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New euthanasia rhetoric at Fox – the National Socialist concept of euthanasia in the context of German history.

‘Just kill them?’ – Why these words about homeless people are reminiscent of Nazi euthanasia from 1939 to 1945, and what that means for psychiatry, the media and politics

Yes, Fox presenter Brian Kilmeade really did say this about mentally ill homeless people: ‘Involuntary lethal injection or something. Just kill them.’

Introduction

On Wednesday, amid the media frenzy surrounding the tragic death of conservative Charlie Kirk, there was a discussion on the programme ‘Fox & Friends’ in which the presenters talked about media coverage of the murder of Ukrainian refugee Iryna Zarutska by a homeless, mentally ill man who had been arrested several times before.

In the presence of Kilmeade and Ainsley Earhardt, co-host Lawrence Jones complained: ‘We don’t have to do this — we feel so much compassion because we see the mental health crisis. But that’s not our job — we shouldn’t have to live in fear while they figure out what’s going on there.’ 

He added, “They’ve allocated billions of dollars to mental health and the homeless population. Many of them don’t even want to take advantage of the programmes, and many of them don’t want the help they need. You can’t give them a choice. Either you take the resources we provide, or you choose to end up in prison. That’s how it has to be now, ‘Kilmeade interjected,’ or an involuntary lethal injection. ‘Jones agreed, and Kilmeade added,’ Or something like that. Just kill them.” (https://www.youtube.com/shorts/9mq3oKI2KhY)

Eighty years after the forced end of a Nazi state killing programme, the words’ involuntary lethal injection ... just kill them’ are uttered without consequence on a publicly broadcast US TV show in reference to mentally ill homeless people. That refers to people who, because of their mental illness, are denied not only adequate care but also decent accommodation by an affluent society.

Such a TV scandal, which has gone entirely unnoticed in this country, should strike a raw nerve. National Socialist euthanasia represents a dark chapter in German history. Between 1939 and 1945, sick and disabled people were systematically murdered as part of the Nazi euthanasia programme. This killing of innocent people who were considered ‘unworthy of life’ was based on an ideology of eugenics and racial hygiene that prevailed during the Nazi era. The aim was to ‘keep pure’ the ‘German national body’ by exterminating’ life unworthy of life’.

What it’s about:

· the history of Nazi euthanasia (Aktion T4, 1939–1945): ideology, bureaucracy, perpetrator profiles, the ‘grey buses’ and the killing centres at Grafeneck, Hadamar, Bernburg and Hartheim,

· how media rhetoric shifts the debate,

· how stigma shapes political decisions, and

· which lives are protected.

It is about clear red lines, a culture of remembrance and concrete solutions with regard to how Western society deals with chronically mentally ill people.

Euthanasia in the context of the Nazi era

The term euthanasia, which initially referred to a gentle, painless process of dying, was perverted by the Nazis and misused to justify their crimes. Action T4, named after the address Tiergartenstraße 4 in Berlin, where the central planning took place, marks the beginning of systematic mass murder. The hospitals and nursing homes in the German Reich became places of horror, where doctors and nursing staff became perpetrators.

Introduction to the ideology of euthanasia

The Nazi ideology of euthanasia was based on the idea that people with disabilities or mental illnesses were a burden on society. This ideology was spread through propaganda and served to win over the population to the murder of sick and disabled people. The Nazis constructed an image of ‘inferior’ life to justify their cruel deeds. The sick were not perceived as human beings, but as objects of Nazi’ racial hygiene’.

The role of the state in euthanasia practices

The state played a central role in Nazi euthanasia. The Führer’s Chancellery was significantly involved in planning and approving the murders. Institutions were instructed to report patients who were considered ‘unworthy of life.’ Experts then decided on life and death. The ‘grey buses’ transported the victims to killing centres such as Grafeneck, Hadamar and Bernburg, where they were gassed or murdered in other ways.

Legislation and euthanasia during the Nazi era

Although there was no formal law legalising euthanasia, the Nazis created an atmosphere of impunity in which the killing of sick and disabled people went unpunished. In August 1941, Hitler stopped Action T4 due to public pressure. However, the murder of sick and disabled people continued in hospitals and nursing homes. By 1945, an estimated 70,000 people had been murdered as part of Action T4 and the decentralised killings in the institutions. 

