“Hereditary illness! An interesting exhibition for educating the public about producing genetically healthy offspring has been opened by the Reich Committee for National Health Service in Berlin. A shocking picture of people with hereditary illnesses in an institution for ‘idiots’.
—Translation of the original German caption for this photograph
This photograph was taken at the Schönbrunn institution in what is now part of Bavaria. It dates from the late 1930s, during the period when the Nazi state was actively surveying and registering institutionalized disabled people for possible sterilization or transfer under the coming Aktion T4 program. The institution housed children, adolescents, and adults with developmental and intellectual disabilities.
The photographer, Friedrich Franz Bauer, was commissioned to produce images for Nazi “racial hygiene” exhibitions, which were used to convince the public that disabled people were a biological and economic burden.
The photo was not taken to document conditions or to advocate for care. It was taken as propaganda material. The fence, the crowding, and the expressions were meant to evoke pity, fear, and distance in the viewer, feeding the message that these individuals were threatening, unproductive, and in need of “management” by the state. This image circulated in traveling exhibitions and pamphlets that warned of the “cost” of supporting disabled people, laying psychological groundwork for later mass sterilization and killing.
These photos are a reminder that the Nazi regime’s systematic murder of millions did not begin with mass shootings or gas chambers. It began with the quiet, bureaucratic killing of disabled children and adults who were seen as “burdens” on society. The program known as Aktion T4 was the first organized mass murder campaign of the Nazi era, laying the foundation for the Holocaust.
Dive Into the History
This documentary describes the Nazi program known as Aktion T4, in which the regime sterilized and then murdered children and adults with disabilities. It shows how the policy grew out of eugenics, how hospitals and doctors were involved, and how killing was framed as medical care.
This video is hard to watch because it includes descriptions of medical abuse, coercion, and the killing of disabled children and adults in institutional settings. It references starvation, lethal injection, and falsified medical procedures. Images in the video are not gratuitous, but they do include children in institutional settings, and mass graves.
But it is important because it shows how this violence did not begin with open brutality. It began with language, medical authority, and systems that presented discrimination and killing as rational, compassionate, or necessary. Understanding that progression is key to recognizing how harm can be normalized.
Transcript
I’m Professor Graeme Johnston, speaking from the Holocaust Memorial in London. Today I’m discussing one of the darkest chapters in human history: the Nazi extermination of approximately 300,000 children and adults with disabilities. The program came to be known as Aktion T4, named after the address of the central office in Berlin, Tiergartenstrasse 4, where the killings were planned and administered. The building is gone now, replaced by the Berlin Philharmonic Hall, but the history remains.
This persecution began just months after Hitler came to power in 1933, with the Law for the Prevention of Hereditarily Diseased Offspring. The law mandated compulsory sterilization for people diagnosed with conditions believed to be hereditary, including what was labeled “feeblemindedness,” schizophrenia, epilepsy, manic depression, hereditary deafness or blindness, and certain physical malformations. Alcoholism, homosexuality, prostitution, and vagrancy were also framed as “degenerate” traits. More than 200 special “hereditary health courts,” each staffed by two doctors and a judge, were created to decide who would be sterilized. Between 1933 and 1939, about 360,000 people were sterilized, and around 7,000, most of them women, died from the procedure.
The Nazis did not hide this policy. It was promoted publicly as racial hygiene and national improvement. The idea of eugenics was widespread internationally, including in the United States, where more than 60,000 sterilizations had been carried out before Germany adopted the practice. Newspaper editorials in the early 1930s praised Germany as a leader in applied eugenics. Britain, which helped originate the eugenics movement, did not introduce forced sterilization, though many universities maintained eugenics departments and prominent doctors advocated for it.
In 1939, the situation escalated. A family requested permission for the euthanasia of their severely disabled infant, Gerhard Kretschmar. Hitler personally authorized the killing, carried out by one of his physicians. Within weeks, the Reich Committee for the Scientific Registering of Hereditary and Congenital Illnesses was created. Doctors and midwives were now required to report newborns and young children with conditions such as Down syndrome, hydrocephaly, microcephaly, severe limb or spine malformations, paralysis, and muscular diseases. Panels of medical experts reviewed the reports, and if three doctors approved, the child could be killed.
