Nursing under National Socialism

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The Nursing in National Socialism is a special part of the history of nursing . In the National Socialist German Reich , the well-being of the people was placed above the well-being of the individual. The ideological, structural and personal development of occupational nursing within the National Socialist health system also included their active participation in the systematic murder of those in need of care.

The political structures of the care associations were adapted to this. There were special ideological concepts for medicine in general (see Medicine under National Socialism ) as well as the professional role understanding of the nursing staff in particular. Special means were used for their instrumentalization.

The period described as the dark years of nursing between 1933 and 1945 in Germany is today a special part of the ethical debate about the role of nursing and its individual responsibility for the patient. In the professional field of psychiatric care, dealing with this time is particularly important.

Initial situation in the Weimar Republic

During the political upheavals after the end of the First World War , the working and pay conditions in the care sector were very poor. Working hours of up to 14 hours, serious staff shortages, poor pay and inadequate health and retirement provision were common for the nursing staff. The overstrain of the nursing staff was discussed by Agnes Karll , among others . In 1903 she founded the professional organization of nurses in Germany , which mainly dealt with the rights and state recognition of nurses. After 1922 this organization gained increasing influence. The professional view of the professionally organized nursing staff changed towards professionalization, which demanded fair remuneration for their work, without breaking out of the conservative understanding of roles, selflessness and obedience to doctors and superiors. For example, Agnes Karll vehemently rejected the eight-hour day required by the unions. This contrasted with the self-image of the religiously motivated sisters, who understood care as an expression of active charity and saw themselves in the tradition of charity . Alongside these two groups were the freelance and unionized nurses who, in addition to fair wages, also fought for a clear improvement in staffing and a clear reduction in working hours.

In the Weimar Republic , these three groups were politically at odds with their individual roles. Nursing became increasingly professional, the demands on training and further education increased, but due to the differences, the various trade union, professional and church organizations could not agree on a common understanding and a uniform political demeanor to enforce their demands.

The National Socialist People's Welfare takes over the welfare work

Importance of welfare to nursing

At the end of the Weimar Republic, nursing was structurally assigned to state or ecclesiastical welfare and health welfare , whose primary tasks include caring for needy, sick or endangered people and thus nursing the sick. As part of this health policy system , the sister associations were mostly affiliated to the charities , which provided the organization and infrastructure for the fulfillment of health policy goals. The measures of the official, denominational or private associations, to which for example the German Red Cross or the later dissolved Red Aid Germany belonged, were coordinated by the state welfare offices and district welfare associations. Changes in the political and organizational structure of nursing took place both through legal regulations and through influencing the welfare associations.

Creation of the National Socialist People's Welfare

NSV membership card

The National Socialist People's Welfare (NSV), founded in 1931 as a private welfare association in Berlin, initially dealt with welfare work within the National Socialist German Workers' Party (NSDAP) and its sympathizers after its registration as an association in 1932 . With the "seizure of power" by Adolf Hitler and the prohibition of workers' welfare in July 1933, the association rose to become one of the most influential leading associations for voluntary welfare. These leading associations, that is, the religiously motivated Caritas and the Inner Mission as well as the secular German Red Cross (DRK) with their affiliated sororities, founded the Reich Association of Free Welfare Care together with the NSV .

In 1934, this Reichsgemeinschaft was renamed the Arbeitsgemeinschaft der Free Welfare Care. At the same time, the social, liberal and Jewish welfare associations were banned, some of whose functionaries were arrested or banned from working. The assets of the associations were confiscated. The NSV benefited in particular from the ban on church organizations, some of whose assets were transferred to them.

With the dissolution of the German Parity Welfare Association , which had been affiliated to the NSV since 1933, the NSV took over most of the facilities of this welfare association and was able to secure a key position within the National Socialist welfare associations. The NSV initially got involved as an aid organization for the Sturmabteilung (SA) of the NSDAP and their families and secured support from the population through further measures aimed at the general public, for example through the winter relief organization founded by the NSV .

Dissolution of the free trade unions and sister associations

Immediately after “ National Labor Day ”, on May 3, 1933, by order of Adolf Hitler, the free trade unions were dissolved and banned. The nursing staff previously organized in the trade unions were integrated into the newly founded German Labor Front (DAF) and thus belonged to the Reich Public Works Group . The task of the DAF was to look after the labor law and collective bargaining issues of its members. At the same time, the Reichsarbeitsgemeinschaft der Profufe im Sozial und Medical Dienst e.V., which reports directly to the Reich Ministry of the Interior, was established . V. (RAG), under whose roof the Reich Student Council of German Sisters and Nurses and the Reich Student Council for Nurses were formed. The Reich student councils should coordinate and organize the job-specific affairs of the carers. As recently as 1933, all publications in the professional and association's own specialist journals were discontinued and replaced by journals from the Reich student councils.

All larger sister associations that were independent up to this point joined the Reich Student Council by 1935 at the latest. Five main groups were formed that represented the main trends in nursing:

  • Professional community, consisting of secular, private and urban sisters, provisional management: Sister Amalie Rau, also Reichsfachschaftsleiterin
  • Diakonie community, consisting of the sororities of the Protestant churches, led by Sister Auguste Mohrmann
  • Catholic sister community in Germany, headed by Superior Emilie Hollstein
  • Red Cross Sisters, Head: General Superior Luise von Oertzen
  • Sister community of the NSV or the NS sisterhood, head: Erna Mach

Co-ordination of welfare work

After the Enabling Act was passed on March 24, 1933, and the law passed on December 1, 1933 to secure the unity of party and state , the NSDAP became the bearer of state power and was given a monopoly on public authority. In the course of this, the NSV also became part of the public administration. The association was monitored by the Central Office for People's Welfare . The hierarchical structure of the party with its levels Reich, Gau, Kreis, local group, cell and block was thus also transferred to the NSV. The managers of the main office became the heads of the NSV. This ensured close cooperation between the NSDAP and the NSV.