The victims of the euthanasia programmes

The euthanasia programmes carried out by the Nazis between 1939 and 1945 claimed countless victims. 

The basis for this was the ‘Würzburg Key’, a classification system for psychiatric diagnoses that was used in Operation T4 for the bureaucratic and systematic registration and selection of victims. A random review of the medical records of Operation T4 revealed the following figures:

Sick and disabled people were systematically registered, assessed and deported to killing centres such as Grafeneck, Hadamar and Bernburg. There they were murdered by lethal injection or gassing. ‘Aktion T4’ and the decentralised killings in hospitals and nursing homes affected not only people with physical or mental disabilities, but also mentally ill people, people with chronic illnesses and those who were considered ‘work-shy’ or ‘antisocial’. The National Socialists perversely defined the term euthanasia and misused it to justify the extermination of ‘life unworthy of life’. The biographies of the individual victims are mainly unknown, but the memorial sites are attempting to reconstruct their stories and give them a face.

Social reactions to the euthanasia crimes

Social reactions to Nazi euthanasia were varied and ambivalent. While the Nazis tried to use propaganda to convince the population of the necessity of euthanasia in the interests of ‘racial hygiene,’ there was also resistance and rejection. In particular, relatives of patients in sanatoriums and nursing homes protested against the killing of their family members. Parts of the church also expressed criticism of the crimes. However, fear of repression was so great that open resistance was rare. After August 1941, when Hitler stopped Action T4 due to public pressure, the killings continued in secret. After 1945, the crimes began to be investigated, but the memory of Nazi euthanasia remains a painful chapter in German history to this day. The Führer’s Chancellery was responsible for the killing of sick people.

Long-term consequences for society

Nazi euthanasia had long-term consequences for society. Trust in medicine and the healthcare system was permanently shaken. The murder of 70,000 people by doctors and nursing staff in institutions undermined the ethical foundation of medical practice. The stigmatisation of people with disabilities or mental illnesses intensified. Only gradually did a rethinking begin that led to a more inclusive society. The examination of Nazi euthanasia contributed to the recognition of the value of each individual life, regardless of its supposed ‘usefulness’ to society. Remembering the victims of Nazi euthanasia serves as a warning to remain vigilant against all forms of discrimination and exclusion. Examining medical history helps to prevent similar crimes in the future. The ‘grey buses’ transported the victims to killing centres such as Hartheim.

Important memorial sites for euthanasia

Remembering the crimes committed between 1939 and 1945 as part of Nazi euthanasia is of central importance in ensuring that these atrocities are not forgotten. Memorial sites have been erected to commemorate the victims of euthanasia and to come to terms with these historical events. Among the most important memorial sites are the former killing centres at Grafeneck, Hadamar, Bernburg and Hartheim. These institutions were used to murder sick and disabled people during Operation T4. Other sanatoriums and nursing homes where decentralised killings took place now also have memorial sites commemorating the suffering of the patients.

Culture of remembrance and coming to terms with the crimes

The culture of remembrance plays a crucial role in coming to terms with the crimes of Nazi euthanasia. Exhibitions, documentaries and educational programmes keep the history of euthanasia as practised by the National Socialists alive and make it accessible to a broad audience. Eyewitness accounts, where available, play an important role in illustrating the personal suffering of the victims. It is essential to examine the ideology and motives of the perpetrators to understand how these crimes could have happened. In doing so, the term euthanasia is critically questioned, and the perversion of the term by the Nazis is addressed. This reappraisal also makes an essential contribution to medical history.

Educational initiatives on the history of euthanasia

Educational initiatives are of great importance in ensuring that the history of Nazi euthanasia is not forgotten. These initiatives are aimed at schoolchildren, students and the general public and impart knowledge about the historical events, the ideological background and the consequences of euthanasia. Through excursions to memorial sites, workshops and seminars, participants are sensitised to the topic and encouraged to examine the past critically. The memorial sites and educational institutions work together to keep alive the memory of the victims of Nazi euthanasia and to take a stand against discrimination and exclusion. 

What happened on the Fox talk show – and why is it perilous?

