Asperger’s career before 1938

In 1911, Erwin Lazar (1877–1932) established the Heilpädagogische Station (Therapeutic Pedagogy Ward) at the Vienna University Children’s Clinic (part of the city’s general hospital), which had achieved international renown under its director Clemens von Pirquet (1874–1929) ([27]: 320, [28]: 161).Footnote 9 Lazar regarded Heilpädagogik as a direct descendant of psychiatry, although the classic psychiatric illnesses such as psychoses were rarely diagnosed in the children he treated. Instead, he diagnosed the vast majority of his patients with “psychopathy” or mental “imbalance.” Most of the ward’s patients—in 1925, he mentioned a figure of 5000 annually—were diagnosed at the outpatient clinic. Only a relatively small number—complicated cases or cases of special clinical interest—was admitted over longer periods. Many children were referred by welfare institutions, the police, or the courts. Under Lazar, Heilpädagogik took inspiration from a variety of concepts, including Cesare Lombroso’s criminal biology, Ernst Kretschmer’s constitutional types, and Sigmund Freud’s psychoanalysis [28].

Asperger joined the children’s clinic in May 1931 under Pirquet’s successor Franz Hamburger (1874–1954). In 1932, he started working at the clinic’s Heilpädagogik ward as an “auxiliary physician” (Hilfsarzt). In May 1935, he took charge of the ward and reached the position of an assistant.Footnote 10 Asperger had not obtained his specialist doctor qualification in pediatrics and had published only a single work in Heilpädagogik (on bed-wetting) [29].Footnote 11 This raises the question why Asperger’s colleague Georg Frankl was not promoted to the position—Frankl was 9 years older and had been working at the ward since 1927.Footnote 12 Two years after Asperger’s promotion, Frankl emigrated to the USA, where he joined Leo Kanner at Johns Hopkins ([21]: 122).Footnote 13 Another highly qualified Jewish employee, the psychologist Anni Weiss (1897–1991), who later married Frankl, had already left Austria in 1935 ([21]: 122).Footnote 14

Austrian universities were sites of virulent anti-Jewish agitation at the time (see [30]), which almost certainly was a factor in their decision to leave. Jewish doctors faced increasing difficulties in securing university positions, with some clinics and departments practically closed to Jews ([31]: 312). With Hamburger’s appointment as chair in 1930, the children’s clinic became a flagship of anti-Jewish policies long before the Nazi takeover ([4]: 69, 112). Regarding Anni Weiss and Valerie Bruck (1894–1961), Asperger’s immediate predecessor as head of the Heilpädagogik ward, hostility towards working women also played a role: The Austrofascist regime (1933–1938) sought to push women out of the labor market, a stance shared by Nazi ideologues such as Hamburger ([16]: 181).Footnote 15

After Pirquet’s sudden death in 1929, Hamburger introduced sweeping changes at the clinic. Pirquet’s former collaborators, many of them Jewish, were replaced. The political orientation of Hamburger’s assistants is illustrated by the fact that of those who attained the highest academic qualification (Habilitation), all but one were dismissed in 1945 as Nazis—the exception being Hans Asperger ([27]: 320).Footnote 16 Among Hamburger’s recruits was Erwin Jekelius, who later became responsible for the deaths of thousands of psychiatric patients and mentally disabled children. He remained at the clinic from August 1933 to February 1936, spending part of this time at the Heilpädagogik ward.Footnote 17 Another result of Hamburger’s influence was a sharp decline in scientific standards and output ([4]: 87–94, 104, 117–8).

Hamburger and Jekelius were not the only fervent Nazis with whom Asperger had close professional contact during his early career. In 1932, he co-authored a paper with Erwin Risak (1899–1968), who had been his colleague at the university’s III. Medical Clinic for a few weeks in 1931 [32].Footnote 18 Under Franz Chvostek junior (1864–1944), this clinic became known as a hotbed of Pan-German nationalist and Nazi agitation. Risak became an assistant to Hans Eppinger junior (1879–1946), director of the I. Medical Clinic, who was later involved in the Dachau seawater experiments.Footnote 19 Following the Anschluss, Risak became one of the figureheads of the Nazi Party (NSDAP) in the Vienna Medical Faculty, along with figures such as Hamburger, the anatomist Eduard Pernkopf (1888–1955), and others ([4]: 129).

Whatever the specific motivations for Hamburger’s decision to appoint Asperger as the head of the Heilpädagogik ward in 1935, Asperger’s promotion was aided by the anti-Jewish and misogynist tendencies then dominating Austria’s social and political life. Although Asperger did not join the Nazis, due to his Pan-Germanic, völkisch orientation, he shared considerable ideological common ground with Hamburger and his network, allowing him to blend in without apparent frictions. When anti-Jewish persecution became state policy after the Anschluss, 65% of Viennese physicians were classed as Jewish according to the Nuremberg Laws, including 77 pediatricians (70% of the specialists in this field). Tellingly, in 1938, not one Jewish pediatrician who had attained a Habilitation was working in Hamburger’s clinic ([4]: 71–3, 112).Footnote 20

Asperger had the unreserved support of Franz Hamburger, even if he did not belong to his mentor’s circle of underground Nazi activists. At a young age, and in an environment marked by political strife and a difficult labor market, he rose to Austria’s most prominent position in the expanding field of Heilpädagogik, which would soon be forced to find its place within the new order of the Nazi state.

Asperger’s political background before 1938

In order to understand how Asperger positioned himself vis-à-vis the Nazi regime after March 1938, it is first necessary to examine his political orientation during his formative years, when there was still a spectrum of political options to choose from. This will help explain why Asperger in 1938 found enough common ground with National Socialism to establish himself as a credible fellow traveler in the eyes of the party, without directly embracing National Socialism.

In Asperger’s own words, his formative experience within the polarized political landscape of interwar Austria was membership in the so-called Bund Neuland, a Catholic youth organization focused on outdoor activities, with roots in the predominantly völkisch-nationalist Wandervogel and the German Youth Movement ([4]: 192–3). In 1914, 92% of the Wandervogel chapters (in Germany and Austria) had no Jewish members, due mostly to formal anti-Jewish regulations ([33]: 92–4).

Founded in 1921, the Austria-based Bund was a split-off from the Christian-Social Student Union (CDSB) but stressed its affinities with the German Youth Movement as represented by the “Meißner formula,” which Asperger cited in 1974 as a guiding principle in his life [3].Footnote 21 After World War I, the CDSB had become rife with aggressive anti-Jewish propaganda, including calls to boycott Jewish businesses ([33]: 175–81), tendencies which the Bund shared.

The Bund’s intellectual influence was greater than its approximately 2000 strong membership would suggest ([34]: 92).Footnote 22 It defined itself as Christian, Catholic, and Pan-German, and in sharp opposition to everything perceived as Marxist-leftist, liberal, or modern, which included parliamentary democracy.Footnote 23 There was a degree of political diversity, and the Bund is sometimes classed as a “socially progressive” Catholic organization because some members supported social reforms in order to bring workers into the fold of the Church ([35]: 46). Nevertheless, in its fundamental principles, the Bund stood close to the fascist and authoritarian currents of the time ([36]: 835). A draft program from 1931 confirmed its opposition to the democratic state “in its current form” and stated that “the equivalence between Volk and state leads necessarily to the ideal of the Greater German Reich” (cited in [34]: 99).

During the 1930s, important sections of the Bund were infiltrated by Hitler Youth groups and members of other Nazi organizations ([34]: 95, 193, [37]). In 1935/1936, press reports estimated that 20% of Neuland members were (illegal) Nazis ([38]: 70–1). The authoritative account of its history states that the “predominant majority in the Bund was oriented towards Pan-Germanism, supported Austria’s unification with Germany, and was at best indifferent vis-à-vis National Socialism,” despite the fact that the official policy was to identify and exclude Hitler Youth cells within the organization ([36]: 586–7). The most striking example for the Bund’s infiltration is its leader Anton Böhm (1904–1998), who joined the NSDAP in 1933 and remained an “illegal” party member until the Anschluss in 1938, even serving as an informant to the Austrian Nazis’ intelligence services and the Gestapo in Munich ([34]: 103, 189–95).Footnote 24 Arguably, the Bund constituted one of Nazism’s most important intellectual bridgeheads in the powerful Austrian Catholic milieu during the crucial years leading up to the Anschluss ([34]: 100–1).

In 1933, Böhm published a programmatic comment on the political situation following the Nazi takeover in Germany, referring also to the persecution of the Jewish population: “There can be no doubt that the strong Jewish influence in Germany has had baleful consequences. Therefore, the anti-Jewish measures in Germany are justified as acts of national self-defense” ([39]: 106–7).

Over the following years, the Bund published a number of articles supporting the anti-Jewish persecutions in Nazi Germany [40].Footnote 25 The Bund’s official mouthpiece also denounced the Viennese “Jewish press” as a corrosive influence in Austrian public life, attacked Jews as an alien element within the Catholic-German Austrian population, and warned against the dangers of “racial” and religious intermarriage ([41,42,43]: 20–1, [44]: 215).

While the Bund’s periodical welcomed the German Nazis’ anti-Jewish policies, its stance towards National Socialism as a whole was more complex. Although the Bund shared the Nazis’ contempt for parliamentary democracy and all forms of cultural and intellectual modernism, as well as their glorification of the German Volk as the basis for cultural regeneration, they nevertheless regarded the NSDAP with the same suspicion as they did all other political parties. Catholicism remained the central point of reference, and the NSDAP was mainly judged according to its policies towards the Church. In 1933, Böhm signaled that the organization would support the Nazis’ “national revolution” in Germany provided that Hitler would choose to strengthen the anti-capitalist tendencies of his movement and, more importantly, grant the Catholic Church and Christianity generally its due place in the German Reich [45]. In the following issue, Böhm openly called for the integration of the Nazis into the Austrian government ([39]: 110).

