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Introduction to the Thuringia Study Trip

This guided tour of Weimar formed part of a trilateral study programme in Thuringia organised by the France-Italy section of the Heinrich Böll Foundation. The study trip was open to university students enrolled in journalism courses and/or with editorial experience, as well as professional journalists. It was open to participants from France, Germany and Italy. The study trip included guided tours of Erfurt and Weimar.

One of the activities involved a series of guided tours exploring the history of the Nazi regime in these two cities. Rather than focusing on well-known monuments and places, the tours concentrated on sites that would later in the year be converted into schools, public offices and homes, places that had become invisible over time.

An Unpleasant Discovery of the City Tour of Weimar

During the city tour of Weimar, our group stopped at Burgplatz 1–2 in Weimar, the house where the writer Johann Wolfgang von Goethe spent much of his life. While learning about the building’s history after Goethe’s death, an unexpected and unsettling detail emerged: during the Nazi dictatorship, this residence became the seat of the city’s Gesundheitsamt, the municipal public health office.

From this location, officials participated in implementing Nazi “racial hygiene” policies, including the bureaucratic processing that led to the forced sterilisation, internment and the framework of the T4 programme – the killing of people with physical and intellectual disabilities.

This study trip aimed to examine the memory of the Holocaust, the evolution of far-right extremism, and the specific role played by Thuringia, an area long associated with extremist movements. Thuringia was, for instance, the first German state in which the NSDAP gained governmental influence: in 1930, Wilhelm Frick was appointed Minister of the Interior and Education, marking the first Nazi ministerial position in German history.

Thuringia’s contemporary history is also marked by violence from the far right. In the late 1990s, the region became one of the operational centres of the National Socialist Underground (NSU), a clandestine neo-Nazi network responsible for a series of racist murders, bomb attacks and robberies between 1998 and 2011. Today, the far-right party Alternative für Deutschland (AfD) has become the strongest political force in several polls and holds a substantial share of seats in the regional parliament, another reason why the programme focused specifically on this state.

How Health Offices and Hereditary Health Courts used to work

Returning to the central theme of this article, the Gesundheitsämter (Health offices), were public administrative offices that collected medical and family data aimed at identifying alleged hereditary diseases. Through these registries, Nazi authorities could reconstruct family genealogies that included information on health status, social behaviour, and, in some cases, ethnic origin, to support practices such as compulsory sterilisation. Wohlfahrtsämter (Social Welfare offices) contributed indirectly to this system by providing social assessments and reports.

They were crucial components of the Nazi racial state. Together with doctors’ offices, hospitals, psychiatric institutions, and the Erbgesundheitsgerichte (Hereditary Health Courts), these municipal and regional offices enforced the Law for the Prevention of Hereditarily Diseased Offspring (1933). They collected medical files, assessed individuals deemed “hereditarily ill”, and forwarded recommendations for compulsory sterilisation, confinement in sanatoria, or, in the most tragic cases, transfer to killing centres.

To explore this history more deeply, I draw on the archival case files analysed in “Eloquent Silence: The Eugenics Crimes of the Nazis and Their Consequences” (Beredtes Schweigen – NS-Eugenikverbrechen und ihre Folgen), a research and public history project coordinated by the University of Jena, Lernort Weimar e.V., Projekt-il, and Stellwerk Junges Theater. Their work reconstructs the biographies of Thuringian victims of forced sterilisation and institutionalisation, revealing the human cost hidden behind bureaucratic procedures. The digital archive currently contains seven cases. There are only a few, but they are sufficient to explain the procedure.

Individuals with disabilities were usually identified through medical examinations conducted in hospitals, psychiatric institutions, or by general practitioners, who were legally required to report conditions classified as “hereditary” under the 1933 Law for the Prevention of Hereditarily Diseased Offspring. Local public health offices (Gesundheitsämter) compiled these medical files, assessed diagnoses, and forwarded cases to the Hereditary Health Courts (Erbgesundheitsgerichte), which decided on compulsory sterilisation or confinement in specialised institutions.

In many instances, this process began when patients were admitted to psychiatric clinics for exhaustion, illness, or social distress. Once being signalled, individuals were subjected to repeated medical scrutiny and bureaucratic evaluation. Children and adolescents with visible physical or cognitive disabilities were often reported early by clinicians and subsequently re-examined to confirm or revise initial diagnoses. Following these evaluations, health offices could authorise sterilisation and transfer to asylums, psychiatric clinics, or other facilities connected to the regime’s racial-hygiene apparatus.