Parents were often told their children were being transferred to special clinics for new treatments. In reality, the children were killed by lethal injection or starvation, and their deaths were recorded as pneumonia. One of the most notorious facilities was the Am Spiegelgrund clinic in Vienna, where between 1940 and 1945, 789 children were killed. Some were subjected to painful and abusive “treatments” presented as research. Autopsies were routinely performed, and the children’s brains were preserved for supposed scientific study. One physician, Heinrich Gross, kept a private collection of children’s brains and continued a respected medical career after the war.
As the war progressed, the criteria for killing expanded. Older children, adolescents, and those with milder impairments or behavioral problems were included. Parents who resisted were threatened with loss of custody or forced labor. At the same time, the regime sought more efficient ways to kill. Carbon monoxide poisoning using mobile gas vans began in 1941, followed by the introduction of Zyklon B at extermination camps.
By 1941, about 5,000 children had been murdered through the Reich Committee process. The policy was then extended to adults. Victims were transported by bus to one of six psychiatric hospitals converted into killing centers. They underwent brief sham medical examinations, were sent to a room disguised as a shower, and were killed with carbon monoxide gas. Their families received falsified death certificates and an urn containing ashes from mass cremations. An estimated 300,000 people were selected and killed in this phase of the program, and as many as 85 percent of psychiatric patients in Germany died this way.
Some opposition did emerge. The Vatican declared the policy contrary to divine law in December 1940. Clemens von Galen, the Bishop of Münster, publicly condemned the killings and was placed under house arrest. In late 1941, the program was officially halted, but in practice, the killings continued throughout the war. The last child killed under the program died on May 29, 1945, more than three weeks after U.S. forces had occupied the area.
After the war, some of the doctors responsible were punished, but others resumed respected careers. Heinrich Gross, for example, became a recognized researcher and expert witness, received national honors, and published medical articles based on the brains of the children killed under his authority. He was eventually investigated, but by the time his case reached court, he was ruled unfit to stand trial.
The most disturbing aspect of this history is not only the scale of the violence but how many ordinary, educated, professional people participated in it. These were doctors, nurses, administrators, and university researchers. They were not fringe extremists. They were people who considered themselves respectable and civilized. This makes Aktion T4 not only a story of atrocity, but of how quickly ethical boundaries can erode when human worth is framed as conditional.
Trace the Timeline
You’ve just seen the broad outline of Aktion T4. The timeline that follows breaks this into clearer stages, showing how legal changes, medical practices, and everyday bureaucracy led to mass murder.
As you read through the timeline, pay attention to how the shift from sterilization to killing happened, step by step.1933
Law for the Prevention of Hereditarily Diseased Offspring
This legalized forced sterilization for people with intellectual and developmental disabilities, psychiatric conditions (schizophrenia, bipolar disorder), neurological disorders like epilepsy, and certain hereditary sensory or physical impairments (blindness, deafness, severe malformations, and Huntington’s disease).
The law created “Genetic Health Courts” where doctors and judges decided who was “fit” to reproduce. Over 400,000 Germans were forcibly sterilized between 1933 and 1939.
This law established the biomedical and bureaucratic foundation for Aktion T4.
Discussion Question
How could so many sterilizations happen with so little public protest?PROPAGANDA
The Nazi leaned heavily on propaganda to influence public opinion. They framed the sterilizations as a modern medical solution to social problems. They used the language of science and progress to convince citizens that preventing disabled people from having children would improve the nation.ECONOMICS
The government propaganda encouraged people to think about human life in terms of economics and suggested that it was irresponsible to invest so much time and money into people they felt did not adequately contribute to society. The state distributed charts, statistics, and cost comparisons to suggest that sterilization was a responsible financial choice for the nation.EUGENICS
These ideas were not unique to Germany at the time. Eugenics was considered modern and rational in many countries, including the United States. Because these beliefs were already culturally accepted, the change to forced sterilization did not feel shocking to many people.EXPERTS
Doctors, judges, and university experts publicly supported the policy, which made it look legitimate and trustworthy.PITY
Posters, films, textbooks, and public lectures explained that people with disabilities were “suffering,” that their conditions were hereditary, and that preventing them from having children would save future generations from pain.All of this created a situation where harm could happen quietly, hidden behind paperwork, professional authority, and the appearance of doing what was “best” for society.