Within the organization, which was far from ideologically homogenous, Asperger belonged to a group called the Fahrende Scholaren (Wandering Scholars), part of the Bund’s decidedly völkisch and right-wing faction. He was associated with the inner circle of “organic romanticists” around Michael Pfliegler (1891–1972), a Catholic priest and founding member of the Bund, and its leader Anton Böhm ([33]: 207–8, 342; [34]: 63–5).Footnote 26

After the Anschluss, at least some of the Bund’s former members joined anti-Nazi networks, notably in Innsbruck and Lower Austria ([35]: 46). Resistance activities, which included an assembly of 300 youths in Vienna on the night of the German invasion, were primarily the work of the younger generation. By contrast, the older generation to which Asperger belonged tended to seek immediate accommodation with Nazism ([36]: 586–8, 839). This is evident in Asperger’s path after 1938, as he joined a number of Nazi organizations (although not the NSDAP) and sought to accommodate himself with the new regime.

Bund Neuland was the most important but not the only political influence in Asperger’s life. The physicians within the Bund delegated him to the St. Lukas guild, which promoted medical ethics along Catholic principles. Regarding eugenics, its position was ambivalent; it opposed some tenets of Nazi race hygiene such as forced sterilizations while developing its own eugenic program within the bounds of Catholicism ([46]: 106–16).Footnote 27

According to a questionnaire dated 1940, Asperger was also a member of the Verein Deutscher Ärzte in Österreich (Association of German Doctors in Austria, Fig. 3).Footnote 28 “German” in this context refers to a Pan-German orientation, excluding Jewish doctors. The Verein Deutscher Ärzte emerged from a 1904 federation between the anti-Jewish Verein Wiener Ärzte and various Pan-German medical associations in Austria ([4]: 78). In the 1920s and again after the Nazi takeover in Germany, the organization called to limit the number of Jewish students ([47]: 90). A considerable portion of leading (non-Jewish) Viennese doctors, including the former head of the pediatric clinic Clemens Pirquet, belonged to the association—an indication of how widespread anti-Jewish sentiment was in Viennese medical circles ([4]: 78).

Fig. 3 In this questionnaire from October 1940, Asperger reported several memberships in organizations affiliated with the Nazi Party. He refrained, however, from joining the NSDAP itself (WStLA, 1.3.2.202.A5, Personalakt) Full size image

In the same questionnaire, Asperger mentioned another membership indicating his affinity to the Pan-German nationalist wing, despite his Catholic orientation. In 1932, he joined the Deutscher Schulverein Südmark (German School Association for the Southern Border Region), which sought to strengthen German cultural influence abroad with the help of German-speaking minorities. Many of the Schulverein’s members were close to the Austrian Großdeutsche Volkspartei (Greater German People’s Party), which in 1933 formed an alliance with the Austrian Nazi Party.Footnote 29

Despite these associations, there is no indication that Asperger actively sympathized with the Nazi movement prior to 1938, unlike many of his colleagues. Rather, the evidence points to an ambivalent attitude. Potential obstacles to his supporting National Socialism were his religious convictions, his humanist background, and his elitist, cultivated habitus. Furthermore, following the ban of the Austrian Nazi Party in 1933, the movement remained attractive only to a core of ideologically hardened supporters, whereas for mere sympathizers or opportunists, the risks of adherence far outweighed potential advantages. Nevertheless, Asperger’s record of organizational affiliations over the years prior to 1938 suggests that there was more common ideological ground than has previously been acknowledged. Asperger’s political socialization in Neuland likely blinded him to National Socialism’s destructive character due to an affinity with core ideological elements (see [40]: 848–9).Footnote 30 In 1974, Asperger himself put it this way: “[Then] the National Socialist time arrived, whereupon it was clear from my previous life that one could well go along with many let’s say quote unquote ‘national’ things, but not with the inhuman [ones]” [3].Footnote 31

In post-World War II Austria, “national” as a political label invariably referred to Pan-Germanism and is to this day used by right-wing groups as a euphemism to avoid overt association with (neo-) Nazism. In other words, Asperger in 1974 distanced himself from the Unmenschlichkeiten (inhumanities) of National Socialism, but not from its Pan-German program, which in 1938 had led to the annexation of Austria and later to World War II. Asperger’s ambivalent attitude towards National Socialism was already palpable in a diary entry from April 1934 (when he spent some time in Nazi Germany), which evinced both skeptical distance and a certain fascination: “How a whole people marches in one direction, fanatical, with narrowed vision, certainly, but with enthusiasm and dedication, with enormous discipline and formidable vigor. Only soldiers, soldierly thinking—ethos—German paganism.”Footnote 32

Political trajectory after the Anschluss in 1938

The established narrative concerning Asperger’s relationship to National Socialism after 1938 is that Asperger actively opposed the regime, or at least kept his distance, under considerable professional and personal risk. In 1993, Lorna Wing argued that as a devout Catholic, he could not have been a Nazi ([24]: 330). This argument is misleading, however, given the overlap discussed above between Catholicism and the völkisch extreme right represented by organizations such as the Bund Neuland.

The strongest claim to the effect that Asperger was an active opponent of the Nazis and that he risked his life defending the children in his care is based on an episode reported in Adam Feinstein’s book on the pioneers of autism research. Allegedly, the Gestapo twice came to the clinic to arrest Asperger, either because of his 1938 talk [1] or because he had refused to “hand [patients] over to officials” ([20]: 17–8). The only known source for this claim is Asperger himself, who mentioned the incident in 1962 at his inauguration as the Vienna chair of pediatrics [48] and in the above-cited 1974 interview:

It is totally inhuman—as we saw with dreadful consequences—when people accept the concept of a worthless life. […] As I was never willing to accept this concept—in other words, to notify the [Public] Health Office of the mentally deficient—this was a truly dangerous situation for me. I must give great credit to my mentor Hamburger, because although he was a convinced National Socialist, he saved me twice from the Gestapo with strong, personal commitment. He knew my attitude but he protected me with his whole being, and for that I have the greatest appreciation [3].Footnote 33

This is the only recorded instance I could find in which Asperger publicly mentioned Nazi “euthanasia”—despite the fact that this was such an incisive event for his field and its patients.Footnote 34 According to this account, the Gestapo was after Asperger because he refused to report patients with certain deficiencies to Vienna’s Public Health Office. It is true that doctors were increasingly obliged to report patients to the authorities in defiance of patient/physician confidentiality. Regarding race hygiene policies, the two most important instances were the compulsory reporting of patients as mandated by the sterilization law and of children with mental deficiencies who were slated for “euthanasia.”Footnote 35 Based on the available evidence, it is impossible to determine whether Asperger in some cases abstained from reporting children who met the criteria for child “euthanasia.” However, it is documented that he personally referred a number of children to the Spiegelgrund “euthanasia” facility (“Limits of ‘educability’: Asperger and the Spiegelgrund ‘euthanasia’ facility” and “Asperger’s diagnoses compared to those at Spiegelgrund” sections).

Other facts speak against Asperger’s self-portrayal as a man persecuted by the Gestapo for his resistance to Nazi race hygiene, who had to flee into military service to avoid further problems. On several occasions, he published approving comments on race hygiene measures such as forced sterilizations (see [49]: 353; for further examples, see the “‘The best service to our Volk’: Asperger and Nazi race hygiene” section), and as is discussed further below, the Nazi hierarchy saw him as someone willing to go along with race hygiene policies. In July 1940, the deputy Gauleiter of Vienna wrote to Asperger’s superior and protector Franz Hamburger that the party had “no objections whatsoever” against his assistant.Footnote 36 The Vienna Gestapo, when asked for a political assessment of Asperger, answered in November 1940 that they had nothing on him.Footnote 37 This contradicts claims that Asperger’s early publications after the Anschluss, including those most frequently cited as proof for his public opposition to Nazi policies, were perceived by the regime as expressions of political opposition.

Initially, before Asperger had a chance to prove his willingness to adjust to the new political order, the NSDAP was unsure about his loyalty. Immediately following the Anschluss, a preliminary investigation was initiated to decide whether the “Decree for the Reorganization of the Austrian Professional Civil Service” of 31 May 1938, which stipulated the dismissal of Jewish and politically undesirable officials ([50]: 235), applied to Asperger. In June 1939, the official charged with implementing the decree, Otto Wächter (1901–1949), decided to close the file because Asperger was “politically acceptable” from the National Socialist standpoint.Footnote 38 According to the Vienna NSDAP Personnel Office, Asperger was “unobjectionable with respect to his character and politics.” His Catholic orientation was considered a minus, but this was mitigated by the fact that he had not been actively involved with the Christian Social Party or the Austrofascist regime. Crucially, the assessment concluded that Asperger “was in conformity with the National Socialist racial and sterilization laws” (Fig. 4).Footnote 39

Fig. 4 Despite Asperger’s Catholic orientation, the Nazi Party authorities considered Asperger to be “politically irreproachable” and as someone who “was in conformity with the National Socialist racial and sterilization laws” (WStLA, 1.3.2.202.A5, Personalakt) Full size image

This investigation in all likelihood constituted the basis for Asperger’s claim, made 24 years later, that he had faced persecution by the Gestapo. Hamburger was certainly in a position to decisively influence the outcome of such a procedure, by vouching for his protégé’s willingness to cooperate with the regime—a less dramatic but much more plausible version than the alleged arrest, for which no documentary evidence exists. This explanation also correlates with Asperger’s 1974 account that Hamburger saved him “from the Gestapo” rather than “from being arrested by the Gestapo,” as he put it in 1962. If the latter story were true, it would be difficult to explain why Asperger (to the best of my knowledge) did not publicly mention it until 17 years after the war, although it would have benefitted both him and Hamburger.Footnote 40 In all, this investigation is the only documented instance of political trouble for Asperger; the sources otherwise reflect a spotless record of political accommodation with National Socialism.

In this context, a crucial question concerns Asperger’s role in a truly heroic episode involving the pediatrician Josef Feldner (1887–1973), who over many years volunteered on the Heilpädagogik ward. In September 1942, he took in Hansi Busztin (1925–1996), a Jewish patient of his, and hid him until the end of the war. Unusually, Busztin lived a relatively open life, with regular visits to the public library and the opera; he estimated that around 100 people knew about him, many of whom provided support [51]. In a memoir written in the 1980s, Busztin referred to “a group of opponents of National Socialism” on the Heilpädagogik ward, “nearly all of whom knew” about him and “helped his later adoptive father in various situations.”Footnote 41 Did Asperger belong to this circle of supporters? Busztin does not mention Asperger—and, interestingly, Asperger did not mention the episode even in instances where he was trying to establish his anti-Nazi credentials [3, 48] or in his 1975 obituary for Feldner [52]. Remarks published by Asperger in 1962 on the occasion of Feldner’s 75th birthday suggest, however, that he at least knew about Feldner’s activities, but did not play an active role in them:

It is clear that such a spirit had to be diametrically opposed to National Socialism. He acted accordingly. What he said and did during those years often made his friends’ hair stand on end. There are episodes—confrontations with the Gestapo, the hiding over years of a Jewish student whose family had been exterminated—which could have been taken from an adventure novel [53].