The tasks of the NSV included the areas of general welfare, family and housing assistance, NSV youth welfare, recreational care, settlement of rent disputes in cooperation with the legal support of the NSDAP as well as nursing. The central task of the nursing department was to organize and monitor the NS Sisterhood for community care and the Free Sisterhood of the NSV for nursing.

Dissolution of the Reich student council

At the beginning of 1935 there were disputes over competence within the RAG, which ultimately led to the dissolution of the RAG. The student councils were then directly integrated into the DAF. At the same time, the Technical Committee for Nursing in the working group for voluntary welfare under the aegis of the NSV was created from the Reich Student Council of German Sisters . The professional associations initially remained in their previous form and distribution.

Another renaming took place in 1936: The professional association of free associations , the so-called “Blue Sisters”, became the Reich Association of Free Sisters . The members of the NSV sorority, known as "Brown Sisters" because of their brown sisters' costume, were merged with the Reich Association of Free Sisters in 1942 to form the National Socialist Association of German Sisters . After 1936 there were no more free sister associations that were not controlled by the leadership of the NSDAP.

Legal reorganization of nursing

Reorganization of the training regulations

The Prussian training regulations for nursing, issued in 1921, were initially adopted by the National Socialists and extended by individual special provisions which, among other things, regulated the admission requirements for training at Nazi nursing schools. This included a two-year training course. The regulation of the statutory provisions for nursing was standardized across the Reich on September 28, 1938 by the law on the regulation of nursing ; only in Austria did this new regulation only come into force on December 2, 1938.

The regulation served, on the one hand, to increase the number of training places offered, for example, in Section 6, the establishment of a nursing school for public hospitals was made compulsory, and on the other hand, it incorporated the Nuremberg Race Laws . Admission requirements for attending a nursing school were, according to Section 7, political reliability, and the applicants also had to be "German or related blood". The nursing school was only allowed to be run by doctors who, according to National Socialist ideas, were “morally and politically” reliable and who were not excluded from civil service under the racial laws because of their parentage or their spouse. According to Section 20, Jewish applicants were only allowed to be taught at Jewish nursing schools. The duration of the training was shortened to one and a half years, the professional permit was issued after one year of professional activity.

On September 15, 1939, the regulation of one year of employment as a prerequisite for professional admission was suspended for an indefinite period. From December 8, 1942, the total training period was set at 2 years, the need for a one-year activity for admission was completely eliminated.

Prohibition of double training

With the ordinance issued on December 19, 1939 to delimit the occupation of midwives from nursing , the occupational combination of occupations in maternity care and nursing was separated. Nurses who had both the midwifery and nursing exams had to surrender one of the two approvals. At the same time, training for nurses to become midwives was prohibited. In addition to basic considerations, such as the transmission of germs by nurses to the woman who has recently given birth or the newborn, the change in the law was justified with the lack of nursing staff. At the same time, there was fear that the strictly National Socialist professional midwifery organization could be undermined by denominational care workers. With the restriction of multiple qualifications for midwives, the qualification within clinical maternity care has been reduced.

Role of nurse and special areas of activity

The nurse in the National Socialist image of women

The National Socialist image of women was essentially shaped by the ideal of the caring and self-sacrificing mother who directs her life towards the "production of racially impeccable offspring" and educates them independently and in accordance with National Socialist doctrine. The distribution of roles and the assumption of socio-political tasks were subject to an extensive and strict gender-specific separation into male and female areas. The woman was assigned household and family-related activities in particular, for example caring for the family and raising children, while the man was responsible for the soldier-military role. For unmarried women, among other things, nursing was one of the few socially recognized professions because, according to National Socialist ideas, it corresponded to the nature of women and served the common good. While the image of the male nurse or nurse increasingly disappeared from the public eye, the image of the nurse changed from the sister of the sick, acting in active charity, to the self-sacrificing and maternal heroine.

General inpatient and outpatient care

The central task of nursing with the increasing decline in private care was still the care of the sick and injured in hospitals and their associated outpatient departments, sanatoriums, health clinics, children's hospitals, facilities for elderly care, psychiatric and home care facilities. After the first concentration camps were established, nurses were also employed there. From the beginning of the war, the nursing work in the hospitals was added, which was traditionally the responsibility of the DRK. As the expansion of the German Reich under Hitler progressed, nursing in the occupied territories also became a field of activity that mainly related to conveying National Socialist ideas.Nursing staff were primarily employed in these assignments in health education and in social work with children and young people . As the war progressed and in view of the increasing number of wounded, more and more nurses were withdrawn into war nursing, the so-called "war nursing". Despite the measures taken by the National Socialist regime to increase the number of available nursing staff, the lack of trained nursing staff could no longer be compensated. In 1941, the six-month compulsory national labor service for young women was extended by a further six months in military service. Through the decree of July 29, 1941, the young women were obliged to perform various services in the authorities or offices of the Wehrmacht, in hospitals and social institutions or in families in need. The shortage of nurses led to a ban on changing jobs for nurses until 1942.

Community maintenance

One focus of the NS sisterhood was community maintenance. The tasks within this area changed under the National Socialists from caring for the family and the sick more and more to a tool of the National Socialist race and health policy. The proximity of the community nurses to the population and the status of a person of trust enabled the National Socialist government direct access to all relevant information on public health and gave the profession a key position in the implementation of National Socialist goals, for example in "heritage and race care" and the decision-making process between " worthy and unworthy life ”in the general population.

The community nurse monitored the health of the population and had an essential function as a health educator for the German people. Among other things, the community nurses gave advice on the party's preferred way of life, on economical housekeeping, they decided on participation in the Kinderland sending program and the approval of recovery cures. In addition to these activities, the community nurses were also obliged to report malformations and “behavioral abnormalities” to their superiors.

The positions as community nurses were almost without exception transferred to nurses of the NS-Sisters' Union, although in 1939 only 9.2% of all German nurses belonged to this.

War Nursing

Restructuring of the DRK in preparation for war nursing

The DRK had close ties to the NSDAP, and the two organizations were closely linked, especially at the management level. Under the presidency of Joachim von Winterfeldt-Menkins , a new statute came into force on November 29, 1933, with which Jewish Red Cross members were excluded and the principle of political neutrality was largely abandoned.