This poster was used in Nazi public exhibitions to promote eugenics. It says, “So this is how it will end. Qualitative decline of the population when the higher-quality have too few children. This is what will happen if the ‘inferior’ have four children and the ‘superior’ have two.”
Bundesarchiv, Bild 102-16748 / Georg Pahl / CC-BY-SA 3.0, CC BY-SA 3.0 DE https://creativecommons.org/licenses/by-sa/3.0/de/deed.en, via Wikimedia Commons
1934-1936
Expansion of Eugenics Propaganda
During this time, Nazi propaganda built upon pre-existing eugenics ideas and turned them into a moral imperative. The phrase Lebensunwertes Leben (“life unworthy of life”) was used to discuss people with disabilities. The regime taught that disabled people were hereditary burdens who weakened the German “people’s body”.
Posters, films, and school lessons framed sterilization and later euthanasia as acts of mercy and fiscal responsibility, while doctors were recast as “biological soldiers” protecting racial health.
This cultural conditioning helped to normalize the dehumanization of people with disabilities.
Discussion Question
Can you think of present-day examples where language makes harmful actions sound helpful or responsible?Let’s explore this by examining some of Trump’s social media posts.
FRAUD, WASTE, INCOMPETENCE, AND ABUSE
The use of bureaucratic terms like “fraud,” “waste,” and “abuse” gives an aura of official seriousness, even when evidence is not presented. It also reframes accountability systems as corrupt obstacles.
Historically, this rhetorical move has been used to undermine trust in courts, public agencies, and legal oversight, clearing the path for unilateral power. It suggests that removing or bypassing oversight is logical and necessary.
When this pattern is applied broadly, it becomes easier to treat institutions meant to protect people as if they are the true threats, which opens the door to replacing rule-based systems with personal authority.HANDING OUT BENEFITS
Framing social support programs as something that is being irresponsibly “handed out” implies that need is a personal failure rather than a structural condition. It tells the public that the moral problem is generosity rather than poverty, disability, illness, or economic inequality.
Historically, this is part of the logic that divides society into “contributors” and “burdens.” Once a group is defined as a burden, it becomes easier to justify harming them, cutting their support, or excluding them entirely.CLEAN AND SAFE CITIES
Referring to unhoused people as something that must be “cleaned up” removes their humanity and replaces it with a problem-object metaphor. The language does not discuss why people are unhoused, or what support systems have failed, but instead focuses on appearance, discomfort, and social order.
Historically, this pattern appears wherever a society starts to categorize groups as undesirable, disorderly, or burdensome. It makes the act of removing or displacing those people sound like responsible governance rather than forced relocation or abandonment.CHEMICAL CASTRATION AND MUTILATION
Calling gender-affirming medical care “mutilation” or “chemical castration” is an example of using extreme, emotionally charged scientific language to make medically recognized treatment sound monstrous. Major medical and psychological organizations describe this care as evidence-based and necessary for many patients.
LGBTQ+ folks were also early targets of the Nazis. When leaders replace medical language with frightening imagery, the public is encouraged to see the care as dangerous and the people receiving it as victims or problems.POISONING THE BLOOD OF OUR NATION
This language suggests that certain groups of people are biologically harmful or contaminating. It frames immigration not as a social or economic issue, but as a threat to the nation’s “health.”
This is similar to how eugenic ideologies treated human difference as a form of disease that must be prevented or removed. It also echoes Nazi rhetoric about Jews.The purpose of examining these examples is not to say that our present moment is identical to the past, but to recognize how certain kinds of language make harm feel rational, necessary, or even compassionate. When we learn to notice these rhetorical patterns, we are better able to interrupt them.
This is another propaganda poster urging support for eugenics. It says, “This person who suppers a hereditary disease has a lifelong cos of 60,000 Reichsmarks to the National Community. Fellow German, that is your money as well.“
Vancouver Holocaust Education Centre, image 6., Public domain, via Wikimedia Commons
1935-1938
Institutional Segregation and Data Collection
During this time, the state perfected its medical surveillance and categorization systems. Doctors, teachers, and welfare officials were instructed to report individuals with “hereditary diseases” to state authorities. These reports flowed into a growing network of state-run registries, giving the regime a nationwide database of people marked as biologically inferior.
At the same time, psychiatric hospitals and residential schools expanded but became more controlled and segregated. Children and adults were classified by “educability” and “work capacity,” with the so-called “non-educable” increasingly isolated from the rest of society.