This episode could help explain why Asperger joined the military in March 1943.Footnote 42 In the 1974 interview already mentioned, he claimed to have volunteered to escape reprisals from the Gestapo because he had refused to cooperate with Nazi race hygiene policies [3]. While this is contradicted by the favorable assessments he continued to receive from Nazi officials (for example during the vetting for his Habilitation), the cited evidence and the timeline of events suggest a direct connection—namely, that he wanted to get away from the Vienna clinic in case Busztin were discovered.

One of the main arguments for Asperger’s ostensible distance to National Socialism is the fact that he never joined the NSDAP.Footnote 43 Given the high proportion of party members among non-Jewish physicians, this is certainly significant. This does not mean, however, that Asperger kept a principled distance from the NSDAP apparatus. In fact, he sought membership in several organizations affiliated with the NSDAP. According to a 1940 questionnaire, Asperger joined the Deutsche Arbeitsfront (German Labor Front, DAF) in April 1938, the Nationalsozialistische Volkswohlfahrt (National Socialist People’s Welfare Organization, NSV) in May 1938, and (as a candidate; see below) the Nationalsozialistischer Deutscher Ärztebund (National Socialist German Physicians’ League, NSDÄB) in June 1938. He also mentioned that he had committed himself to working for the Hitler Youth.Footnote 44

The DAF and the NSV were mass organizations often used to demonstrate loyalty to the regime while avoiding the ideological commitment of NSDAP or SS membership. The NSDÄB was a different matter, however. It saw itself as the ideological spearhead of the Nazi Party within the medical profession, as an advisor to the NSDAP “in all questions regarding public health and race biology” and as a recruitment pool for medical positions in the party apparatus. While full membership was restricted to NSDAP members, other health professionals who supported the goals of the NSDÄB could obtain the status of candidates, as did Asperger [54].Footnote 45

These memberships should be seen against the backdrop of the heavy Nazi influence at the clinic (see [4]: 120–1). Most likely, Asperger took these decisions in order to protect and further his career. By foregoing NSDAP membership, he chose a middle path between keeping his distance to the regime and outright alignment.

It is important to note that Asperger had all the political protection he needed through his mentor Franz Hamburger. Given the hierarchical structure of Austrian universities and the strong position of clinic chiefs, Hamburger was in a position to make or break Asperger’s career even under less complicated political circumstances. The political capital Asperger enjoyed thanks to Hamburger’s unwavering patronage was much stronger than anything he could have achieved on his own. Hamburger was one of the NSDAP’s figureheads within the Vienna medical school and had considerable clout within the Nazi medical establishment both in Vienna and—thanks to his position as president of the German Association of Pediatrics—in Germany generally ([4]: 129, 134). After the Anschluss, when the ban on the NSDAP was lifted, Hamburger could openly declare his allegiance to Adolf Hitler ([4]: 126). In a programmatic speech in 1939 (“National Socialism and Medicine,”) he revealed how central Nazi ideology was to his approach to medicine: “A teacher of obstetrics, a teacher of pediatrics, internal medicine, or neurology has to be a true National Socialist. He has to be completely permeated with the foundations of National Socialist life and health leadership” ([55]: 142). Asperger, without being a convinced National Socialist, clearly managed in Hamburger’s view to conform somehow to this highly ideological model of a physician.

As mentioned above, NSDAP functionaries on several occasions wrote confidential assessments of Asperger’s political orientation. Although they are the best sources available regarding Asperger’s attitude towards National Socialism and his standing in the eyes of the regime, these documents have not previously been examined. In all, they demonstrate how after an initial phase of distrust the party authorities came to see Asperger in an increasingly positive light. On 4 January 1939, for example, Asperger’s Ortsgruppenleiter (Local Party Group Leader) put the following on record: “no merits for the [Nazi] movement,” “attitude towards the NSDAP before the Anschluss indifferent,” “does not participate in public political life,” and “political orientation of the family Christian-Social”. It was noted positively that he had not taken any stance against the Nazi takeover in Austria. The Kreisleiter (District Party Leader) added to the same document: “his readiness to engage is only partially existent, because as a former Christian-Social he is quite indifferent.”Footnote 46

Less than 2 years later, Asperger’s political evaluations had changed in tone, even if his past affiliation with the Christian-Social camp was still held against him. One of several similar documents from his NSDAP personnel file reads as follows:

In response to your enquiry from 25 October 1940 I declare that Dr. Asperger is a faithful Catholic, but without supporting the political tendencies of Catholicism. Although he was a member of the Catholic association ‘Neuland’, he had no common interests with the politicians of the [former Austrian] system. Regarding questions of the racial and sterilization laws he conforms to National Socialist ideas. With respect to his character and in political terms he is considered unobjectionable.Footnote 47

Another high-ranking Nazi official’s evaluation from roughly the same time is similar in tone:

Dr. Asperger hails from Catholic circles and his orientation during the period of the [previous Austrian] system was strictly Catholic. He was a member of the Catholic organization ‘Neuland’ and of the physicians’ association ‘Lukas Guild’. He has never taken active steps of any kind against National Socialists, although it would have been easy for him to procure incriminating evidence at the Pediatric Clinic, which was staffed exclusively with Nazi physicians. In terms of his character, Dr. A. receives favorable descriptions.Footnote 48

Due to his political past, the party hierarchy treated Asperger with a certain reservation. This changed over time, however, as he was increasingly regarded as politically reliable, and no obstacles to his career resulted. This development culminated in Asperger obtaining his Habilitation in 1943, the academic qualification necessary to become a lecturer (and, eventually, a professor). According to the Nazi doctrine, medicine should be based both on science and the ideology of National Socialism. Therefore, Asperger had to both submit a postdoctoral thesis (his work on “autistic psychopaths”) and pass political vetting by the Nationalsozialistischer Deutscher Dozentenbund (National Socialist German Lecturers League)—which raised no objections (Fig. 5).Footnote 49 Additionally, since he had not obtained the title of Facharzt (medical specialist) in pediatrics, the NSDAP Gauärzteführer (Physicians’ Leader) of Vienna, Otto Planner-Plann (1893–1975), had to certify that he had the necessary qualifications. This is another indicator that Asperger enjoyed the trust of the highest ranks of the Nazi medical establishment in Vienna.Footnote 50

Fig. 5 In April 1943, the Vienna chapter of the NSDAP’s Nationalsozialistischer Deutscher Dozentenbund (National Socialist German Lecturers’ League) approved Asperger’s application to receive his postdoctoral Habilitation. (UAW, MED PA 17, Asperger) Full size image

After the Anschluss, Asperger tried to prove his loyalty to the new regime in various ways. In public lectures (which were later published), he argued in favor of his discipline’s mission within the Nazi state and declared his allegiance to the tenets of Nazi medicine (see the “‘The best service to our Volk’: Asperger and Nazi race hygiene” section). Indeed, Asperger went so far in these attempts that his collaborator, Josef Feldner, had to reign him in lest he risk his credibility: “Your lecture: the introduction is good as it is (maybe just a little bit too Nazi for your reputation). E.g., I would drop the thanks to the Führer. … I write what I have in mind, forcing myself to blow Hitler’s horn a little. Maybe you can make something of it.”Footnote 51 Asperger’s case files also demonstrate how he tried to prove his loyalty. Beginning in 1938, he took to signing his diagnostic reports with “Heil Hitler”—a merely symbolic, but revealing gesture.Footnote 52

Asperger’s Jewish patients

The question of Jewish patients on Asperger’s ward has not been raised in the literature so far, despite the fact that their fate is relevant for a number of reasons. How they were diagnosed and what decisions about their future were taken at the clinic had an important impact on their chances of survival. The files on the Jewish children also provide insights regarding Asperger’s actions under National Socialism and on his general attitude towards Jews.

Jewish children were proportionately under-represented among the ward’s patients even before they were successively excluded from public medical institutions after 1938. Perhaps the strong Nazi influence that pervaded the clinic after Hamburger’s takeover in 1930 deterred Jewish parents from seeking the clinic’s services—although the case records of Jewish children from the decade before the Anschluss (16 in total), except for isolated instances of stereotyping, show no evidence of anti-Jewish bias.Footnote 53

At the time of the Nazi takeover in Austria, two 13-year-old Jewish boys, Alfred S. and Walter Brucker, were patients at the ward. Alfred’s file contains no evidence that he was treated in any way differently from the other children. Admitted because of a scuffle at school, Asperger diagnosed the boy as an “autistic psychopath” on 22 March 1938. He found Alfred’s intellectual capabilities “above average in some respects” and recommended placing him with Jewish foster parents rather than returning him to his non-Jewish foster mother (whom Alfred liked). At the time, approximately 8000 children had been entrusted to foster families by Vienna’s youth welfare services. A number of these children—like Alfred—were Jews living with non-Jewish families. When the Nazis took over the city administration, this came to be regarded as a problem, and Jewish foster children were separated from their caretakers and segregated in Jewish orphanages, which for many became death traps during the Holocaust. Whatever his specific motivation might have been, in recommending Alfred’s placement specifically with Jewish foster parents, Asperger anticipated the Nazis’ official policy of segregation which took shape in the following years ([56]: 90, 101).Footnote 54 At a time when Jews were subjected to humiliation and violence in the streets and anti-Semitism became official policy, the decision to highlight the boy’s Jewish background—for which no medical or pedagogical reasons were given—seems questionable. A safer alternative would have been to avoid any reference to Alfred’s biological family, although in retrospect, it is impossible to say whether this would have made a difference. The diagnostic report itself is rather benevolent in tone; Asperger considered Alfred capable of functioning among adults, who would feel less provoked by his behavior than children. Ultimately, Asperger’s recommendation was not followed, and Alfred was transferred to a Jewish orphanage. His fate is unknown.Footnote 55