From 1933 to 1945 the flag of the DRK's women's department was used

Ernst-Robert Grawitz, who was appointed by Hitler on January 1, 1937, played a decisive role in the continued ties between the DRK and the National Socialist system at the management level and in the restructuring of the association . At first he became deputy president of the DRK, from 1937 he took over the role of executive president of the association. He filled essential association functions with members of the Schutzstaffel (SS). The aim of the restructuring of the DRK was to align the association with the leader principle and to prepare it for the war effort. For this purpose, on December 9, 1937, both the DRK as a registered association and the previously largely independent DRK sororities were dissolved. On January 1, 1938, a new statute came into force that obliged the DRK to perform the medical service of the Wehrmacht and declared Hitler the patron of the association. The leader's oath was introduced in the sisterhood, and in the service ordinance for the sisterhood of the German Red Cross , membership of the student nurses in the Association of German Girls (BDM) became mandatory. The sisters were expected to join the Deutsches Frauenwerk . For professional advancement, for example to head nurse, attendance at an ideological training course , led by the Racial Political Training Department attached to the Presidium of the DRK , became mandatory. Party membership in the NSDAP or the National Socialist Women's Association was mandatory for nurses in management positions.

In preparation for the increasing need for nursing staff expected during the war, Grawitz made massive efforts to significantly increase the number of DRK nurses. The number of student nurses in the DRK rose by 50% from 1933 to 1939, the number of DRK sisters intended for military service by 32% in the same period. Even before the war began, the DRK began conducting medical courses for military service and trained nurses who were intended to take care of the sick in the hospitals as soon as the DRK nurses were recalled for military service. The notification of suitable nurses and auxiliary nurses to the Commissioner for Voluntary Nursing was also carried out by the DRK sororities, which thus prepared the application of the Defense Act of May 21, 1935, which also regulated the duty of women in the event of war. In addition to voluntary helpers who did not necessarily have the appropriate level of training as nurses, the DRK was responsible for all war nursing. The DRK's monopoly on nursing in the event of war was retained until the fronts expanded in the years after 1940.

Areas of application and working conditions

Nursing staff was usually employed in conjunction with the association's own doctors and served together with members of the medical corps . Officially, the sisters were subordinated to the military order, within the war nursing hierarchy the management levels were divided into head nurse, army or field superior and superior general. The nursing staff mainly worked in the mobile or stationary hospitals of the Army , the Navy and the Air Force or accompanied hospital trains . The first aid for the wounded was the task of the medical companies, but by circumventing the service regulations, nurses were also deployed at the front . The locations covered all occupied areas and German front lines, including in Africa and Norway.

The work in the hospitals was very demanding from the start, and the nurses were completely overburdened from the start of the war. The hygienic conditions as well as the supply of bandages and medication were poor. The planning regarding bed occupancy was insufficient: in the years after 1940 the beds were double or four times overcrowded. Due to the increasing need for nursing staff during the war, nurses' helpers from the occupied territories were also admitted to military service if they acknowledged “Germanness” as foreigners. Sisters from associations other than the DRK as well as conscripted women were also used.

Nazi sisterhood

On May 17, 1934, the NS Sisterhood was founded and from June 1, 1934, the areas of education and training were subordinated to Hermann Jensen ; the areas of organization, administration and finance were the responsibility of the head of the National Socialist People's Welfare, Erich Hilgenfeldt .

Health policy task of the NS sisters

The Nazi sisterhood was sworn in on Hitler and was supposed to be the will-bearer of the Third Reich in the area of ​​the health management of the German people due to its commitment to the National Socialist worldview. The central task of the NS sisterhood within the framework of the National Socialist health policy was to be community maintenance, in which, in addition to the concern for public health, the dissemination of National Socialist ideas should also play an essential role. This reassessment of the socio-political role of nursing, which had hitherto been viewed as rather apolitical, gave the profession a clear appreciation.

Understanding of the role of the National Socialist sister

The nurses of the NS sisterhood swore their oath on the Fuehrer analogous to the National Socialist understanding of welfare and the so-called " New German Medicine ":

“I swear unfailing loyalty and obedience to my Führer Adolf Hitler. I undertake to fulfill my tasks as a National Socialist sister faithfully and conscientiously in the sense of the national community at every place where I am placed, so help me God. "

This oath symbolized the changed understanding of roles in the National Socialist nursing: the national community took the place of the sick and in need of care, the nurse no longer had to protect their individual well-being, but the well-being of the people. The community was given priority over the individual. Through this ideological construct, which spread to all professional nursing associations, it was possible for the sisters to decide in favor of the common good and against “unworthy living”. In connection with the bourgeois-conservative tradition of subordination of care to authorized officers, both inside and outside the Nazi sisterhood, this led to unreflected participation in the so-called murders of the sick, the systematic murder of the sick and the disabled as part of the Nazi racial hygiene .

Participation in mass extermination, forced sterilization and abortion

Letter from Hitler, dated September 1, 1939

Legal requirements

In the targeted killing of sick, disabled and weak people, euphemistically referred to as " euthanasia ", which according to the ideas of the National Socialist racial hygiene should lead to a pure and healthy Aryan race, the nursing staff was involved to a not inconsiderable extent. In defiance of all humanitarian ideals, nurses, mostly on medical advice, were involved in the murder of thousands of dependent children and adults.

With the enactment of the Law for the Prevention of Genetically Diseased Offspring of 14 July 1933, the "eugenic extermination" led gradually over forced sterilization and forced abortions to the first "mercy deaths" severely disabled children from 1939 to systematically " child euthanasia " and later for " Adult euthanasia ”. An informal letter from Hitler from October 1939, dated back to the beginning of the war on September 1, 1939, marks the beginning of the murder of hundreds of thousands of patients, mostly mentally ill and disabled people, as part of the "Action Gnadentod", which after the war is referred to as " Action T4 " has been. This letter gave physicians the authority to “grant death by mercy” according to human discretion. Because of public rejection and after church protests, the T4 campaign was officially canceled in 1941. General practitioners became more cautious about the disastrous diagnosis of the hereditary disease in their patients. When more and more complaints and legal complications arose in the courts and public prosecutors due to the lack of a legal basis, a meeting of leading judges and public prosecutors took place in Berlin, and the Reich Ministry of Justice issued a circular ("concerns: destruction of life unworthy of life ") of April 22, 1941, that these and future legal cases are to be handed over to the ministry unprocessed by the public prosecutors and courts.