This period created the administrative and psychological infrastructure for Aktion T4.
Discussion Question
How did expanding surveillance systems make mass violence possible later on?What looked like routine paperwork slowly transformed living human beings into entries in a system.
This system changed how professionals understood their role. Doctors became evaluators of genetic “fitness,” teachers became informants, and clerks became organizers of life and death data.
When the regime later decided to sterilize and kill disabled people, they did not need to search, investigate, or identify who fit their criteria. The infrastructure had already done that. The killing program looked efficient because the paperwork had already reorganized the population: who was seen as valuable, who was seen as burdensome, and who was seen as not worth the resources of care.
A useful connection to the present is to look at medical data surveillance today.
In 2025, federal agencies announced initiatives to create large integrated data platforms using Medicaid claims, electronic health records, genetic data, and even wearable device information to study autism and other conditions. Officials describe these projects as scientific research that will lead to better care and understanding.
Disability and civil liberties groups have raised concerns that the language of “science” and “improving outcomes” can hide the risks of centralized data collection, especially if future policymakers decide to use the information in ways that restrict autonomy rather than support it.
The important take-away is not that the intentions behind the two systems are the same, but that once surveillance systems exist, their purpose can change very quickly.
When a population is monitored, categorized, and centrally recorded, the meaning of that data is determined not just by today’s goals but by whatever goals future policymakers adopt. Systems that look neutral or helpful today can become tools of exclusion or control if the political climate shifts.
The question is therefore not only what data is collected, but who has the power to decide what it means.
This is a photo of children at Schönbrunn Psychiatric Hospital, taken by Heinrich Himmler’s personal photographer to counteract claims of poor treatment in psychiatric hospitals.
Bundesarchiv, Bild 152-04-28 / Friedrich Franz Bauer / CC-BY-SA 3.0, CC BY-SA 3.0 DE https://creativecommons.org/licenses/by-sa/3.0/de/deed.en, via Wikimedia Commons
1939
Creation of the Reich Committee for the Scientific Registering of Hereditary and Congenital Illnesses
This was a deceptively titled organization that marked the beginning of the “child euthanasia” program.
Under new regulations, doctors, midwives, and nurses were required to report all children under three years old who showed signs of severe mental, physical, or developmental disability. The reporting forms appeared routine, but they fed directly into centralized medical review boards staffed by pediatric specialists loyal to Nazi racial ideology. Parents were told their children would receive advanced care in special clinics, yet these transfers often ended in starvation, lethal injection, or overdose within weeks.
By framing the deaths as humane and medically justified, the regime trained a generation of professionals to equate the destruction of disabled life with compassion, setting the precedent for mass murder on an industrial scale.
Discussion Question
What made it possible for doctors and nurses to view these deaths as compassionate rather than violent?Professionals were rewarded for aligning their ethics with state goals and punished, socially and professionally, for resisting. But, scientists and doctors also participated in the murder of disabled children because they had come to believe that it was scientific, rational, and even humane.
Eugenics was widely accepted as cutting-edge medical knowledge at the time, and universities taught future doctors that preventing certain births was a form of public health.
From there, killing was framed as simply extending the same logic: if it was good to prevent future suffering by stopping births, then it could also be seen as good to prevent current suffering by ending the lives of children already born.
Another key part of this shift was how disability itself was described.
Disabled children were portrayed as living only pain, burden, and tragedy. Families were told that their child could never experience joy, growth, or love. Doctors began referring to these children as “empty shells,” “hopeless cases,” or “non-persons.”
Once disability was defined as unending suffering, or a life not worth living, killing could be reframed as kindness. Nurses recorded deaths as “peaceful” and “merciful.” The violence was hidden under the language of medicine, pity, and compassion.
The moral logic was reversed. Violence was renamed care.
We can see a similar pattern in some modern proposals to expand involuntary psychiatric commitment of unhoused people.
In July 2025, the White House issued the executive order titled Ending Crime and Disorder on America’s Streets, which encourages states to expand civil commitment laws for people identified as “unable to care for themselves” because of mental illness or substance use, and are experiencing homelessness.
The order frames confinement and institutional treatment as “care” and “protection.”