Walter Brucker was admitted to the clinic on 14 March 1938, the day following the Anschluss, because of extreme agitation. His record allows a rare insight into daily life on Asperger’s ward during these critical days. On 15 March, amidst cheering youngsters, Walter had to listen to a triumphant speech by Hitler. Despite the fact that as a Jew Walter had every reason to panic, his fearful reaction was held against him. The entry of that day (not in Asperger’s handwriting) stated that Walter “is much more disagreeable than three weeks ago, when he was [last] here. During Hitler’s speech, he put his head into his hands on the table and stared into a void. He was very agitated; when a child broke out in cheers he opened his eyes wide and turned pale.” Asperger’s diagnosis all but ignored the boy’s precarious situation and framed his mental troubles as follows: “severe psychopathy, with a particular sensitivity and paranoid irritability.” Asperger thus pathologized and de-politicized the boy’s reactions to the anti-Jewish persecution then pervading the city; based on the same logic, in a formulation that was perhaps meant as an act of generosity, he stressed that Walter could not be held fully responsible for his sometimes aggressive reactions. In his diagnosis, Asperger omitted the fact that Walter was Jewish and that his life was under threat from the Nazi regime. Although this is in line with Asperger’s general tendency to attribute mental troubles to “constitution” rather than environmental factors, in this particular case, it is possible that he was also trying not to highlight the boy’s Jewish background (in contrast to his actions in Alfred’s case). As it turns out, Walter indeed had every reason to be fearful. He died on 26 February 1945 as a slave laborer of “Projekt Riese,” the construction in Lower Silesia of underground facilities that included Hitler’s new headquarters [57].

As far as the written record is concerned, there is no indication that Asperger was guided by personal animosity towards Jews, but there is a notable absence of empathy for their plight under Nazi rule.Footnote 56 The report he wrote in November 1940 on 11-year-old Ivo P. supports this interpretation. He stressed that the boy was “not constitutionally dissocial,” and that he had good potential, provided that he would be held under permanent supervision in an institutional setting. Almost as an afterthought, he added: “The only problem is that the boy is a Mischling of the first degree” (Nazi jargon meaning that he had one Jewish parent)—a piece of information that under the circumstances was extremely dangerous for the boy.Footnote 57

Racial stereotyping became—not surprisingly—more frequent following the Anschluss. Marie Klein, admitted as a 9-year-old in late 1939, was described by one of Asperger’s assistants as a “normally developed, slightly underweight girl of Jewish appearance.” Asperger himself remarked that her manner of speaking stood “in contrast to her quite Jewish character” and noted on the cover sheet of her record that she was a “Mischling.” According to her file, Marie had never caused any trouble until she and her mother—who was a Catholic of Jewish descent—were forced out of their apartment in August 1938.Footnote 58 They had to move to an asylum run by the Catholic relief organization “Caritas Socialis” for Catholics of Jewish descent and children classified as “non-Aryan.”Footnote 59 From then on, Marie began to suffer from violent fits, which led to her admittance first to the psychiatric clinic and then to Asperger’s ward. When she spoke of the violent abuse she had suffered at the asylum, this was taken as an indication of her dishonesty rather than an explanation for the changes in her behavior.Footnote 60 Two years after her transfer from the Heilpädagogik ward to a children’s home in February 1940, Marie Klein was deported to the Wlodawa ghetto, 11 km north of the Sobibor extermination camp. The precise time of her death is unknown, but in summer 1942, there was an “Aktion” specifically targeting Jewish children between 10 and 14 years of age (Marie would have been 12 by then), who were separated from their parents and killed in the gas chambers at Sobibor [58, 59].

Lizzy Hofbauer, a 12-year-old Jewish girl, was admitted in 1939 because of severe mental troubles: “Two days before admittance she acted as if insane, talked of anti-Jewish persecution, was in great fear, asked herself is she was confused or insane. She thought a Jewish acquaintance had died from hanging, but could be convinced that this was not true.” Asperger interpreted these signs of distress as symptoms of schizophrenia and wrote the following: “For her age and race conspicuously retarded sexual development.”Footnote 61 These comments suggest that Asperger had at least partly internalized the sexualized anti-Jewish stereotypes circulating at the time.

This leads to the broader question whether Asperger held anti-Semitic views. Apart from the case files quoted above, there is scant direct evidence. On the one hand, hostility towards Jews and their alleged corrupting influence was a common ideological denominator of the groups Asperger associated with. Until the end of his life, as far as his public statements are concerned, he never distanced himself from the racialized anti-Semitism that pervaded Austrian and German political life during the twentieth century nor did he comment on the destruction this had brought down on the Jews of Europe during the Holocaust.Footnote 62 On the other hand, Asperger worked closely with Jewish colleagues such as Anni Weiss and Georg Frankl before the Anschluss—a relationship that due to the tightly knit community at the Heilpädagogik ward went beyond the purely professional and was renewed after the war ([10]: 102–4, 109). Like many aspects of Asperger’s life, his relationship to Jews was fraught with ambivalence—and further complicated by the fact that his early career profited from the removal of so many Jewish colleagues, including those he called his friends.

“The best service to our Volk”: Asperger and Nazi race hygiene

Although Asperger published at least a dozen papers during the Nazi period, the existing (especially English-language) literature focuses almost exclusively on two of these: “The Mentally Abnormal Child” from 1938 and “The Autistic Psychopaths in Childhood” from 1944 [1, 2]. In the following, I will broaden this narrow scope and present an analysis based on the full range of Asperger’s published statements on politics, race hygiene, and the role of Heilpädagogik in society. I will show that Asperger on several occasions supported tenets of Nazi race hygiene and medicine, contributing to their legitimization.

Among Asperger’s Nazi-era publications, the 1938 paper stands out for several reasons. Published 5 years before Leo Kanner’s famous 1943 article on autism, it contains the first account in the scientific literature of “autistic psychopathy” as a not previously described syndrome. As the written version of a lecture held less than 7 months after the Anschluss, it also reveals how Asperger positioned himself vis-à-vis the new rulers as someone who could be trusted to adapt to the new political situation. Crucially, Asperger opened with an endorsement of National Socialism’s anti-individualistic and totalitarian approach to medicine and health:

We stand in the midst of a massive reorganization of our intellectual and spiritual life, which has seized all areas of this life—not least in medicine. The central idea of the new Reich—that the whole is more than its parts, and that the Volk is more important than the individual—had to bring about fundamental changes in our whole attitude, since this regards the nation’s most precious asset, its health ([1]:1314).

Before the initiation of “euthanasia” killings in 1939, the most serious consequence of these ideas was the Law for the Prevention of Hereditarily Diseased Offspring of July 1933, under which 220,000 individuals had already been forcibly sterilized in Germany by the beginning of 1938 ([60]: 233).Footnote 63 Asperger’s audience of physicians were well aware of these policies, which had been widely debated in medical circles, so they must have understood what he meant by the following exhortation to cooperate with the regime’s sterilization policies:

You know by what means one strives to prevent the transmission of diseased hereditary material—many cases that belong here are hereditary disorders—and to promote hereditary health. We physicians have to take on the tasks that accrue to us in this area with full responsibility ([1]:1314).

Asperger repeated this motive of “responsible cooperation” with Nazi race hygiene in later writings. We will see shortly what these tasks entailed and how he handled them in the context of his own work. In his lecture, he went on to specify how the sterilization law should be implemented with regard to those children who had “features opposed in nearly every way” to the high-functioning autistic type described for the first time in the paper:

These children are intellectually below average (including to the degree of feeble-mindedness)—whereby with intelligence we mean abstract intelligence—whereas practical reason, in short everything that has to do with instinct, including the practical usefulness and the values of character, are much better developed in relative terms. These cases are important—or at least they will be as soon as the Law for the Prevention of Hereditarily Diseased Offspring comes into force here. If the physician has to take a decision in such a case, he will not be allowed to do so based solely on a questionnaire or the intelligence quotient. Rather, he will base it primarily on his knowledge of the child’s personality, taking into account all of the child’s skills in addition to abstract intelligence ([1]:1317).

This passage has been quoted as evidence that Asperger tried to publicly protect his patients from forced sterilizations ([8]: 364; more cautiously [9]: 206–7). This call for restraint is all the more significant given the pending investigation into Asperger’s political reliability (closed in June 1939, see above). Why did these comments then not hurt his standing in the eyes of the Nazi hierarchy, which came to the conclusion that he was in conformity with Nazi race hygiene policies?

It should be noted that calling for a “holistic” approach to children’s personalities was not unusual as such—it was in fact characteristic of the approach at the Heilpädagogik ward since Lazar’s days. In the ideological context of post-Anschluss Vienna, putting Gemüt (“soul” or “character”) and “practical intelligence” over “abstract intelligence,” far from being out of line, corresponded with the Nazis’ overall disdain for analytical thought, which they connoted as “Jewish.” Indeed, the official legal commentary on the sterilization law defined “feeble-mindedness” along similar lines ([61]: 119). The notion of Lebensbewährung (“probation in life”), which the sterilization courts applied in cases with unclear heredity, also underlines how race hygiene policy was guided by a “holistic” approach to intelligence ([62]: 124). In 1940, practical skills and “performance” became the decisive criteria in decisions on race hygiene measures.Footnote 64

It is important to note that Asperger focused on skills, where others were primarily concerned with defects. Overall, however, assessing “hereditary value” according to a range of criteria rather than intelligence alone could cut both ways for the patients; those classified as “autistic psychopaths” may well have scored better on intelligence alone. While Asperger’s 1938 speech should not be misconstrued as a fundamental critique of race hygiene, it is an example of how he managed to formulate certain concerns without violating the boundaries of the politically acceptable.

Another of Asperger’s publications (from 1939) captured in a nutshell the central tenets of Nazi medicine, including its typically euphemistic language, as in “restrictive measures”:

In the new Germany, we physicians have assumed an abundance of new responsibilities in addition to our old ones. To the task of helping the individual patient is added the great obligation to promote the health of the Volk, which is more than the welfare of the individual. I do not need to elaborate on the enormous dedicated work being performed in terms of positive, supporting measures. But we all know that we also have to carry out restrictive measures. Just as the physician often has to make painful incisions during the treatment of individuals, we also have to perform incisions on the national body [Volkskörper], out of a sense of great responsibility: We must ensure that the diseased who would transmit their diseases to remote generations, to the detriment of the individual and of the Volk, are stopped from transmitting their diseased hereditary material ([63]:943).