In part, the complicity related to the support of the system, but even after the suspension of Operation T4, sisters actively murdered patients in several institutions throughout the Reich from 1941 as part of Operation Brandt , the decentralized and secret continuation of Operation T4. In some cases, this was done through the administration of medication or through a deliberately induced air embolism , in some cases it was a passive contribution to their death, as the nursing staff and responsible doctors starved those in need of care.

Participation in euthanasia in children's departments

With the first “killing off grace” of a handicapped child at the request of the parents in 1939, preparations were made in the Führer’s office for the large-scale “child euthanasia” campaign. With a circular of the Reich Minister of the Interior of August 18, 1939, the registration of the children concerned was determined and ordered which children should be killed and how the killings should be decided. The circular was aimed at doctors, midwives, maternity hospitals and children's hospitals and stipulated that newly born children with idiocy or mongolism , microcephaly , hydrocephaly or with malformations of any kind and paralysis including Littlean disease had to be reported for assessment. This report was forwarded to the Reich Committee for the Scientific Registration of Hereditary and Constitutional Serious Ailments, which, according to the files, decided on the “treatment” of the child as a “euthanasia case” in one of the “ children's departments ” specially set up for this purpose . Initially, this only applied to children up to the age of three, from 1941 also to young people up to the age of 16.

The children's departments were set up at psychiatric hospitals and children's clinics, to which the children judged by the Reich Committee for "unworthy of life" were admitted. There the children and adolescents were often made available for scientific research without their consent and without that of their parents, before they were killed by barbiturate overdoses , systematic malnutrition and hypothermia provoked pneumonia. The nursing staff in these specialist departments, in particular the pediatric nursing profession that only emerged at the beginning of the 20th century , was directly and indirectly involved in the murder of the children. On the one hand, as carers for the children, they were informed about the increasing deterioration in their health, the scientific examinations and the lack of food; on the other hand, on the orders of the doctors, the sisters actively killed the children by administering medication. The nurse Anna Katschenka , who was employed in the children's department of the Viennese municipal youth welfare institution “Am Spiegelgrund , testified in the Vienna People's Court in 1948: “Dr. Jekelius further explained to me at the time that children who could absolutely no longer be helped are given a sleeping pill so that they can 'fall asleep' painlessly. A law on this should later be created [...]. "

Involvement in the murders of the sick in psychiatric care

In the basement of building C16 in the Pirna-Sonnenstein killing center, 13,720 mentally handicapped and mentally ill people were gassed in 1940/41.

In psychiatric care in particular, nurses and guards were involved in the murder of patients from 1940 until the end of the war: people suffering from schizophrenia , epilepsy and syphilis , the mentally and emotionally disabled, as well as senile, criminal and non-German inmates of psychiatric hospitals. With the start of the state-organized euthanasia as part of the T4 campaign, nursing staff were deployed in sanatoriums that had their own gas chambers to murder the patients. These “euthanasia centers” were in Brandenburg, Bernburg, Grafeneck, Hadamar, Hartheim and Sonnenstein. They were used until the end of the "Aktion Gnadentod" due to protests by the church and the population by August 1941 at the latest. After the end of Aktion T4, the systematic killing was officially ended and the killing of patients continued less obviously to the public.

The nursing scientist Hilde Steppe was able to prove that psychiatric nurses were involved in the systematic mass murders in at least four areas and that it can be ruled out that they were unaware that the patients were murdered. It was the task of the nurses to prepare their wards for evacuation, to pack their personal belongings, to mark the patients and to write information about the person between the shoulder blades of the patient on the skin. They accompanied the transport and provided with medication and fixations for smooth handling. In the killing centers, the accompanying nurses introduced the people in need of care to the doctors and accompanied them to the gas chamber. After their patients had been murdered, the nursing staff received their own as well as personal items and then returned to the nursing homes without their patients.

Use of nurses in concentration camps

Nurses were in concentration camps , youth camps , transit and transit camps , SS medical grounds and the SS and police departments used, where nurses work mainly in the women's departments or the youth and women's concentration camps there and the department medical service were subordinated and the SS jurisdiction .

After the liberation on April 11, 1945, photograph of the infirmary in Buchenwald concentration camp

The nurses employed were mainly recruited from the staff of the Nazi Reichsbund Deutscher Sisters who had already been found suitable by doctors and the Berlin headquarters for the T4 campaign for "special operations" or were recruited directly from the former professional backgrounds of the responsible concentration camp doctors, as in the example of the concentration camp doctor Karl Gebhardt , who brought trustworthy nurses with him to the Ravensbrück concentration camp, who had already worked with him during his work as senior doctor in the Hohenlychen sanatorium . Other nurses and nurses were made compulsory or volunteered for service in the wake of the SS or in SS facilities. In addition, nurses with training or prior training were often given the opportunity to switch to work as warehouse supervisors, which is well-paid compared to other women's professions, as in the cases of Irma Grese or Grete Boesel .

A significant part of the nursing care of prisoners was transferred to the prisoner nurses, who were mostly nurses by profession. This included in particular the area of basic care , while treatment care and medical assistance were the responsibility of the “brown” and “blue” sisters of the Reichsbund. According to statements made by surviving prisoners, the nurses were sometimes not interested in the care and support of their patients, refused to provide assistance and did not try to remedy the catastrophic conditions in the prisoner infirmaries. Nursing staff has been involved in the forced sterilization, forced abortion and killing of inmates. The assistance and direct participation of the nursing staff in pseudo-medical experiments is documented, for example, on the basis of statements made by the so-called "Rabbits of Ravensbrück", a group of Polish women imprisoned in Ravensbrück on whom extensive sulfonamide and gas fire experiments were carried out.

