"Transferred to another institution": clinical histories of psychiatric patients murdered in the Nazi "euthanasia" killing program.

This study aims to examine the practice of medical reporting in a totalitarian environment including systematic killing of people with mental illness in Nazi Germany. The historical analysis is based on patient documents and administrative files at today's District Hospital, Günzburg, as well as on patient documents of inventory R 179 of the branch office of the Federal Archives (Bundesarchiv) in Berlin/Lichterfelde. The paper describes four patient histories and attempts to reconstruct some aspects of patients' (mostly institutional) histories against the background of the Günzburg State Hospital serving as an assembly institution in the context of "Aktion T4." There is no certainty regarding the places of death of the four patients whose medical documentation is reported. In the patient records examined, the practice of medical description and reporting was characterized by a mixture of medical terminology, ideological diction and common language. The type of medical description and documentation used is an expression of stigmatization and discrimination of patients and of traumatizing institutional practice, and it reflects institutional violence. It is an ethical responsibility to reconstruct and commemorate the individual histories of mentally ill patients who were victims of the program of organized mass killings of people with mental illness. Places of death were camouflaged by the "Aktion T4," and there is uncertainty for many patients regarding where they were killed.