The starting point is the short television clip described above: ‘involuntary lethal injection ... just kill them’ – said about people with severe mental illness who, left without care, are forced to live in homelessness. Millions of Americans heard it. The sentence was not posted in the comments section of an anonymous account, but on a significant national morning show.

Language frames thinking. Anyone who suggests ‘just killing’ them shifts the debate away from care, dignity and rights – towards disposal. That is precisely where an extremely dangerous normalisation arises. Once uttered, the phrase becomes less strange with each repetition.

The debate touches on real fears: visible poverty, overburdened services, isolated cases of violence. That is precisely when a stance is needed. Otherwise, the public will slip into a knee-jerk reaction: harshness instead of help, locking people away instead of providing care, silence instead of standards.

Mental illness and homelessness: statistics

The following statistics on the frequency of mental illness can be found among the homeless population in the USA and Germany:

• The percentages are rounded and given as estimated ranges, as the data varies depending on the study.

• Categories such as ‘mental disorders in old age’ are now mostly subsumed under dementia/geriatric psychiatry.

• The category’ psychopathic personalities’ now corresponds to dissocial/antisocial personality disorder.

Feel free to compare the historical table with current data yourself!

• Among the victims of the Nazi era, severe disorders (schizophrenia, mental disability) dominated the statistics of those who had to be cared for in institutions.

• Today, affective and anxiety disorders are more prevalent, while severe forms of schizophrenia are less common but still relevant.

• What is striking is the decline in chronic neurological and psychological consequences of bacterial and viral infections due to vaccinations and antibiotics.

• All differences are the result of advances in diagnostics, social change and altered care structures.

In Germany, the incidence of mental illness among homeless people is generally three to four times higher than in the general population. Substance-related disorders (especially alcohol dependence) and psychotic disorders (e.g. schizophrenia) are many times more common among homeless people: schizophrenia is about 10 to 30 times more common, and addiction disorders are about 20 times more common than in the general population. 

The causes in the Western world are:

• The interaction of poverty, social exclusion and mental illness,

• The increased risk of homelessness in cases of severe mental illness,

• The lack of access to treatment and prevention, and

• The frequent co-occurrence of other mental illnesses with addiction.

This underlines the urgent need for low-threshold, integrated support services and targeted prevention for these particularly vulnerable people. The suffering of those affected is not caused by themselves, but by a society whose conservative politicians traditionally espouse social Darwinism and whose TV presenters seem to be resorting to euthanasia rhetoric with impunity once again.

Does mental illness actually increase the propensity of those affected to commit violence? What do research and practice say?

The cliché ‘mentally ill = dangerous’ dominates discourse in a constitutional state. Data paint a different picture. Poverty, substance use, exclusion and lack of continuity of treatment increase risks. The vast majority live peacefully, suffer violence themselves and avoid conflict.

Politicians create the misery on which gaps in care and social decline thrive, instead of setting clear priorities: treatment, housing stability, and social integration. These factors reduce the frequency of crises, relieve emergency rooms and reduce police contacts. Security comes from care – constitutional, effective, humane.

That turns the narrative on its head: it is not the person who is the ‘problem’, but a care system with gaps. Closing these gaps protects neighbourhoods and biographies.

Yet there are effective solutions in the USA for protecting lives and the public: Housing First, ACT, and FACT.

Housing First puts housing first—your own flat, rent, keys – no strings attached. Support services follow: outpatient psychiatry, social work, and peer support. Stability relieves pressure. Crises decrease, structure emerges, confidence grows.

ACT (Assertive Community Treatment) works in a multi-professional, active manner, with 24/7 on-call service. The team stays on top of things, coordinates transitions, and prevents revolving door cycles between the street, hospital, and prison.

FACT (Forensic ACT) combines this model with cooperation with the justice system – the goal: relapse prevention, treatment adherence, participation.

Such approaches deliver measurable results, including increased housing stability, reduced coercion, and lower overall costs. They respect rights and improve safety – not against each other, but together.

What does euthanasia rhetoric mean today?

Euthanasia rhetoric refers to language that marks a group as ‘expendable’ and suggests state killing as a ‘solution’ – directly or with allusions. It robs people of their dignity before laws, budgets, or measures follow.

Such rhetoric takes up historically familiar perspectives in neoliberalism. Its narratives juggle labels such as ‘ballast,’ ‘burden,’ and ‘cost factor.’ They do not ask about treatment, housing, or participation, but about surveillance, imprisonment, and elimination. Words create images – today as in the past – images develop attitudes, and attitudes justify politics.