On the other hand, there are also reports that confirm that sisters helped prisoners, among other things, by trying to alleviate suffering by giving unauthorized painkillers. For example, the nurse Maria Stromberger , who was responsible for sick camp personnel in the Auschwitz infirmary , was a positive exception. She organized food and medication for the inmates, smuggled mail from the camp and worked with the internal resistance. A special case is Eleonore Baur , who, as Hitler's personal friend, received permission from him to work in the Dachau concentration camp . Her role as a nurse is unclear, but whether she specifically belonged to the SS entourage is unknown.

Processes and the question of guilt

The question of individual guilt and involvement in crimes against humanity was attempted in various trials after the era of National Socialism, with nurses being charged significantly less often than members of the medical profession. Most of the accused nurses justified their behavior on the basis of medical or state authority, which they believed should be respected and whose instructions should be followed accordingly. As recipients of orders in the bourgeois-conservative view of the subordination of nursing to the medical profession, they took no responsibility for their actions. Luise Erdmann, accused in the Munich nurses trial in 1965, said: "But we had to be obedient and carry out the doctor's orders." Erdmann had admitted to being involved in around 200 murders. Another 14 nurses were charged with her, all of whom were acquitted, although several thousand patients were killed in the institution in question in Obrawalde . In many cases, nurses have been judged by the courts as having reduced criminal capacity because it is in the nature of the nursing profession not to act independently and to implement orders.

In Hamburg Curiohaus seven found from December 1946 to July 1948 Ravensbruck processes before a British military court of the concentration camp of the camp staff instead. The accused also included nurses from the SS and prisoner nurses accused of mistreating, killing and selecting Allied female prisoners. In the first Ravensbrück process the nurse were with nine other defendants Elisabeth Marshal and the inmate nurse Vera Salvequart on 3 February 1947 for their crimes in the concentration camp to death by hanging convicted and executed . In the fourth Ravensbrück trial, in addition to two camp doctors , the nurses Martha Haake , Liesbeth Krzok and the prisoner nurse Gerda Ganzer were tried in the early summer of 1948. Haake and Krzok received early prison terms, while Ganzer's death sentence was later commuted to a lifelong and finally a temporary prison term. In no case was an occupational ban pronounced; most of the accused and the nurses known to have been involved in the killing operations in the various facilities continued to be employed in nursing, some of them in responsible positions.


Sr. Maria Restituta (Helene Kafka)

Both the resistance against National Socialism within the associations and the refusal of individuals to participate in the implementation of National Socialist goals have so far hardly been investigated. Analogous to the processes, one of the reasons for this is the general “namelessness” of the nursing staff; it was traditionally always addressed as a "sister". However, it is known from reports from various people imprisoned in concentration camps as well as from patients or their relatives that individual nurses defended themselves. This happened, among other things, through the refusal to report patients as "unworthy of life" or through the dispensing of pain relievers. In principle, nurses who refused to abuse patients during medical examinations within institutionalized care or to kill them by administering barbiturate did not face serious consequences. Censure from superiors, transfer to another ward or the threat of dismissal from service were to be expected as disciplinary punishments. In contrast, individual sisters, such as Anna Bertha Königsegg or Helene Kafka , who spoke out publicly against National Socialism and did not support the objectives of the genetic and racial hygiene policy, were imprisoned, deported to concentration camps or killed.

The resistance of the sister associations not involved in the party was only slight after the synchronization, as the non-National Socialist associations feared for their position within the health system and had to expect their dissolution in the event of collective rejection. It was only within the Catholic community of sisters that there was an increased refusal to participate in forced abortions, sterilization or the murder of the sick. Individual institutions, for example, refused to select patients. As a result, these houses were visited by medical officers who made their own assessments of the patients. Due to their historical structure, the Protestant sororities, summarized in the diakonia community, were strongly guided by the duty of obedience to superiors and doctors. The adoption of the motherhouse principle typical of the Diakonie for the sororities, the traditional diaconal costume for the Nazi sisters and the use of pietistic terms such as "sisterhood" and "honor dress" for the nurses' uniform led to a largely unreflected acceptance of the health policy system there.

Relationship of care to National Socialism after 1945

German nurse cares for prisoners of the Wöbbelin concentration camp on May 14, 1945 after the liberation of the camp

After the end of the Second World War and the associated end of National Socialist rule, the past of nursing was only discussed within the court processes that took place because of the participation of individuals in the mass extermination. A massive shortage of nursing staff and the rebuilding of nursing structures in the destroyed hospitals, as well as the scarcely manageable supply of personnel to the war victims and the streams of refugees, prevented effective denazification . Questions about membership of a National Socialist sister association or about professional activity during National Socialism were rarely asked. The role model and self-image were based on the ideals of the pre-war period until the 1960s, and nursing was seen as a vocation and a fulfillment of the essence of women.

In the mid-1970s, with the development of patient-oriented nursing and the increasing separation of nursing from medicine, a new professional understanding set in, which moved away from the traditional obligation to obey the medical profession and placed nursing tasks and the patient at the center of professional activity . With the significantly increased professionalization, academization and the development of evidence-based nursing , the nursing scientific examination of the role of nursing under National Socialism began after 1980. The main questions raised were the subordination of nursing to medicine, the service oaths usually to be performed and the political structures of nursing. The clarification of detailed questions through nursing research in connection with nursing under National Socialism illustrates the delimitation of nursing ethics and history from medical ethics and history . In particular for psychiatric care, but also for all other areas of care and nursing education, the question of the individual understanding of health and illness and the personal responsibility of the caregiver has become of central professional ethical importance.


