Difficult to read, but important as so many books covering this period tend to focus on the 'Final Solution' and ignore the 70,000+ who were killed because of their mental disorders, birth defects, congenital malformations and diseases and injuries that resulted in loss of productivity. This text is important because it lays out the historical factors that lead first to the eugenics movements and Germany's eventual sterilization policies which were bolstered by the forced sterilization policies in the U.S. and moved toward the 'life unfit for life' philosophy that was being intellectually discussed by both the right and left leaning philosophers, to the eventual killing through starvation, injection and gassing of people held in asylums and hospitals.
These policies did not happen merely because of the madness of the National Socialist Policies, but in a intellectual debate on what it is to be human which was being held across national boundaries, whose arguments supported the ideas of the Nazi Party on genetic superiority, and the purification of the volk that would make up the Germany of the future.
The methods and the secrecy of these systematic killings did not come from demands on high, as the some histories would have one believe, with participants acting in fear of their lives and under duress. It started with the change in the civil service system, placing Party members in charge of asylums, the cutting of all funds to maintain those who had the least protections and political voice, it involved the collusion of thosands in the selection process, the killing and the disposal of remains and the vast bureaucracy that collected data on who was unworthy of life and to create the death certificates that were sent to families listing one of the 92 causes of death they could list that might not create to much questioning from families.
The men and women who were the main actors in this euthanasia developed the methods and indeed were some of the people transferred to run the death camps, because they had become so skilled in the murders of the 'unfit'.
Strangely, post war very few of these people were ever brought to trail by German authorities, who either acquitted them or gave them light sentences such as several months to four years for the direct murder of thousands, as the courts declared that these perpetrators did not know that the killing of thousands of Germans was illegal. Also many of these perpetrators were honored members of the community and friend of people in high places in post-war Germany.
It also has a chapter that focuses on the film propaganda, and the tourist trade the government provided giving thousands of Germans tours of asylums so they could see for themselves how unworthy of life these charges were. The films presented the economic arguments, telling audiences how much it cost to maintain these creatures, when these funds could go to them, the viewer in better housing, or more food access, if only the state wasn't being burdened.
Atrocities will always be with us, but they are not only the work of a few, these few always need the complicity of the general population, the willingness of a large number of people who can be bought with additional pay, food & alcohol allowances, and the right to some of the spoils of those they dispose of.
This text is quite balanced giving no quarter to any specific point of view, but by providing documents and diaries of perpetrators lets the reader come to their own conclusions. A very important read on the direction medical and personnel can easily be subverted.