The potential impact of the Nazi race hygiene paradigm on Asperger’s work was to a large extent determined by the role inheritance was thought to play in the transmission of personality traits and mental disorders. In this regard, Asperger stressed the benefits of optimal environmental conditions (such as those present at his clinic) even when hereditary makeup (what he referred to as “constitution”) was defective:

Therefore we are called more than others to contribute decisively to what is probably the most important area of research on human heredity, namely the questions concerning the inheritance of mental traits and mental abnormalities. We must also lead the way in the practical tasks of eugenics, especially with regards to the problems relating to the Law for the Prevention of Hereditarily Diseased Offspring—and not just the physicians, but also the special school teachers we work with. But we also have […] opportunities few others have to study the decisive question: ‘What influence do optimal environmental conditions have on hereditarily burdened individuals, what can “education in spite of inheritance” achieve, is pedagogic work with individuals outside the norm worth the trouble?’ ([49]:353)

Although many race hygienists were more dogmatic in terms of a one-sided genetic determinism, Nazi ideology was not monolithic. Asperger’s flexible approach was not only compatible with hardline measures such as forced sterilizations (as this passage illustrates), it was also in line with other powerful currents such as the Hitler Youth’s paradigm of pedagogy and leadership or the mainstream of Nazified Heilpädagogik ([64]: 161–6, 178–92).Footnote 65

In his 1944 paper on autism, Asperger reiterated his belief that an individual’s possibilities of mental development were primarily determined by their genetic makeup; thus, Heilpädagogik could only hope to achieve improvements within these predetermined parameters: “It has been firmly established that psychopathological states are anchored in the human constitution and are therefore inheritable; yet it has also been established that it is vain to hope to find a clear, simple mechanism of inheritance” ([2]: 135). While this view has stood the test of time with regard to specific disorders such as autism, it was seriously misguided in other cases, for example, when Asperger diagnosed children as young as five in terms reminiscent of Lambroso’s “born prostitutes” or “born criminals.” In cases of sexual abuse, he often tended to blame the victims, based on the notion of constitutionally determined patterns of behavior which supposedly encouraged (or “seduced”) the perpetrators.Footnote 66

A key element in the established narrative of Asperger as a principled opponent of Nazi policies derives from his repeated appeals to treat troubled children with the utmost dedication to help them overcome their challenges ([20]: 17, [21]: 127–9). A number of Asperger’s publications indeed convey an attitude of sympathy towards his patients, and on several occasions, he pleaded for tolerance and attention towards them. One of the most significant passages in this regard is contained in his 1944 paper on autism:

We think that such individuals have their own place in the organism of the social community, which they fully occupy, some of them maybe in ways nobody else could. […] Such individuals show more than others what capacities for development and adaptation even abnormal personalities dispose of. Often, in the course of development, possibilities for social integration arise which one would not have expected before. […] This fact determines our attitude and our value judgment towards difficult individuals of this and other kinds and gives us the right and the obligation to stand up for them with the whole force of our personality ([2]:135).

This is in line with his 1938 speech, in which he also expressed his determination to side with his patients:

But let me discuss this problem today not from the standpoint of the Volk as a totality—in this case one would have to primarily focus on the Law for the Prevention of Hereditarily Diseased Offspring—but from the standpoint of the abnormal children. How much can we accomplish for these children shall be the question ([1]:1314).

Again the question is whether this approach put Asperger at odds with the regime or even made him vulnerable to reprisals, which is a central claim in the narrative of his resistance to the Nazis. The evidence, however, does not support this. Indeed, the fact alone that Asperger’s statements continued to be published in journals controlled by Nazi loyalists shows that they were not perceived as critical of the regime. Furthermore, Asperger’s career advanced unhindered during this period. Repeatedly vetted for promotion, he received positive assessments regarding his political reliability, as discussed in the “Political trajectory after the Anschluss in 1938” section.

Most importantly, it is a misunderstanding that therapeutic support for “abnormal” children had no place in the Nazi state, determined as it was to exterminate mentally disabled individuals. Due to increasing labor shortages, it became a political and military imperative to rehabilitate as many potential workers as possible, even those considered of inferior hereditary quality. In the context of “euthanasia,” the extermination of “incurable” patients—after attempts to improve their condition had failed—coincided with an increased interest in “active therapy.” The dichotomy of murder and therapy is exemplified in the introduction of electroconvulsive therapy, which was promoted by “T4,” the organization responsible for the gassing of tens of thousands of patients, to reduce the residual group of “incurable” patients [65].Footnote 67 In this light, Asperger’s pleas to spare no effort in educating and guiding “difficult” children were not necessarily a challenge to Nazi pedagogy and race hygiene; rather, this was easily compatible with the Nazi state’s aim to control, discipline, and organize children and youths deemed “worthy” of belonging to the Volksgemeinschaft (“people’s community”). This was stressed by Asperger himself, who repeatedly insisted on the productive role Heilpädagogik could play within the new Nazi order, including in his 1938 speech:

And if we help them [the abnormal children] with all our dedication, we also render the best service to our Volk; not only by avoiding that they burden the Volksgemeinschaft with their dissocial and criminal acts, but also by trying to ensure that they fulfill their duties as productive individuals in the living organism of the Volk ([1]:1314).

Indeed, even the most virulent Nazis among Asperger’s colleagues endorsed therapy for those seen as potential assets to the state. This includes Asperger’s mentor Franz Hamburger and also applies to Erwin Jekelius, a pediatrician trained at Hamburger’s clinic, who in 1940 became the main organizer of the “T4” killing operation in Vienna. He made sure that local authorities and hospitals cooperated and that the operation ran smoothly. From June 1940 to the end of 1941, Jekelius directed the child killing facility Am Spiegelgrund, where hundreds of disabled children were murdered.Footnote 68

Jekelius had received part of his training at the Therapeutic Pedagogy Ward under Asperger’s direction, where he was employed from August 1933 to February 1936 ([10]: 102, 49). The two men maintained professional contacts during the Nazi period. In 1941, when Jekelius became the first chairman of the newly established Viennese Association for Therapeutic Pedagogy, Asperger represented the Pediatric Clinic along with Hamburger ([4]: 172–3). At Vienna’s Main Health Office, where Jekelius directed a unit in charge of “the mentally ill, psychopaths, and addicts”—a position that he used as a cover for his activities for “T4”—Asperger on 1 October 1940 began to work (part-time) as a medical specialist and evaluator of children with mental “irregularities” (Auffälligkeiten). One document in Asperger’s personnel file suggests that in this capacity, he was attached to Jekelius’ unit, while others place him in a different unit of the same department, a discrepancy possibly due to disruptions in the city administration during this period.Footnote 69 In any case, the fact that Asperger was named as a member of Jekelius’ staff suggests that he obtained the position on Jekelius’ recommendation or at least with his consent. Due to a lack of sources, the exact nature of Asperger’s work for the city in this context (and of his collaboration with Jekelius) remains unclear—with the crucial exception of the screening of more than 200 children in a mental institution in Gugging near Vienna, many of whom were sent to die at Jekelius’ Spiegelgrund institution (see the “Limits of ‘educability’: Asperger and the Spiegelgrund ‘euthanasia’ facility” section).

Erwin Jekelius represents Nazi medicine in its most inhumane extremes: a fanatical Nazi and a murderer responsible for the deaths of thousands of patients. Had Asperger deviated from the party line, Jekelius would certainly have reined him in. Instead, this is what Jekelius had to say about Asperger and his therapeutic approach:

At this opportunity, I would like to remind you of the substantial lecture on therapeutic pedagogy which our Dr. Asperger gave last year in this same place. He explained in a vivid and convincing way that especially in the Third Reich, with an abundance of new tasks and a lack of manpower, one cannot relinquish those who ‘stand at the margin’. He mentioned impressive examples of former patients at the Heilpädagogik ward who proved themselves brilliantly on the internal and external front during the great struggle for the final liberation of our German people. And more than one former ‘problem child’ who today bears the Iron Cross for valiant behavior before the enemy would probably have gone to the dogs had one not taught him according to therapeutic pedagogic principles how to defeat the inner enemy ([66]:386).

To be sure, when their writings are set side by side, there is an enormous divide between the two men in tone. This is also apparent in the following passage, in which Jekelius states what should be done with children not deemed treatable with Heilpädagogik: “The idiot is sent to an asylum, and the anti-social to a concentration camp for minors” ([66]: 385).Footnote 70 This is far harsher language than Asperger ever used, who instead emphasized empathy for “abnormal” children. But as Jekelius’ approving nod to Asperger indicates, even he agreed on the role of Heilpädagogik in rehabilitating troubled children in order to turn them into productive members of the German body politic.

This utilitarian approach, broadly accepted as the raison d’être of Heilpädagogik, is a leitmotif throughout Asperger’s writings during the Nazi period and beyond:

I wanted to emphasize this from the beginning, when I talk today about our Aesculapian obligation specifically towards the psychologically abnormal individual, as I see this obligation. […] The question is: is the task of caring for intellectually or personally abnormal individuals worth our full commitment? […] The mentioned facts show us well enough that we often have to be very careful with the disdainful verdict of ‘inferior value’ and potential consequences that might follow from it. […] But if we care for these people—and be it with painful commitment and willing to make sacrifices—we will be able to take at least part of them to a point where they will not be a burden and danger to the national community, but its productive members ([63]:944).