Basic literature on nursing under National Socialism

  • Ludger Tewes : The Red Cross Sisters in National Socialism . In: Red Cross Sisters. The care professionals. Humanity - The Idea Lives , pp. 97–122 . Ed .: Association of Sisterhoods of the German Red Cross eV, Berlin. Olms Verlag, Hildesheim, ISBN 978-3-487-08467-1 .
  • Hilde Steppe: Nursing in National Socialism . 9th edition. Mabuse-Verlag, Frankfurt / Main 2001, ISBN 978-3-925499-35-7 .
  • Winfried Süss: The "People's Body" in War: Health Policy, Health Conditions and Sick Murder in National Socialist Germany 1939-1945 . Oldenbourg Wissenschaftsverlag, 2003, ISBN 3-486-56719-5 .
  • B. von Germeten-Ortmann, B. Venhaus-Schreiber: Nursing in National Socialism - a topic for the classroom . In: Care. The scientific journal for nursing professions . 2nd year, issue 2nd Verlag Hans Huber, October 1989, ISSN  1012-5302 , p. 105 to 113 .
  • Ludger Tewes, Red Cross Sisters Your assignment in the mobile medical service of the Wehrmacht 1939-1945 , Verlag Schoeningh, Paderborn 2016, ISBN 978-3-506-78257-1 .

Profession and image of women

  • Claudia Bischoff-Wanner: Occupational structure of nursing in the 19th century . In: Gertrud Stöcker (Hrsg.): Education and care: A job and educational policy position determination . 2nd Edition. Schlütersche, 2002, ISBN 3-87706-690-9 , 1.1, p. 15 to 36 .
  • Carola Kuhlmann: Social work in the National Socialist social system . In: Werner Thole (ed.): Ground plan social work: An introductory manual . VS Verlag, 2005, ISBN 3-531-14832-X , p. 77 to 96 .
  • Ilsemarie Walter : Effects of the “Anschluss” on Austrian nursing . In: Sonia Horn, Peter Malina (Hrsg.): Medicine in National Socialism. Ways of processing . Publishing house of the Austrian Medical Association, Vienna 2001, ISBN 3-901488-21-9 , p. 143 to 159 .
  • Claus Füllberg-Stolberg (ed.): Women in concentration camps. Bergen-Belsen / Ravensbrück . Edition Temmen, Bremen 1994, ISBN 3-86108-237-3 .
  • Birgit Panke-Kochinke and others: Front Sisters and Friedensengel. Nurses in the First and Second World War , Mabuse-Verlag Frankfurt / Main 2002, ISBN 978-3-933050-91-5
  • Ulrike Gaida, Between Maintaining and Killing. Nurses under National Socialism , Mabuse-Verlag Frankfurt / Main, 2nd edition 2008, ISBN 978-3-938304-39-6
  • Horst-Peter Wolff, Gerhard Fürstler: Biographical lexicon for care history . Elsevier, 2004, ISBN 3-437-26671-3 .
  • Claudia Taake: Accused: SS women in court (=  series of publications by Fritz-Küster-Archis ). BIS - Library and Information System of the University, Oldenburg 1998, ISBN 3-8142-0640-1 , SS doctors and nurses in the concentration camp , p. 30th ff . ( [PDF; 476 kB ] Diploma thesis University of Oldenburg 1998).
  • Ludger Tewes: Diary (1926 to 1945) of the Red Cross nurse Klara in the Army Medical Service . A construction of reality. (=  Contributions and miscelles 11 ). 2nd Edition. Gustav Siewerth Academy, Cologne 2020, ISBN 978-3-945777-02-2 .

Associations, organizations and political structures

  • Markus Wicke: SS and DRK: The Presidium of the German Red Cross in the National Socialist system of rule 1937-1945 . BoD, 2002, ISBN 3-8311-4125-8 .
  • Brigitte Trabert: Patients of the Jewish Faith and the Nursing in German Clinics Social Representations of Nursing Action: Social Representations of Nursing Action . LIT Verlag, 2005, ISBN 3-8258-9105-4 .
  • Heide-Marie Lauterer: Diaconal organizations and associations in the consolidation phase of the Nazi violent regime using the example of the Kaiserswerther Association . In: Gerhard Besier, Elisabeth Müller-Luckner, Stiftung Historisches Kolleg (eds.): Between “national revolution” and military aggression: Transformations in church and society during the consolidated Nazi tyranny (1934–1939) . Oldenbourg Wissenschaftsverlag, 2006, ISBN 3-486-56543-5 , p. 103 to 120 .

