Despising the weak
In Germany, paediatrics evolved at the end of the 19th century in an atmosphere of social Darwinism and nationalism which paved the way towards elimination of handicapped infants. Killing handicapped children was organized in Hitler’s Chancellery from 1939, targeting infants with idiocy and mongolism, micro- or hydrocephaly, malformed limbs, head, or spine, and palsies. A system of reporting and rating such infants was established, leading to their admission to one of 30 ‘Special Children’s Departments’. There, sedatives were applied in a dose depressing respiration which led to a slow death disguised as natural. A hundred physicians were directly involved in killing, and many more including eminent paediatricians in reporting infants. After the war, court trials were initiated, but usually discontinued. Physicians involved in murdering children continued to teach and to conduct research on the victims’ brains. Their textbooks conveyed little compassion for the weak, malformed, and handicapped. There was widespread unwillingness to keep preterm infants alive. When from 1960 artificial ventilation of neonates became possible, opposition against it persisted. Despising the weak was an enduring legacy of Nazism that may have delayed the introduction of modern neonatology in Europe.