In the 1941 paper referred to by Jekelius, Asperger defined the relationship between his own professional credo and the Nazi state’s pedagogic program in even more explicit terms:

Our time has brought revolutionary changes in the field of education: Whereas in earlier times a number of philosophical, political, and religious orientations stipulated their pedagogic goals and consequently were in competition with each other, today National Socialism has established its pedagogic goal and demands that it be the only valid one. As much as this development is to be approved, we nevertheless have to stress: This one goal, the integration into the National Socialist state, can only be achieved with these children by using different means. […] From innumerable reports and visits, also from letters from the front, from soldiers’ visits we know how many of our former children, including very difficult cases, entirely fulfill their duties in their professions, in the armed forces, and in the [Nazi] party, not a few among them in eminent positions. This is how we know that the success of our work is worth the effort [67].Footnote 71

This paper was originally presented in September 1940 at a prominent pediatric conference in Vienna. Asperger was one of only three speakers from Vienna. The keynote speaker was Reich Health Leader Leonardo Conti (1900–1945).Footnote 72 While this helps explain Asperger’s references to the war effort and the party, it also demonstrates that he was deemed trustworthy enough to represent his field in such a prominent forum and that the positions he adopted were by no means considered unacceptable or even controversial by the Nazi hierarchy. On the same occasion, Werner Villinger (1887–1961), the founding father of youth psychiatry in Nazi Germany and an expert evaluator for the “T4” killing campaign, expressed the dichotomy between “education” and “elimination”: “Only where this [successful educational attempts] proves to be impossible, a weeding out needs to take place, with permanent internment in a work colony of sorts” ([68]: 1161).Footnote 73 The complex and sometimes contradictory attitude towards children with disabilities or other challenges is underlined by the fact that the Hitler Youth had special formations for the blind and the deaf ([64]: 166–75). Overall, as we have seen, it was not in dispute that Heilpädagogik had an important role to play in helping alleviate the acute shortage of manpower that threatened Nazi Germany’s war effort.

The decisive question that remained was what should happen to the residual group of children whose disabilities were so impairing that efforts towards rehabilitation could not be justified under the utilitarian approach dominant at the time, and also professed by Asperger. While Jekelius explicitly mentioned “concentration camps” (for the rebellious) and “asylums” as a last resort (omitting the extermination of disabled children then taking place under his direction), Asperger chose to remain silent on this matter. This has critical implications, not least with regard to the relatively small subset of his patients whom he labeled as “autistic psychopaths.”Footnote 74 Some authors argue that Asperger put the spotlight on children at what is often called the “high-functioning” end of the spectrum, interpreting this as a tactic to protect all children with autistic traits from race hygiene measures (e.g., [21]: 129, 216). This argument is problematic for several reasons.

First, the idea that Asperger tried to protect autistic children from Nazi race hygiene cannot be easily reconciled with the fact that he dedicated a section of his 1944 paper to the hereditary basis of the condition, insisting that “any explanation based on exogenous factors is absurd”. While this position anticipated later advances in autism research, the question arises whether under the circumstances it was prudent to put such an emphasis on heredity. Had protecting his autistic patients been his primary goal, he could have taken a more flexible position, one less likely to draw the attention of race hygienists to his patients ([2]: 128–32).

Second, his prognoses for the “autistic psychopaths” were far from universally optimistic. In his 1938 paper “The Mentally Abnormal Child,” he presented two boys. One boy was “intelligent far beyond his age” but suffered from mental and physical “oversensitivities” (no link to autism). The other represented the first case of an “autistic psychopath” in medical literature. Like the first boy, he exhibited “a contrast between pathological and in some ways valuable traits,” but as Asperger insisted, he suffered from a “profound disorder of the personality.” In this article, Asperger did not highlight the potential of “autistic psychopaths” but rather contrasted them unfavorably with other, less impaired patients. Even if the boy Asperger chose as an example of “autistic psychopathy” clearly belonged to the “high-functioning” group, Asperger emphasized that the condition varied greatly in terms of “social prognosis” and “worthiness.” While he deemed some of the “autistic psychopaths” capable of “great intellectual achievements,” in other cases, “autistic originality” was deemed “bizarre, eccentric, and useless”, with “fluid transitions towards schizophrenia” whose “main characteristic is also autism, the loss of any contact with the surroundings” [1]. The four boys featuring in his better known 1944 paper also varied considerably regarding the degree of their impairments, belying the notion that he focused on the most promising cases in order to present “autistic psychopathy” in a mostly favorable light. Fritz had (for his age) outstanding abilities in mathematics, but was incapable of attending regular school, having passed the first three school years by homeschooling. Harro’s autistic symptoms were less severe, but despite his good intellectual potential, he also had great difficulties concentrating and learning in the traditional school setting. The best hope for “autistic psychopaths,” according to Asperger, was to find a way to compensate for the lack of “instinctive social adaptation” via the intellect. The problem was, however, that the “autistic character” also occurred in the “intellectually lesser able, and even in the severely feeble-minded” ([2]: 85–103). In the case of Ernst, Asperger expressed “doubt whether he was particularly smart or feeble-minded” (he struggled to keep up even in special school). But, as Asperger insisted, there were “numerous clearly feeble-minded children who also exhibited the unmistakable features of the autistic psychopath” ([2]: 108). These latter cases, according to Asperger, were often very similar to conditions caused by organic brain damage such as birth trauma. He illustrated this with the fourth case in his study, Hellmuth, whom he described not as an “autistic psychopath” but as an “autistic automaton” ([2]: 110–1).

One could argue that even though Asperger mentioned children with impairments so severe as to exclude them from any useful place in society, he nevertheless embellished the overall picture of “autistic psychopathy” as far as his scholarly standards would allow him. Indeed, he insisted that only a small number of “autistic psychopaths,” those additionally burdened with a “clear mental inferiority,” were incapable of at least some degree of social integration. Nevertheless, the argument that Asperger focused on the better-functioning cases in order to protect all of his patients (presumably, by deflecting attention from the less well-functioning) is questionable given that Asperger by no means withheld from his readers the severe impairments of some of the boys.

Third, there is a fundamental flaw in the assumption that highlighting the potential of some of his patients would benefit all of them. The children at the lower end of the spectrum did not benefit from the potential ascribed to those on the higher end, even if they shared the overall diagnosis of “autistic psychopathy.” Their fate did not depend on the diagnostic label but on the individual assessment of their skills or disabilities. If anything, the utilitarian argument of “social worth” employed by Asperger (and by many of his colleagues) increased the danger to those children who could not fulfill these expectations. Focusing on the higher functioning children did nothing to lift the boat for all of them; those on the lower end still risked being left to drown. Often, Heilpädagogik’s function in this context was to decide where to draw the line.

The preference for children who could be expected to respond positively to pedagogical intervention and the exclusion of the “hopeless” was a feature of Heilpädagogik from its inception in early twentieth-century Austria. It is important to keep in mind that the mission of Asperger’s Heilpädagogik ward was primarily to deal with “difficult” children who caused problems that their caregivers were unable to confront without professional help.Footnote 75 Children with severe mental disabilities were considered to fall outside the remit of Heilpädagogik since they promised no tangible progress. At the 1935 founding meeting of the Austrian Society of Heilpädagogik, Theodor Heller (1869–1938), one of its most influential figures, stated: “Curative pedagogy, however, will only attend to the educable elements and must hardly burden itself with the care for idiots.” The “uneducable” should be cared for in special institutions on humanitarian grounds, by contrast to the rationally and economically justified efforts of Heilpädagogik for the “educable” ([69]: 8–9).Footnote 76 During the Nazi period, Bildungsunfähigkeit (uneducability) became the key criterion in the child “euthanasia” program [70].

Highlighting the potential of some patients should not then be mistaken for the defense of all children with disabilities. Rather, it served to point out the usefulness of Heilpädagogik to society. Also, Asperger did not adopt this strategy in reaction to the Nazi takeover in Austria. A 1937 paper (with the same title he would use in 1938) already used similar arguments in support of Heilpädagogik’s mission [71]. It is not hard to see why in the post-Anschluss climate Asperger felt it necessary to explain what he and his discipline had to offer to the new political regime, by stressing his allegiance to the fundamental principles of National Socialism and by adapting earlier arguments of Heilpädagogik’s utilitarian mission to the new political realities.

Overall, Asperger’s pleas to devote the best possible care to “abnormal” children did not place him outside the mainstream of Heilpädagogik and the nascent discipline of youth psychiatry under National Socialism. The papers presented to the first conference of the newly founded German Society for Child Psychiatry and Heilpädagogik, held in Vienna in September 1940, also reveal that Asperger’s positions clearly aligned with the opinions considered legitimate at such a representative forum. Although some of the speakers emphasized Heilpädagogik’s role in implementing mechanisms of race hygienic selection, the positive aspects of helping children reach their potential (within the limits set by their inherited constitution) also had a prominent place. If Asperger’s writings on his patients stood out because of their warmer tone, nothing, however, of what he said was out of line with the officially sanctioned discourse ([72]; for details, see also [73]).Footnote 77

The adaptation of the Viennese brand of Heilpädagogik to the new political order and its race hygiene paradigm was facilitated by the fact that, since 1930, Hamburger had purged the influence of currents such as psychoanalysis and established the predominance of a purely biologistic paradigm based on the importance of inherited “constitutional” defects [74, 75]. Asperger, who had begun his career under Hamburger, shared many of these views, including a staunch opposition to psychoanalysis [76].