People with mental disorders experience breakdowns, loss of housing and exclusion. Dignity would come from treatment, relationships and stability, rather than discriminatory threats.

What does the T4 campaign (1939–1945) teach us in relation to the TV appearance?

Estimates put the number of people murdered during the central T4 phase at around 70,000; after that, decentralised killings continued until the end of the war.

The perpetrators wore lab coats and uniforms. Doctors, nurses, administrative staff, drivers – a system based on the division of labour that cloaked murder in seemingly normal work processes. The ‘grey buses’ picked people up; the killing centres Grafeneck, Hadamar, Bernburg and Hartheim carried out the crimes. Murder was given euphemistic names, forms and stamps.

However, the T4 crimes did not arise spontaneously. Eugenics and ‘racial hygiene’ provided the ideology, and propaganda spread it. The Führer’s Chancellery coordinated, experts decided, institutions reported, buses drove. The state created an atmosphere of impunity in which murder appeared to be ‘treatment’.

At its core was depersonalisation. People appeared as file numbers, bed numbers, and cost rates. This grid separated faces from stories. It made it easier for perpetrators to act and for bystanders to look away. That is precisely where remembrance comes in: numbers are given names, places are given voices.

The lesson must be clear: ideology plus bureaucracy plus silence breeds violence. Where society morally waters down the ‘if’, institutions slip into a ‘how’.

Protecting human rights instead of merely using politically correct language – rights-based psychiatry

Politically correct language does not correct inhumane decisions. Various ramblings about ‘people with schizophrenia’instead of ‘schizophrenics,’ ‘people without homes’ instead of ‘the homeless’ remain verbal smoke and mirrors when those affected are invisible in reality and downgraded to administrative files—only rights-based psychiatry anchors autonomy, consent, complaint procedures and violence prevention.

The rule is simple: people instead of problems. A society’s respectful treatment of those affected reduces stigma, facilitates access and builds trust. In clinics, government agencies, editorial offices and schools, a culture of action is needed instead of politically correct wording. That is precisely where professional responsibility begins.

How does media rhetoric shift the debate?

The debate describes what is considered publicly acceptable and conceivable. The conservative presenter’s drastic statement shifts this window. The first time, it is followed by outrage; the second time, perhaps a shrug of the shoulders. The third time, such statements become ‘uncomfortable truths’. It is precisely this shift that threatens the human rights of an entire population group: 531,600 people in Germany (6.4 per 10,000 inhabitants) and 771,480 people in the United States (22.6 per 10,000 inhabitants).

Politicians in Western Europe are currently drowning in their moral outrage against the ‘Right’ and ‘fake news’, which is primarily intended to legitimise anti-democratic censorship. Editorial offices are taking action – with standards, corrections and training. Advertisers are taking action – brand safety against unwelcome content and keywords. Platforms are issuing community guidelines and setting trolling digital accounts against unwelcome content, to the point of a dead internet.

Yet a sober rule of three would be more effective and democratic: name violations, provide facts, show solutions. This would keep the public debate space intact, without censorship, but with a stance – in the case of the New Right, as well as in dealing with homeless people.

What would that mean for editorial offices, advertisers and platforms?

Editorial offices: Classify quotes clearly, name dehumanisation explicitly, make standards visible, correct on-air, and train teams. There is no ‘just kidding’ when lives are at stake.

Advertising: deduct budgets from programmes with eliminatory rhetoric, brief agencies, and extend brand safety criteria beyond politically mandated sensitivity—those who pay bear joint responsibility for tone and reach.

Platforms: Consistently apply transparent rules on real violence and hate, label clips with context, comprehensibly limit the reach of uninhibited calls to action, and offer contact persons for editorial offices. Moderation does not serve to stifle opinion, but to promote human dignity and transparency.

Responsible politics beyond the neoliberal reflex

Diagnosis

Neoliberalism sorts people according to their usefulness. Those who do not promise profit are pigeonholed into three categories: austerity (cutbacks), privatisation (outsourcing) and criminalisation (locking away). This triad shifts responsibility onto individuals and turns social risks into ‘individual mistakes’. The result: emergency solutions that are expensive for society and highly profitable for private providers, more suffering, fewer rights.

