It isn’t a well-known story, but the first “Final Solution” ordered by Adolf Hitler was not in response to an ethnic problem, but a medical one — how to rid Germany of people with severe mental and physical disabilities. After all, those with epilepsy, Down syndrome and muscular dystrophy were not useful to the Reich. On the contrary, they were an impediment because they needed to be housed, fed and treated, at considerable expense to the state, which, when Hitler finally decided to plunge Europe into war, would need money to care for wounded soldiers.
But their financial drain aside, the real problem was that the Nazi Party considered these severely disabled Germans to be inferior humans —“racially valueless” and “unworthy of life,” as they were called. It was therefore necessary to rid the Reich of them to purify the German people eugenically, thereby ensuring the future glory and superiority of “Greater Germany.” To that end, this week (Sept. 1) in 1939, Adolf Hitler officially authorized Aktion T4 — theT4 was short for “Tiergartenstrabe 4,” the address of the headquarters of a massive euthanasia program directed at the mentally and physically disabled.
The program began with little children, including newborns. Once doctors had determined — often based on cursory examinations — that these children had “severe” disabilities, they were taken from their parents and summarily murdered, after which false death certificates would be issued and parents would be told they had died of natural causes.
And then adults with disabilities were included in T4. Euphemism being a particular talent of the Nazis (think “Final Solution” to describe the Holocaust), those running T4 were instructed to “enlarge the authority … in such manner that [adult] persons who, according to human judgment, are incurable, can be … accorded a mercy death.”
That meant the number of potential victims increased dramatically, which necessitated finding more efficient ways of killing these “racially valueless.” Lethal injections, which had been used on the children, were too cumbersome, and, given the addition of many thousands of disabled adults to the program, using drugs to kill them became too expensive.
And so, in January of 1940, T4 started using poison gas, which made possible murder on a massive scale. In fact, from September of 1939 when T4 began, to 1945 when it was shut down, between 200,000 and 275,000 mentally and physically disabled Germans were murdered.
Unsurprisingly, T4’s cheap, efficient use of poison gas for mass murder made a favorable impression on many high-ranking officials in the Nazi Party, including SS Obergruppenführer Reinhard Heydrich, who had been charged with implementing that other, ethnic “Final Solution,” the one designed to cheaply and efficiently destroy Germany’s — and all of Europe’s — Jews.