These bureaucratic procedures were the first step towards death. Not only were they sterilised, but also murdered under racially motivated policies that escalated into mass killing programmes. Through the Aktion T4 programme and its extensions, disabled adults and children were systematically killed in various ways. Some were gassed in specialised killing centres using carbon monoxide or other poisons, while others died from starvation, lethal overdoses of medication, or deliberate denial of medical treatment.

The ongoing medical institutionalisation and sterilisation

The second part of the project’s name “Eloquent Silence: The Eugenics Crimes of the Nazis and Their Consequences” points to how institutional logics, rather than explicit ideology, survived the end of the Nazi regime. During the second day of the trip, we examined how the German Democratic Republic (GDR) constructed its own narrative of antifascism: a state that had supposedly broken decisively with National Socialism and eradicated its racist and eugenic policies. In reality, while the eugenic doctrine itself was no longer endorsed, certain institutional practices, such as the long-term institutionalisation of disabled people, the medicalisation of social deviance, continued in more bureaucratic, depoliticised and “acceptable” forms.

These continuities were not the result of a deliberate ideological project, but reflected the persistence of administrative structures, clinical habits, and professional cultures inherited from the pre-1945 period. Although forced sterilisation under the 1933 Hereditary Health Law was formally no longer legal, the underlying logics of control, institutionalisation, and pathologisation persisted in some welfare and health practices, such as long-term institutionalisation, psychiatric evaluation, and bureaucratic management of people deemed ‘socially or medically problematic.

In unified Germany, debates on accountability emerged only much later. While compensation schemes and official state recognition were gradually introduced in the 2000s for victims of Nazi-era sterilisation and “euthanasia,” disability organisations continue to call for broader forms of redress. Their demands extend beyond financial compensation to include public memorials, clearer acknowledgements of the post-war continuities in institutional treatment, and recognition of the lifelong consequences experienced by survivors. These claims highlight how the legacy of eugenics persists not through explicit ideology, but through the endurance of institutional cultures and medical practices that long outlived the regime that produced them.

How different is it today?

The legacy of coercive control over disabled bodies persists even today, long after the formal structures of the Nazi Gesundheitsämter disappeared. The DW documentary “No Right to be a Mum?” investigates the ongoing forced sterilisation of disabled women in Europe, highlighting it as a continuing human rights concern. According to the report, such procedures remain legally permitted in 13 countries where the law still allows sterilisation in certain circumstances.

The documentary mentions that three countries, Hungary, Portugal and the Czech Republic, have authorised this procedure for minors.

Although most EU countries have ruled that this practice is illegal, including in Germany, the documentary highlights that parents or guardians often justify these interventions as being in the child’s best interests, particularly to health and well-being. Not only bad things happen; good things happen too. The documentary illustrates how, in some German federal states, welfare and youth support services provide assistance to parents with disabilities, particularly in situations where parents face difficulties in caring for their children independently.

This support is typically delivered through social workers and youth welfare services, which assess family needs and, where necessary, offer guidance, practical assistance, or coordinated interventions aimed at safeguarding children’s well-being. It also highlights how such support can include learning and empowerment components, enabling parents to better recognise and respond to their children’s needs.

While the practice today is framed under medical or welfare policies rather than eugenic ideology, the documentary illustrates how coercive decision-making continues to affect disabled individuals, frequently without full consent or agency. The report also notes that diagnoses of intellectual disabilities are sometimes delayed, complicating consent procedures and raising ethical questions about timing and necessity. DW emphasises that the issue is not limited to reproductive rights: institutional and familial control can extend to other aspects of life, such as access to healthcare, social support, and participation in everyday decisions, highlighting the fine line between care and coercion.

Taken together, the historical and contemporary evidence highlights a persistent continuity: systems for managing and regulating disabled individuals remain embedded in institutional frameworks, even after the formal abolition of eugenic ideology. From the bureaucratic operations of the Nazi Gesundheitsämter to contemporary legal and social practices, the boundaries between care, oversight, and coercion continue to be negotiated. Examining this legacy is essential to understanding how institutional authority can shape the lives of disabled people and to critically assess current policies and practices.

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