Supporters describe these changes as compassionate responses to suffering, but disability and housing rights groups warn that the language assumes that being unhoused or mentally ill means a life without autonomy, and that confinement is therefore a form of help.
When a group is defined not by their relationships and capacities but by presumed suffering and burden, removing their freedom can begin to look like care.
This is a photo of one of the so-called “grey buses” used to collect disabled children and adults from hospitals and care homes and transport them to the killing centers under Aktion T4. These one-way transfers were presented as medical relocations, but communities quickly recognized that no one who boarded these buses ever returned.
Pressestelle der Diakonie Neuendettelsau, Public domain, via Wikimedia Commons
1939-1941
Aktion T4
Hitler signed a secret authorization granting physicians power to grant a “mercy death” to those deemed “incurably ill.”
Six centralized killing centers were established: Brandenburg, Grafeneck, Hartheim, Sonnenstein, Bernburg, and Hadamar. The methods of killing included carbon-monoxide gas, lethal injection, and starvation. Victims included adults and children with physical, intellectual, and psychiatric disabilities. Victims’ bodies were cremated, and families were sent falsified death certificates.
This was industrialized murder disguised as medical treatment.
Discussion Question
What similarities do you see between the logic behind Aktion T4 and later parts of the Holocaust?Aktion T4 made it clear that the state could decide which lives were valuable and which were disposable.
In Aktion T4, disabled children and adults were described as “burdens,” “empty shells,” or lives full of suffering. Doctors and public officials argued that ending these lives was an act of mercy and a rational use of resources.
This reasoning taught the public to see some people as less than fully human, as cases to be managed rather than as individuals with relationships, feelings, and futures.
This same logic appeared later in the Holocaust, but applied to different groups.
Jewish people, Romani people, Slavic people, queer people, and others were described as threats to the health or purity of the nation.
The language again framed mass violence as protection, efficiency, or self-defense.
Once a society accepts the idea that some people’s existence harms the collective, killing can be described not as cruelty, but as necessary.
The steps were not sudden. They moved from labeling, to segregation, to confinement, and then to extermination.
The ideology of disposable humans simply shifted from disabled people to other targeted groups. The Nazi party just had to define a group as a problem rather than as people, then treat their removal as responsible and justified.
Recognizing this pattern helps us understand how ordinary professionals and citizens could participate in or look away from atrocity. It shows why it is necessary to challenge any system that sorts people by worth and frames harm as care, protection, or necessity.
This is the Hartheim Euthanasia Centre, where over 12,000 people with disabilities were killed. It later became a site for killing concentration camp inmates that were “unfit to work”.
Liberaler Humanist, CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0, via Wikimedia Commons
1940-1941
Public Exposure and Temporary Halt
By mid-1941, rumors of mass killings in psychiatric hospitals had begun to spread among families, clergy, and medical staff. Letters from relatives who received identical, suspiciously worded death notices exposed that patients were being transferred to certain institutions and never returned.
Across Germany, dissatisfaction and disbelief grew into broader, though still cautious, resistance. Parish communities questioned hospital transfers, doctors hesitated to sign paperwork, nurses leaked information, and some local officials expressed private alarm. Small-scale protests, anonymous letters, and persistent community pressure forced the regime to recognize that the killings were no longer hidden and that continuing them openly risked public unrest during wartime.
In response, Hitler ordered the official termination of Aktion T4 in August 1941. By that point, approximately 70,000 disabled adults and children had been killed.
Discussion Question
Why do you think religious leaders played an important role in the resistance?The strongest public religious resistance to Aktion T4 came from Catholic and Protestant clergy who still had platforms and legal standing in early 1941.
Jewish and Romani spiritual leaders could not protest publicly, because by the time T4 began, they were already targets of state violence and had lost access to speech, protection, and public space.
Christian clergy could still reach large audiences in 1940–41 through pulpits, parish bulletins, confessionals, and hospital chaplaincy.
When bishops and pastors spoke, they reframed the killing of disabled children as a moral issue, not a medical or budget issue. Sermons turned abstract policies into concrete questions: who has the right to decide whether a child lives.
Bernhard Lichtenberg, the provost of St. Hedwig’s Cathedral in Berlin, prayed publicly for Jews and for the victims of the “euthanasia” program every night. He was arrested in 1941 and died in 1943 while being transported to Dachau. His steady, public prayers turned compassion into visible resistance.
