malati-mentali-e-disabili-AEyLxMCH

Quine 2002. Italy’s social revolution.

Schianchi 2020. Le associazioni della disabilità: Tra Stato e società civile. L’emergere di una questione sociale e le prime associazioni.

Schneider et al 2017. Schedati. Perseguitati. Sterminati. https://www.dgppn.de/_Resources/Persistent/4fce1a17281491bdd575ac8435d7cbe5b1bcc6fa/Broschuere_italienisch.pdf

Wildt 2012. Massenmord und Holocaust. https://www.bpb.de/shop/zeitschriften/izpb/nationalsozialismus-krieg-und-holocaust-316/151942/massenmord-und-holocaust/