Breaking with this logic means not linking rights to employment status, decommodifying care, and safeguarding dignity—without advance payment, without means testing.

Rights as entitlements, not rewards

·  Anchoring the right to housing: justiciable entitlement, anti-eviction protection, vacancy tax, pre-emptive rights for local authorities, prohibition of misuse with teeth.

·  Writing rights-based psychiatry into law: strictly limiting coercion, independent complaints and monitoring bodies with sanctioning powers, mandatory de-escalation and anti-stigma standards.

·  Diversion before punishment: in crises and when symptoms are severe, prioritise treatment over punishment; binding interfaces between the judiciary, clinics, Housing First, ACT/FACT.

·  Abolish discriminatory fitness fictions: access to benefits without a work capacity label; do not link fundamental social rights to ‘cooperation in exploitation’.

·  Establish data ethics: ban algorithmic risk scoring that labels poverty/illness as a security risk; transparency and audit requirements.

Guiding principle: Fundamental rights apply without exception, especially for vulnerable groups. It is not exploitability but human dignity that matters.

From austerity to social infrastructure

·  Reallocate resources: away from emergency rooms, prisons and temporary accommodation—towards housing, crisis and peer support.

·  Multi-year basis instead of patchwork projects: reliable, inflation-proof budgets with quality and performance indicators, no annual begging.

·  Limit profit-taking in core areas: do not treat psychiatric and housing-related care as a source of return; prioritise the common good and non-profit organisations.

·  Reverse land and real estate policy: land funds, municipal pre-emptive rights, leasehold models, vacancy and speculation taxes, earmarking of land revenues for affordable housing.

·  Upgrade care and social professions: collective bargaining agreements, staffing ratios, supervision, further training—otherwise the infrastructure will collapse.

·  Improve data quality: standardised key figures (see below) and public dashboards; budget follows proven impact, not PR.

Mantra: Continuity saves money and suffering—emergency solutions burn through both.

Re-municipalise, decommodify, decriminalise

·  Re-municipalised housing platform: municipal/state-owned companies acquire properties, renovate them carefully, allocate them to Housing First clients; rent caps, occupancy rights, social mix.

·  24/7 crisis response without a police focus: mobile crisis teams, short-term stabilisation places, peer-run services; clear protocols with de-escalation.

·  Community-based care across the board: team caseload ≤ 1:10, 24/7 on-call service, shared case responsibility, close integration with probation/social services; quality audit according to recognised fidelity measures.

·  ‘No wrong door’ principle: no matter where the entry point is—home, clinic, street work—help tackles the problem instead of taking it away.

·  Participation instead of control: social tickets, basic digital equipment, care and day structure places as rights, not as ‘rewards’.

What must stop immediately

·  Normalising elimination rhetoric: Stop. On-air corrections, standards, training; if repeated—check broadcasting slot, contract, advertising partners.

·  Criminalising poverty: Away with evictions without alternatives, displacement policies, ‘cleanliness’ regulations against visibility instead of care.

·  Projectitis: No more one-year pilot projects that disappear by next winter.

·  Performance hurdles: no preconditions such as compulsory abstinence or ‘therapy compliance’ as a prerequisite for access to housing and assistance.

We cannot afford neoliberal management of misery

Instead of eloquent publication of output statistics (processed applications, decisions), outcomes count:

·  Housing stability after 12/24/36 months (Housing First).

·  Crisis reduction: unplanned hospital stays, coercive measures, police contacts.

·  Health: length of stay in stability, continued treatment after discharge (≤7 days).

·  Participation: frequency of contact, daily structure, voluntary employment/training without pressure.

·  Protection of human rights: documented complaints, processing time, remedy rate, and external audits.

·  Budget distribution: ≥60% in housing & community care, ≤30% in acute/forensic care, ≤10% in administration—published annually.

From ‘usability’ to “dignity”

The narratives of the constitutional state, not only of the German federal government, demand: ‘Only those who perform receive protection.’ A democratic response would be: ‘Protection is the soil in which achievement grows.’ That applies to work, neighbourhoods, and society as a whole – in dealing with the mentally ill.