Individual evidence

  1. Monika Stöhr, Nicole Trumpetter: Developing professional self-image and learning to cope with professional demands. Analysis and suggestions for teaching . Elsevier, Urban and Fischer, Munich 2006, ISBN 3-437-27620-4
  2. Monika Stöhr, Nicole Trumpetter: Developing professional self-image and learning to cope with professional requirements: Analysis and suggestions for teaching . Elsevier, 2006, ISBN 3-437-27620-4 , Care in the Weimar Republic, p. 18 and 19 .
  3. Agnes Karll, 1919: "Now, in the rush and chaos of the moment, demanding the eight-hour day and making unreasonable demands for money, as happens in the private care of large cities, is unworthy of our profession." In: Hilde Steppe: Nursing under National Socialism. 7th edition. Mabuse-Verlag, Frankfurt / M. 1993, ISBN 3-925499-35-0 . Page 41
  4. a b Carola Kuhlmann: Social work in the National Socialist social system . In: Werner Thole (ed.): Ground plan social work: An introductory manual . VS Verlag, 2005, ISBN 3-531-14832-X , 4th Welfare Associations and National Socialist People's Welfare, p. 83 f .
  5. ^ The journals of the Reichsfachschaften appeared until 1935 under the title Dienst am Volk , then under Die deutsche Sister .
  6. Descriptions of the different uniforms and classifications according to Gordon Williamson, Ramiro Bujeiro: World War II German Women's Auxiliary Services: German Women's Auxiliary Services . Osprey Publishing, 2003, ISBN 1-84176-407-8 , pp. 33 f .
  7. Reichsgesetzblatt I 1938, p. 1309. Austrian National Library ( ALEX ), accessed on November 6, 2011 (Law on the Order of Nursing and Ordinances).
  8. Sonia Horn, Peter Malina (ed.): Medicine in National Socialism. Ways of processing . Publishing house of the Austrian Medical Association, Vienna 2001, ISBN 3-901488-21-9 , p. 143 to 159 .
  9. Reich Law Gazette I, p 2458. Austrian National Library, accessed 6 November 2011 (§§ 1 and 2).
  10. Wiebke Lisner: Guardians of the Nation. Midwives under National Socialism . Campus Verlag, Frankfurt / Main 2006, ISBN 3-593-38024-2 , p. 232 f .
  11. Michaela Kuhnhenne: Women's models and education in the West German post-war period . VS Verlag, 2005, ISBN 3-531-14633-5 , pp. 166 f .
  12. Brigitte Trabert: Patients of the Jewish Faith and Nursing in German Clinics Social Representations of Nursing Action: Social Representations of Nursing Action . LIT Verlag, 2005, ISBN 3-8258-9105-4 , pp. 37 f .
  13. ^ Decree of the Führer and Reich Chancellor on the further war deployment of the Reich Labor Service for the female youth of July 29, 1941. In: Arno Buschmann: National Socialist Weltanschauung und Gesetzgebung. 1933-1945. Volume II. Documentation of a development . Springer, Vienna 2000, ISBN 3-211-83407-9 , pp. 547 .
  14. Hilde Steppe: Nursing in National Socialism . 9th edition. Mabuse-Verlag, Frankfurt / Main 2001, ISBN 978-3-925499-35-7 , p. 127 .
  15. Martina Hasseler, Martha Meyer: Prevention and Health Promotion - New Tasks for Nursing: Basics and Examples . Schlütersche, 2006, ISBN 3-89993-161-0 , 1.2 The thought of prevention in community care until 1945, p. 15-16 .
  16. Federal Archives Koblenz, NS 37-1940. In: Hilde Steppe: Nursing in National Socialism . 9th edition. Mabuse-Verlag, Frankfurt / Main 2001, ISBN 978-3-925499-35-7 , p. 67 .
  17. ^ Association of Sisterhoods of the German Red Cross e. V. (Ed.): Red Cross Sisters: the nursing professionals. Humanity - the idea is alive . Georg Olms Verlag, Hildesheim 2007, ISBN 3-487-08467-8 , p. 101 .
  18. ^ Reichsgesetzblatt I, p. 609, Defense Law. Austrian National Library, accessed on November 6, 2011 .
  19. ^ Association of Sisterhoods of the German Red Cross e. V. (Ed.): Red Cross Sisters: the nursing professionals. Humanity - the idea is alive . Georg Olms Verlag, Hildesheim 2007, ISBN 3-487-08467-8 , p. 109-110 . (Ludger Tewes, The Red Cross Sisterhoods in National Socialism and in the Second World War (1933–1945), pp. 97–122, here).
  20. Ludolph Fischer, Fritz Gross, Gerhard Venzmer : Hand and textbook of nursing . 2nd Edition. Franckh'sche Verlagshandlung, Stuttgart 1940. Quoted in Monika Stöhr, Nicole Trumpetter: Developing professional self-image and learning to cope with professional demands. Analysis and suggestions for teaching . Elsevier, Urban and Fischer, Munich 2006, ISBN 3-437-27620-4
  21. ↑ Professional oath of the National Socialist sister, which was taken after training. Federal Archives Koblenz 37/1039
  22. ^ Reichsgesetzblatt I, p. 529. Austrian National Library, accessed on November 6, 2011 (Law for the Prevention of Hereditary Diseased Offspring).
  23. Lothar Gruchmann: Euthanasia and Justice in the Third Reich . (PDF) In: Vierteljahrshefte für Zeitgeschichte , 1972, issue 3, p. 271 ff.
  24. The continuation of Action T4 is also referred to as "wild euthanasia", the term is rejected today, cf. Heinz Faulstich : Death from hunger in psychiatry 1914-1949 . Lambertus-Verlag, 1998, ISBN 3-7841-0987-X , p. 511 f .
  25. Udo Benzenhöfer : Correction to the "Kind K" case, in: Monthly Pediatric Medicine 155 (2007), p. 1097. ISSN  0026-9298
  26. Udo Benzenhöfer: Correction in Dtsch Arztebl 2007; 104 (47): A-3232 / B-2844 / C-2744
  27. Decree of the Reich Minister of the Interior of September 20, 1941 Az .: IVb 1981/41 - 1079 Mi, “Subject: Treatment of deformed newborns, etc.”, last paragraph, quoted from Ernst Klee: Euthanasia in the Nazi state: The destruction of life unworthy of life . 11th edition. Fischer, 1985, ISBN 3-596-24326-2 , pp. 303 and 304 .
  28. ^ Matthias Dahl: The killing of disabled children in the institution "Am Spiegelgrund" 1940 to 1945 . In: Eberhard Gabriel, Wolfgang Neugebauer (eds.): Nazi euthanasia in Vienna . Böhlau, Vienna 2000, ISBN 3-205-98951-1 , p. 75-92 .
  29. Vienna People's Court Trial in 1948 against the nurse Anna Katschenka u. a. (Regional Court for Criminal Matters Vienna, Vg 12 Vr 5442/46, as a copy in the documentation archive of the Austrian resistance under DÖW 18282). Quoted in Eberhard Gabriel, Wolfgang Neugebauer: Nazi euthanasia in Vienna . Böhlau, Vienna 2000, ISBN 3-205-98951-1 , p. 75 to 92 .
  30. Leaflet in facsimile. State Center for Political Education Baden-Württemberg, accessed on September 29, 2008 (M 17).