Heilpädagogik, then, was not only compatible with the Nazi state’s goal of building a national community (while excluding “unworthy” and “racially alien” elements); there was even an increased demand for experts willing to draw the line between those who could be expected to become useful members of this community and those who should be cast aside ([73]: 184). This increased demand, together with the exclusion of Jewish doctors,Footnote 78 led to additional career opportunities for Asperger, for example, his appointment as an expert witness in May 1938 to the Vienna Juvenile Court.Footnote 79 As mentioned, in October 1940, he additionally acquired a part-time position at the Public Health Office as the city’s medical specialist for “abnormal children,” a function related to Vienna’s special school system.Footnote 80 In this capacity, he routinely wrote expert opinions which are hard to reconcile with his 1974 claim not to have reported patients to this office [3]. According to Hamburger, Asperger’s expert opinions were regarded as the “highest authority” not only by the youth welfare office and the youth court but also by the National Socialist Welfare Organization (NSV).Footnote 81

Public health offices in Nazi Germany systematically collected information for a “hereditary index” (Erbkartei) of the whole population, designed to direct race hygiene measures against those deemed of inferior hereditary quality.Footnote 82 Staff at the Spiegelgrund “euthanasia” facility routinely reported patients in this context.Footnote 83 The records from Asperger’s ward, by contrast, contain only a small number of such documents.Footnote 84 This would indicate that Asperger was indeed reluctant to report his patients for the “hereditary index”—provided that the records have not been purged of incriminating documents, which cannot be ruled out, since they were kept at the clinic where Asperger was director from 1946 to 1949 and again from 1962 until his retirement in 1977 [77]. In some cases, however, he demonstrably cooperated in such matters. At least seven patient files from his ward contain correspondence with the Public Health Office’s Department for Hereditary and Racial Care (Erb- und Rassenpflege), in four cases signed by Asperger personally. There is no indication as to why the department responsible for the “hereditary index” was involved in these cases but not in so many other similar ones.Footnote 85

A sample of 30 patients admitted both to Asperger’s ward and to Spiegelgrund allows for a comparison of how children were diagnosed at the two institutions. In the next section, we will see what this comparison reveals about Asperger’s diagnostic approach, not least with regard to his often-claimed “pedagogical optimism” (details on the sample are also offered there). Regarding references to heredity and race hygiene, the result is the following: In 14 of the 30 cases, the files contain reports suggesting a hereditary factor in the child’s condition. In two of these cases, both Asperger and the Spiegelgrund staff suggested a hereditary etiology. In two other cases, Asperger included a reference to heredity in his report, but the Spiegelgrund staff did not. In ten of the cases, however, only the Spiegelgrund doctors referred to heredity. In the four cases in which Asperger referred to a hereditary factor, he did so by using the term “degenerative” (for example ascribing to the children a “degenerative constitution” or “degenerative personality”), without however suggesting any eugenic measures such as sterilization.Footnote 86 The doctors at Spiegelgrund were clearly more inclined to refer to heredity, either directly as an alleged etiological factor or indirectly by including negative information on the child’s Sippe (kin).

Neither the Spiegelgrund files nor the case records from Asperger’s own ward contain evidence that he ever reported one of his patients to the Public Health Office for the purpose of sterilization.Footnote 87

These findings support Asperger’s claim of non-cooperation with the sterilization program, though here, too, we must allow for the possibility of files having been purged. This raises the question whether this non-cooperation by omission should be considered a form of resistance. It is important to note that the sterilization program in Nazi Austria was never implemented on a scale comparable to Nazi Germany between 1934 and 1939 and that children were not its primary targets. In Vienna, the Hereditary Health Court decreed a total of 1515 sterilization cases. Although in one case a child as young as 13 was ordered to be sterilized, 83% of victims were older than 20 ([78]: 97, 144).Footnote 88 Failure to comply with the sterilization law was widespread at the time, and there are no indications that this carried personal risks such as persecution by the Gestapo ([78]: 115). In 1942, the Public Health Office complained to the director of the general hospital (to which Hamburger’s pediatric clinic belonged) that the hospital’s clinics often failed to report patients with hereditary conditions ([78]: 116). Also, for those of Asperger’s patients who were admitted to the clinic, this responsibility fell on Hamburger as the director, shielding Asperger from—in any event unlikely—consequences.Footnote 89

Crucially, only one of the surviving patient records from Asperger’s ward contains an explicit reference to the sterilization law; the documents are in accordance with Asperger’s publicly stated position on sterilization, calling for “responsible implementation.” In 1940, Asperger wrote a diagnostic opinion on Therese B., a 16-year-old former patient whose father wanted to have her sterilized because of alleged promiscuity. Asperger diagnosed her with psychopathy and “traits of nymphomania,” but pointed out that strictly speaking, she did not fall within the purview of the sterilization law, since her behavior had in all likelihood been caused by an earlier encephalitis, and not by a hereditary defect.Footnote 90

More problematic is a report on a 15-year-old deaf-mute boy which Asperger addressed to the Health Office’s Department of Hereditary and Racial Care in March 1942. Under the category “kin,” Asperger listed various cases of deaf-muteness among Ernst’s relatives.Footnote 91 Although Asperger did not explicitly refer to sterilization, the information provided meant that the addressee would have to initiate a sterilization procedure on the grounds that the condition appeared to be hereditary.Footnote 92 Asperger could have omitted this information without any risk, but in this case (as in those he referred to Spiegelgrund, analyzed in the next section), it seems that he was willing to cooperate as long as he did not have to take direct responsibility for the consequences.

There is one case in which documents suggest that Asperger may have helped shield a patient from possible persecution. In the fall of 1939, he examined Aurel I., the 14-year-old son of a civil servant, who showed “behavioral peculiarities.” In his report, Asperger wrote that the boy would suffer mental and physical damage if placed among a group of children, which resulted in his exemption from school. His family then moved him to the countryside, where he spent the war in the care of relatives. In a 1962 letter, his sister credited Asperger with having saved Aurel from “castration” and possibly worse.Footnote 93 Asperger wrote his report just days before the sterilization law was introduced in Austria, an event that was widely publicized [79]. In 2009, a Cologne art dealer (who had bought Aurel’s estate of drawings and papers) wrote to Asperger’s daughter speculating that Aurel, who after the war was diagnosed with schizophrenia, might have shown autistic traits when examined by Asperger.Footnote 94 Ultimately, it is impossible to say with certainty what happened in 1939, and to what extent the dramatic elements of the story are a product of the years that passed before the quoted letters were written.

What emerges from the available sources is that Asperger’s approach to the forced sterilization program was ambivalent. On the one hand, as mentioned, he publicly signaled his fundamental agreement with the policy while calling for its cautious and “responsible” implementation—which is consistent with his overall strategy to demonstrate his willingness to cooperate with the regime without taking hardline positions on race hygiene. At the same time, based on his ward’s patient records, it appears that he abstained from reporting children for sterilization—a stance that does not seem to have put him at odds with the Nazi authorities, given the circumscribed implementation of the sterilization law in Austria. By the time the first procedures under the sterilization law were carried out in Austria in the fall of 1940, the prevention of “hereditarily diseased offspring” could rely on another, more radical method; with the establishment of Am Spiegelgrund in July 1940, the child “euthanasia” program had a dedicated killing facility in Vienna. Even if the vast majority of Asperger’s patients did not suffer from the degree of mental disability that the program was designed to eradicate, a number of them were killed at Spiegelgrund. His role in this context is the topic of the next section.

Limits of “educability”: Asperger and the Spiegelgrund “euthanasia” facility

In his wartime publications, Asperger appears as someone who declared his willingness to cooperate with the Nazi state, propagated—albeit less enthusiastically than others—elements of Nazi race hygiene, and tried to argue that his discipline had an important role to play within the new political order. His main argument was the ability of Heilpädagogik to turn troubled, difficult, or “abnormal” children into useful members of society. His professed pedagogical optimism reached its limits, however, in children with greater degrees of mental disability. Although in his ward he usually dealt with more promising cases, in the course of his manifold activities as an expert for “abnormal” children, he was also confronted with children for whom the Nazi state had little more in mind than discreet medicalized extermination. In this regard, as we will see, his record was mixed.

Am Spiegelgrund was founded in July 1940 on the premises of Vienna’s Steinhof psychiatric hospital, after approximately 3200 patients had already been sent to the T4 killing facility in Hartheim [80]. The new facility was headed by Erwin Jekelius, Asperger’s former colleague at the university clinic. During Jekelius’ tenure at Spiegelgrund, the facility became a collecting point for children who did not conform to the regime’s criteria of “hereditary worthiness” and “racial purity.” From 1940 to 1945, nearly 800 children perished at the institution; many of them murdered by poisoning and other methods [81].

On 27 June 1941, 2 months before her third birthday, Asperger examined a girl at his clinic named Herta Schreiber (Fig. 6). The youngest of nine children, Herta showed signs of disturbed mental and physical development ever since she had fallen ill with encephalitis a few months before. Asperger’s diagnostic report on Herta reads as follows:

Fig. 6 Herta Schreiber at the Spiegelgrund “euthanasia” clinic, where she died 3 months after admission (photo has been cropped) (WStLA, 1.3.2.209.10, Nervenklinik für Kinder, Krankengeschichte Herta Schreiber) Full size image

Severe personality disorder (post-encephalitic?): most severe motoric retardation; erethic idiocy; seizures. At home the child must be an unbearable burden to the mother, who has to care for five healthy children. Permanent placement at Spiegelgrund seems absolutely necessary.Footnote 95 (Fig. 7)

Fig. 7 Hans Asperger recommended Herta’s transferal to Spiegelgrund because she “must be an unbearable burden to her mother,” 27 June 1941 (WStLA) Full size image

Herta was admitted to Spiegelgrund on 1 July 1941. On 8 August, Jekelius reported her to the Reich Committee for the Scientific Registration of Serious Hereditary and Congenital Illnesses, the secret organization behind child “euthanasia.” In the form he sent to Berlin, Jekelius pointed out that Herta had no chance of recovery but that her condition would not curtail her life expectancy—an unacceptable combination in the eyes of the euthanasia “experts” (Fig. 8). On 2 September, a day after her third birthday, Herta died of pneumonia, the most common cause of death at Spiegelgrund, which was routinely induced by the administration of barbiturates over a longer period of time.Footnote 96

Fig. 8 On 8 August 1941, Erwin Jekelius reported Herta to the Reich Committee for the Scientific Registration of Serious Hereditary and Congenital Illnesses, the secret organization responsible for the child “euthanasia” program (WStLA) Full size image

A note in Herta’s Spiegelgrund file indicates that her mother not only knew what fate awaited her child at the facility but that she accepted or even expected it:

Mother asks to be notified if the condition of the child should get worse. The husband should not be informed, he would be too upset. She says in tears that she can see for herself that the child is mentally not well. If she cannot be helped, it would be better if she died. She would not have anything in this world, she would only be ridiculed by others. As the mother of so many other children she would not want that for her, so it would be better if she died.Footnote 97 (Fig. 9)

Fig. 9 A note in Herta’s Spiegelgrund file suggests her mother was aware that her daughter would be killed at the clinic (WStLA) Full size image

In the context of Nazi-ruled Vienna, it seems that Herta’s mother, with a husband at war and six children to take care of—one of them with a severe mental disability—had reached a point where the possibility of having that responsibility taken off her shoulders would seem like a relief, even if it meant knowingly surrendering her daughter to death. In a society permeated by contempt for “unworthy life,” the social stigma of mental disability must have been acute—and the fear of ridicule is indeed the main argument in the quoted document. From Herta’s religious denomination gottgläubig (deistic), it can be inferred that the family had left the Catholic Church under the influence of the Nazis’ opposition to organized religion, a practice that was usually followed only by a radical minority of Nazi sympathizers ([82]: 281–3). To this, we have to add a lack of institutional support since more and more homes for disabled children were dissolved and rededicated as institutions for the “healthy” and “valuable” children.