Dignity instead of exploitability prevents a relapse into the thinking that led to catastrophe between 1939 and 1945. Memory sets the boundary. Responsible politics worthy of the name respects it.

Instead:

Legal

· Ensure a balance between the individual freedoms of a person and the legitimate actions of the government (due process), strictly limit coercion, establish independent complaints bodies with real sanctioning power, make diversion a binding priority, and implement mandatory discharge management.

· Codify the right to housing; remove discriminatory suitability fictions; regulate algorithmic risk assessment.

Financial

· Provide permanent funding; increase staffing levels and secure pay scales; improve data quality and make it public; limit profit-taking in core areas; introduce land and vacancy taxes; build up municipal housing stocks.

Practical

· Municipal alliances between health, social services, justice, housing authorities, civil society and memorial sites; mandatory training, management briefings, joint guidelines; 24/7 crisis teams; remunicipalisation of housing; No Wrong Door in everyday life. The result: a system that works — without the pressure to exploit, with a guarantee of dignity.

What objections arise — and how can they be answered objectively?

‘That was humour.’

Calling for the killing of mentally ill people is not funny, but inhumane. Furthermore, even genuine humour does not absolve one of responsibility. Those who reach millions shape norms. Only a clear ‘That crosses a line’ protects spaces for debate. 

‘Tough measures protect the public.’

Social security grows through care, not dehumanisation. Community-based care reduces crises, lowers costs and stabilises neighbourhoods.

‘There’s no money for that.’

Certainly not, as long as billions are available for militarisation. Chaos creates bigger holes. Emergency rooms, police operations, detention, and temporary accommodation – all of this costs more than stable housing and reliable teams. Every crisis intervention that is avoided relieves the burden on households and people.

Why does this current TV debate remind us of T4 – without making a false comparison?

Historical comparisons require accuracy. Nazi euthanasia was state-organised mass murder. The US TV talk show cited broadcasts an irresponsible talk show segment without comment; it does not pass laws, issue orders or send grey buses.

However, the mechanism of devaluation remains recognisable: the words rob the people affected of their dignity, normalise brutality and shift boundaries.

Remembrance creates a moral seismograph against such behaviour. Anyone familiar with T4 reacts sensitively as soon as language erases the person. This sensitivity preserves an open society. It prevents the step from breaking taboos in routine.

The present, therefore, needs two things: clear red lines in media language, and tangible, evidence-based services for the care of mentally ill people who cannot care for themselves.

Remembrance deprives dehumanisation of its stage. Those who take history seriously start setting boundaries early on: in sentences, in conference rooms, in city councils, in studios. Remembrance provides the compass, practice provides the paths. Remembrance shapes the spaces in which politics is decided. That creates a culture of vigilance.

Conclusion: dignity, treatment, housing and rights for mentally ill people – four pillars against society falling back into old patterns

Between 1939 and 1945, medicine, administration and society strayed into a system of murder. Today, the choice is clear: repetition – or decisive present-day policies with memory as a guiding star.

It begins with a sentence in the studio. It ends with a mission: Never again will devaluation and elimination be the solution. The present demands an attitude, standards and care for the mentally ill based on:

1.  Dignity – the person before the problem, no collective guilt.

2.  Care – crisis services, peer support.

3.  Housing – long-term financing, reliable networks.

4.  Rights – channels for complaints, clear boundaries against coercion and violence.

Key points at a glance

·  Nazi euthanasia (Aktion T4): ideology, bureaucracy, ‘grey buses’, killing centres – a cautionary foundation for any contemporary debate.

·  Culture of remembrance: memorials and educational work sharpen judgment in politics, the media and practice.

·  Euthanasia rhetoric today: dehumanising language shifts the debate towards violence.

·  Facts instead of clichés: violence correlates with poverty, exclusion and substance use – not with diagnoses.

·  Evidence-based solutions: assisted living, crisis services and peer support reduce crises and costs.

·  What counts is the person, precise, respectful – this creates access and trust.

·  Media & advertising: standards, corrections, brand safety decisions – clear signals against elimination rhetoric.

·  Platforms: Apply rules on violence and hate transparently, contextualise clips.

·  Politics: Secure rights, redistribute budgets fairly, build local alliances – security through provision.

·  Compass: Dignity, treatment, housing, rights – without exceptions.

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