  31. a b Peter Jacobs: The sister / the nurse . 29th year, booklet 5. Bibliomed-Medizinische Verlagsges. mbH, 1990, ISSN  0340-5303 , p. 374 .
  32. ^ Hilde Schädle-Deininger: Specialist care psychiatry . Elsevier, Urban and Fischer, Munich 2006, ISBN 3-437-27120-2 , chapter 2.1. Historical Aspects of Psychiatric Nursing and Psychiatry, p. 41 f .
  33. Concentration camps for women were the Moringen (1933–1938), Lichtenburg (1937–1939) and Ravensbrück (1939–1945) concentration camps . Concentration camps with their own camp areas for women existed in Auschwitz-Birkenau (1942–1944), Mauthausen (1943–1945) and Bergen-Belsen (1944–1945). The Uckermark concentration camp (1942–1945) was a youth protection camp for girls . On the living conditions and organizational structure of the women's concentration camps, cf. Helga Amesberger , Katrin Auer, Brigitte Halbmayr : Sexualized violence. Female experiences in Nazi concentration camps . Mandelbaum, 2007, ISBN 3-85476-219-4 , p. 27 f .
  34. Claudia Taake: Accused. SS women in court . Library and information system of the Carl von Ossietzky University of Oldenburg, Oldenburg 1998, ISBN 3-8142-0640-1 , 4.1 SS doctors and nurses in the concentration camp, p. 30 ( [PDF; accessed on September 23, 2008]).
  35. Silke Schäfer: On the self-image of women in the concentration camp. The Ravensbrück camp. Berlin 2002 (Dissertation TU Berlin), urn : nbn: de: kobv: 83-opus-4303 , doi : 10.14279 / depositonce-528 , p. 87.
    Hermann Langbein : People in Auschwitz . Ullstein, Frankfurt am Main, Berlin, Vienna 1980, ISBN 3-548-33014-2 , pp. 235 f .
  36. Silke Schäfer: On the self-image of women in the concentration camp. The Ravensbrück camp. Berlin 2002 (Dissertation TU Berlin), urn : nbn: de: kobv: 83-opus-4303 , doi : 10.14279 / depositonce-528 , p. 123f.
  37. Manuela Bellarosa: Human experiments in National Socialism . In: The care letter . tape 3/2001 , no. 53 , March 12, 2001, ISSN  1433-2795 , pp. 3 f . ( [PDF; accessed on September 23, 2008]). ( Memento from October 26, 2007 in the Internet Archive )
  38. Extensive descriptions of the military medical experiments, interviews and statements of the surviving women in Freya Klier: The Rabbits of Ravensbrück. Medical experiments on women during the Nazi era . Droemer Knaur, 2001, ISBN 3-426-77162-4 .
  39. ^ Susan Benedict: Maria Stromberger. A Nurse in the Resistance in Auschwitz . In: Nursing History Review . tape 14 , January 1, 2006, ISSN  1062-8061 , p. 189-202 (English).
  40. Hans Holzhaider: "Sister Pia". Beneficiary between victims and perpetrators . In: Wolfgang Benz and Barbara Distel (eds.): Perpetrators and victims. Dachauer Hefte, Heft 10, 1994, ISSN  0257-9472 , pp. 101-114.
  41. Quotation from the second Hadamar trial: “All of the accused of the nursing staff are people of simple mind who, as nurses, were used to obeying the doctor and as subjects of the government. Inwardly, they were all too dependent and obsessed with too much indolence of will to be able to cope with situations of such severity as those that arose for the accused. ”Quoted in Monika Stöhr, Nicole Trumpetter: Developing and learning professional self-understanding to cope with professional requirements: analysis and suggestions for teaching . Elsevier, 2006, ISBN 3-437-27620-4 , Care in the Weimar Republic, p. 20 .
  42. Silke Schäfer: On the self-image of women in the concentration camp. The Ravensbrück camp. Berlin 2002 (dissertation TU Berlin), urn : nbn: de: kobv: 83-opus-4303 , doi : 10.14279 / depositonce-528 , p. 32f.
  43. Gerhard Fürstler: National Socialism and Austrian caregivers from the time of National Socialism . In: Austrian Health and Nursing Association (Hrsg.): Austrian Care Journal . No. 12 . Austrian Health and Nursing Association, 2003.
  44. Wolfgang Neugebauer: "Our conscience forbids us to participate in this action." - The Nazi mass murder of the mentally and physically handicapped and the resistance of Sr. Anna Bertha Königsegg. Documentation Center of the Austrian Resistance, November 12, 1998, archived from the original on January 18, 2016 ; accessed on September 25, 2008 (lecture on the occasion of a memorial event for Sr. Anna Bertha Königsegg, Goldegg Castle, November 12, 1998 (abridged)).
  45. Blessed Maria Restituta - Life story of Blessed Restituta. Franciscan Sisters of Christian Charity, accessed November 18, 2012 .
  46. Heide-Marie Lauterer: Diakonische Werke and associations in the consolidation phase of the Nazi violent regime using the example of the Kaiserswerther Association . In: Gerhard Besier, Elisabeth Müller-Luckner, Stiftung Historisches Kolleg (eds.): Between "national revolution" and military aggression: Transformations in church and society during the consolidated Nazi tyranny (1934–1939) . Oldenbourg Wissenschaftsverlag, 2001, ISBN 3-486-56543-5 , p. 103 to 120 .
  47. This is clear from excerpts from Marie Cauer: "Guide for professional training in nursing", 1947: "Nursing, on the other hand, is not, like the subjects listed, a form of livelihood that can be chosen at will, it is a profession in the truest sense of the word, an activity, to which one must have an inner calling. ”…“ But how can it be explained that, despite all these difficult things, the vast majority of the sisters are so happy in their work. That they not only accept all such demands of their profession without complaint, but explain with a shining eye, they do not want to swap with anyone else? (...) The answer is simple enough: Because this job, like no other, is a fulfillment of the essence for women. In contrast to the man who wants to penetrate and possess, the woman strives to surrender. ”Quoted in: Monika Stöhr, Nicole Trumpetter: Developing professional self-image and learning to cope with professional demands. Analysis and suggestions for teaching. Elsevier, Urban and Fischer, Munich 2006, ISBN 3-437-27620-4 , page 20/21
  48. Monika Stöhr, Nicole Trumpetter: Developing professional self-image and learning to cope with professional requirements: Analysis and suggestions for teaching . Elsevier, 2006, ISBN 3-437-27620-4 , 2.1.2 The historical development of professional self- image , p. 13 f .
  49. ^ Hilde Schädle-Deininger: Specialist care psychiatry . Elsevier, 2006, ISBN 3-437-27120-2 , pp. 42 f .
This version was added to the list of articles worth reading on November 2, 2008 .