Theophil Wurm, the leading Protestant bishop in Württemberg, sent formal protests to authorities and encouraged other pastors to speak. His letters used careful legal and biblical reasoning that officials could not easily dismiss as politics.
Parish networks copied sermons by hand, passed them family to family, and read them aloud in other churches. This created a parallel information channel that the state could not fully control. It also gave fearful citizens a language for dissent: the idea that every human life has inherent dignity, regardless of productivity or cost.
This is Clemens von Galen, a Catholic Bishop who publicly condemned the killings in a series of sermons in 1941, denouncing them as immoral and unlawful. Copies of his sermons were secretly duplicated, passed hand-to-hand, and even read aloud in other parishes, allowing his message to circulate across Germany despite state censorship.
Domkapitular Gustav Albers († 1957), CC BY 2.5 https://creativecommons.org/licenses/by/2.5, via Wikimedia Commons
1941-1945
Continuation in Decentralized Form
The suspension was largely cosmetic. The staff, methods, and infrastructure of the killing program were redeployed under decentralized control, allowing the murders to continue unofficially in hospitals and nursing homes. Without formal orders but under clear ideological guidance, staff simply stopped feeding certain patients, overdosed them with barbiturates, or denied them medical care.
Mobile “euthanasia” units followed German armies eastward, killing thousands of psychiatric patients, disabled civilians, and institutionalized children across Poland, Ukraine, and the Baltics. In concentration camps, experiments on disabled or ill prisoners were justified as “scientific research,” continuing the same perverted logic that had equated killing with medical progress.
Former T4 doctors and technicians helped design and operate the first extermination centers at Belzec, Sobibor, and Treblinka, where gas vans and chambers adapted from T4 technology became the prototype for the Holocaust.
Discussion Question
Where in today’s world do we see debates about who is “deserving” of care, resources, or rights?Here a few modern debates that can be framed around who is “deserving” of care or rights.
Healthcare Access
Some people argue that medical care should depend on ability to pay, while others believe it should be available to everyone. The debate reveals whether we view health as a privilege or a human right.Disability Support and Benefits
Programs that support disabled people are sometimes framed as “welfare” or “handouts,” which implies that some people must prove they deserve support. This suggests that care is conditional, not guaranteed.Housing and Homelessness
Some policies treat housing as something individuals must “deserve,” often excluding people who cannot meet strict conditions. Others argue housing is a basic foundation for human dignity and stability.Immigration and Refugee Protection
Immigrants and refugees are often described as “drains” on resources or threats to identity. This language divides people into those believed to deserve safety and those who do not.Reproductive Care and Bodily Autonomy
Debates over abortion and reproductive healthcare often revolve around who is trusted to make decisions about their own body. Power is exercised through determining which lives and futures are prioritized.Access to Gender-Affirming Care
Trans people are sometimes described as confused or harmful to themselves, leading to laws that remove their right to make their own medical decisions. The question becomes whether identity must be “approved” to be valid.Elder Care and Long-Term Support
Some societies view aging people as burdens who are too expensive to sustain. Others see elder care as a shared responsibility grounded in respect and community.Education Funding
Schools in wealthier neighborhoods often receive more resources than schools in poorer ones. This suggests some children are seen as more “worth investing in” than others.Food Assistance and Poverty Relief
Programs that provide food support often require proof of “deservingness,” such as work requirements. This frames hunger as a personal failure instead of a social responsibility.Disaster Relief and Climate Migration
Communities facing floods, fires, or drought may be offered aid based on political or economic usefulness. This shapes whose suffering is treated as urgent.Criminal Justice and Rehabilitation
People who have been incarcerated are often treated as permanently undeserving of housing, employment, or healthcare. This defines worthiness by past mistakes instead of current humanity.This is a photo of Richard Jenne, the last known victim of the Nazi euthanasia program. He was murdered at Kaufbeuren-Irsee Sanitorium in 1945.
Kaufbeuren-Irsee sanitorium, CC0, via Wikimedia Commons
Look at the Legacy
After World War II, the treatment of people with disabilities did not immediately improve, even though the Nazi euthanasia program was exposed during the war crime trials.
In Germany, the T4 killings were officially condemned and some of the worst doctors were tried, but many medical staff who had participated in the program returned to professional life.