What took place between Herta’s mother and Asperger before the latter decided to transfer Herta to Spiegelgrund? Did they openly discuss the possibility of “euthanasia”? If so, did she turn to Asperger with her mind already made up, or was it he who offered this as a “solution” to her? Or did he decide independently what he thought best, based on the information she provided? From the available documents, we cannot know with certainty. All we have to go by is Asperger’s short note on Herta in which he calls for her “permanent placement” at Spiegelgrund—whether this was a conscious euphemism for murder or not, it is clear that he did not expect Herta to return.

This case is revealing not least with respect to Asperger’s therapeutic credo. As previously mentioned, he repeatedly called for giving people with mental anomalies the best available care in order to develop their potential as far as possible. However, he never addressed the question of what should happen in cases without hope of improvement. The children Asperger advocated for were those who promised some future benefit to society. We must not confuse them with the group labeled bildungsunfähig (uneducable), which was targeted for murder in the child “euthanasia” program. In Herta Schreiber’s case, Asperger did not expect any future improvement, rendering further efforts futile. His diagnosis (albeit with a question mark) was “post-encephalitic status.” In 1944, he published an article on this topic, in which he wrote: “All the work done at our ward is carried forward by a strong pedagogic optimism. But in the case of these post-encephalitic personalities, we too have to say that one in most cases has to largely capitulate” ([83]: 116).Footnote 98 The transfer of Herta Schreiber to the Spiegelgrund facility looks like such a capitulation.

Perhaps it is no coincidence that another girl who was recommended for transferal to Spiegelgrund by Asperger suffered from similar symptoms, also attributed to an earlier infection. According to Asperger’s evaluation, the case of 5-year-old Elisabeth Schreiber (no apparent relation to Herta) bears other similarities as well:

Erethic imbecility, probably on a post-encephalitic basis. Salivation, ‘encephalitic’ affects, negativism, considerable language deficit (is now slowly starting to speak), with relatively better comprehension. In the family, the child is without a doubt a hardly bearable burden, especially under their crowded living conditions, and due to her aggressions she endangers the small siblings. Therefore it is understandable that the mother pushes for institutionalization. Spiegelgrund would be the best possibility.Footnote 99 (Fig. 10)

Fig. 10 In the case of Elisabeth Schreiber, Asperger also recommended transferal to Spiegelgrund (WStLA, 1.3.2.209.10, Nervenklinik für Kinder, Krankengeschichte Elisabeth Schreiber) Full size image

According to Asperger’s notes, it seems that Elisabeth’s mother was also unable or unwilling to take care of her, but there was no explicit reference to the possibility of her death. What can be said with a degree of certainty is that she sought institutional care for her daughter and that Asperger recommended transferal to the killing facility. However, Elisabeth was not immediately transferred to Spiegelgrund, probably because there was no bed available. Instead, she was sent to another institution for children with mental defects, where she stayed for a few months. In March 1942, she was transferred to Spiegelgrund. One of the nurses wrote that she was friendly and affectionate but that she spoke only one word: “Mama.” She died of pneumonia—like Herta and so many other children at Spiegelgrund—on 30 September 1942, shortly before her sixth birthday.Footnote 100

Was Asperger aware that Elisabeth would have almost no chance of survival at Spiegelgrund, that he was sending Herta to her death? Is it possible that he meant “permanent placement” just in its literal meaning, or do we have to consider it a euphemism for murder (comparable to “special treatment,” “final solution,” or less obliquely, “euthanasia”)? Significantly, the extermination of the mentally ill was never explicitly referred to in written documents, at least not outside the smallest circles of the initiated. For example, Hitler’s 1939 “authorization” providing cover for the extermination of 70,000 people in gas chambers only mentioned the intention to “accord a merciful death” in individual, carefully selected cases ([84]: 114). In documents not protected as state secrets, it would have been a grave breach to even mention the possibility of killing patients. Asperger’s expression, used in reference to a secret killing facility, could hardly be understood as anything other than a recommendation for “euthanasia”—provided that he knew what was going on there.

While the “euthanasia” killings at Spiegelgrund (as elsewhere) were officially a secret, and parents were routinely deceived about the true nature of the institution and the fate awaiting their children, rumors nevertheless abounded, and Asperger was in an exceptional position to know the truth. After his arrest in 1945, Ernst Illing (1904–1946), Jekelius’ successor as Spiegelgrund’s director, gave the following statement:

I point out that my clinic [Spiegelgrund] was always overcrowded, since other clinics […], including the University Pediatric Clinic, transferred—or wanted to transfer—such hopeless cases, evidently because they believed that in my clinic euthanasia was possible on account of the mentioned circular, while they were not allowed to practice euthanasia. I am absolutely convinced that the directors of the mentioned institutions were aware of euthanasia and the mentioned circulars.Footnote 101

Illing had every reason to diminish his own responsibility, but there is further evidence for the close ties between Spiegelgrund and the university clinic. As mentioned before, Spiegelgrund’s founding director Jekelius had trained under Hamburger and Asperger; Jekelius and Asperger were colleagues at the Vienna Public Health Office, and all three men played a leading role in the establishment of the Viennese Association for Heilpädagogik in 1941, part of a broader attempt to strengthen curative pedagogy’s profile in Nazi Germany as a medical discipline in accordance with race hygiene ([4]: 172–3). In line with Illing’s testimony, children were routinely sent from the pediatric clinic to Spiegelgrund ([13]: 203). A number of them were subjected to tuberculosis vaccine experiments by Asperger’s colleague Elmar Türk. After the experiments, the children were sent to Spiegelgrund, where they were murdered so that the vaccine results could be compared with the pathological findings. Staff at the pediatric clinic were not only aware of what happened at Spiegelgrund but exploited the research opportunities created by the murders [85].

Furthermore, knowledge of the mass murders euphemized as “euthanasia” was not limited to insiders; it was in fact widespread among the Viennese population. During the so-called “T4” killing campaign, patients’ relatives staged public protests in front of the Steinhof psychiatric hospital in Vienna. They could not prevent approximately 3200 Steinhof patients from being transported to the gas chamber at Hartheim, but they took a courageous stance against the regime’s campaign of murder.Footnote 102 Rumors were so widespread that the Viennese edition of the Völkischer Beobachter—the Nazi Party’s daily newspaper—was compelled to deny the killings. The article mentioned lethal injections and even gas chambers, which shows how specific the public’s knowledge was ([86]: 7). Anny Wödl, a Viennese nurse, had no doubt that the transfer of her son Alfred to Spiegelgrund, enforced in 1940 despite her resolute resistance, would mean his death ([87]: 298). Even abroad, the killings at Spiegelgrund became known. In the fall of 1941, the Royal Air Force dropped leaflets mentioning both the Steinhof hospital and Jekelius’ name in connection with the systematic murder of patients.Footnote 103

In light of this evidence, it seems extremely implausible that Asperger—a longtime colleague of Erwin Jekelius and a well-connected player in his professional field—was unaware of the activities at Spiegelgrund. When he reflected on the Nazi period in 1974, Asperger did not mention the child “euthanasia” program directly but claimed that he had from the outset refused to accept the Nazis’ concept of “unworthy life” or to participate in race hygiene measures, implicitly acknowledging that he was aware of its ramifications [3].

In the cases of Herta and Elisabeth, were there alternatives to sending them to Spiegelgrund? Could he have saved their lives? Under the circumstances, and given the parents’ lack of support, ensuring the long-term survival of the two children would certainly have been difficult. Facilities for children with severe disabilities continued to exist (both public and religious), but they were under pressure to hand over those among their patients deemed “unworthy” of support. Nevertheless, Asperger was under no obligation to send children directly to the killing facility, even if they suffered from severe disabilities. He could, without any risk to himself, have transferred them elsewhere, and in a number of other cases, he did just that.

Among the children who died at Spiegelgrund, there were at least four others apart from Herta and Elisabeth who had previously been examined by Asperger, two of them while the Spiegelgrund “euthanasia” facility was already in operation. Their conditions were so severe that the “euthanasia” apparatus ultimately caught up with them, although Asperger initially had them transferred to other institutions.Footnote 104 Why did he send Herta and Elisabeth to Spiegelgrund, but not Richard and Ulrike? While Asperger’s diagnostic report on Richard (who was diagnosed at Spiegelgrund with “mongolism”) is not included in the surviving records, Ulrike’s file contains a report in which Asperger described her as “mentally extremely retarded, severely autistic,” and as a “severe burden” at home. Over the course of a year, he had observed a process of “cerebral decay” which led him to recommend a home for mentally disabled children.Footnote 105 There is insufficient evidence to determine with certainty why he decided one way or the other, although in the cases of Herta and (less clearly) Elisabeth, the attitude of the parents may have played a role. The evidence in these two cases suggests that at least under the given circumstances he accepted the killing of disabled children as a last resort. This needs to be kept in mind when assessing Asperger’s role in a wave of transferals to Spiegelgrund which resulted in the deaths of a considerable number of children.

In December 1941, the authorities in Niederdonau (the province surrounding Vienna) noticed that patients in the children’s ward at the Gugging psychiatric hospital were not attending school, despite not having been excused.Footnote 106 An expert committee was consequently convened to evaluate the children with regard to their “educability.” Children evaluated as “educable neither in a special school nor within a psychiatric institution” were to be “delivered to the operation of Dr. Jekelius as soon as possible.”Footnote 107 This formulation implies that the recipients of the document would know who Dr. Jekelius was and that the children deemed “uneducable” by the committee should be killed.

Due to overlapping jurisdictions (the Gugging hospital was on Viennese territory and property of the city, but leased to the Niederdonau administration), the committee consisted of seven members from both provinces. Asperger was asked to join in his role as medical advisor for Vienna’s special school system. He was the only expert on Heilpädagogik on the panel and the only clinician with scientific credentials (the only other physician was the director of the Gugging mental institution, the psychiatrist Josef Schicker, 1879–1949).

After 106 children had been transported in March and May 1941 to the killing center in Harthe