Institutions for disabled people remained crowded, segregated, and underfunded through the 1950s and 1960s. Disability was still seen as a private family burden rather than a social responsibility.
Change came slowly and mainly through the efforts of disabled people themselves, who pushed for the right to live in communities, attend school, marry, work, and have autonomy. Germany’s disability rights movement grew especially in the 1970s and 1980s, highlighting the connection between institutionalization and past abuses.
In the United States, eugenic thinking did not disappear after the war.
The US had a chance to implement universal healthcare in 1945 under President Truman, but the proposal failed due to opposition from the AMA, insurance companies, and political leaders who feared socialism. Medical care and support services for disabled people remained uneven and sometimes inaccessible.
Forced sterilization laws remained on the books for decades and were used most heavily against poor people, institutionalized people, Black women, Native women, and disabled people.
Large state-run institutions continued to house disabled children and adults in overcrowded and abusive conditions. The most well-known case was the Willowbrook State School in New York, where investigative reporters exposed severe neglect in 1972.
These revelations sparked national outrage and helped launch the disability rights movement.
Globally, the postwar period saw a growing recognition that disability is a human rights issue.
In 1948, the United Nations adopted the Universal Declaration of Human Rights, affirming that all people have inherent dignity. After years of advocacy, this principle was extended specifically to disabled people in the late twentieth and early twenty-first centuries.
Countries such as the United Kingdom and many in Scandinavia created national healthcare systems that made medical care available regardless of income. Schools gradually moved away from separate and segregated classrooms and toward inclusive education.
In 2006, the United Nations adopted the Convention on the Rights of Persons with Disabilities, which established the right to live in the community, access public life, receive accommodations, and participate fully in society.
There has been major progress, but the legacy of the past is still visible.
Many countries still struggle with adequate funding for care, the closure of old institutions, disability discrimination, and access to healthcare and housing.
At the same time, disability-led movements continue to push for autonomy, self-determination, and inclusion. Disabled people are not only recipients of care but are recognized as leaders, organizers, scholars, workers, and cultural contributors.
The shift has been profound: from disability as “a burden on society” to disability as a part of human diversity and community life. But we need to keep putting in the effrot
Take Action
You can learn more about the post WWII history of the Disability Rights Movement on the American Association of People with Disabilities website.
They also have explainers and other advocacy resources on their site, including tips for protest organizers and disabled protestors.
You can donate to help the organization continue their advocacy work.
In addition to supporting national organizations, you can also advocate and support self-advocacy in your own community.
- Listen to and amplify disabled voices.
Follow disabled activists, creators, leaders, and scholars online and share their work. Let disabled people define their own needs rather than assuming what those needs are. - Support local advocacy organizations that are led by people with disabilities.
Look for groups where disabled people are not just clients, but leaders and decision-makers. Leadership matters because it shifts power. - Practice accessibility in the spaces you participate in.
This can mean adding alt text to images, using microphones in group discussions, offering multiple ways to participate, or asking “What do you need in order to be included?” rather than assuming one size fits all. - Learn and use respectful, person-centered language.
Different people identify differently (for example, “disabled person” vs “person with a disability”). Ask, do not guess, and follow their lead. - Challenge “deservingness” thinking when you see it.
If someone suggests a person must earn access to housing, medical care, or community belonging, ask why. Push the conversation from charity to rights. - Support inclusive education and community programs.
Speak up when schools, workplaces, or public events exclude disabled people. Inclusion is not just placement, it is belonging. - Ask your elected officials what they are doing to expand accessibility and disability rights.
This can be as simple as sending one email a month. Consistent small pressure adds up.
Talk About It
Share your thoughts on our subreddit.
Resources for Teachers
Lesson Plan for Grades 9-12: How Eugenics led to the T-4 Program and the Final Solution
Lesson Plan for Grades 9-12: Unworthy to Live
Lesson Plan (Canada): Life Unworthy of Life
Recharge
This is a dark, heavy topic. It’s important to make space for hope, laughter, and resilience too. Humor has always been a way for marginalized communities to survive, to resist, and to reclaim their own narratives.
So before we wrap up, take a moment to recharge with this brilliant and hilarious stand-up set by Joe Wells, an autistic comedian who brings sharp wit to the ways society misunderstands autism, and even ties it back to the historical roots we’ve been talking about.