Am Spiegelgrund was a children's clinic in Vienna where 789 patients were murdered under the Nazi program of child euthanasia. The clinic was established in 1940, and operated out of Am Steinhof psychiatric hospital buildings emptied by Aktion T4. It was closed in 1945, after the liberation of Vienna.
At Am Spiegelgrund, sick and disabled children and adolescents were subjected to unethical human experimentation and medical neglect, as well as physical and psychological abuse. Some died by lethal injection and gas poisoning; others by disease, starvation, exposure to the elements, and "accidents" relating to their conditions. The brains of up to 800 victims were preserved in jars and housed in the hospital for decades. In 1942, the clinic was divided into the Vienna Municipal Mental Clinic for Children "Am Spiegelgrund" and the Vienna Municipal Reformatory "Am Spiegelgrund". Children and adolescents committed to the reformatory were also physically and psychologically abused.
The clinic has gained contemporary notoriety, due in part to the treatment of children by lead psychiatrist Heinrich Gross. Gross was responsible for the deaths of at least nine "defective" children, but may have played a major role in the killing of hundreds more, and preserved many dead children as medical specimens. Gross went unpunished for his actions after the end of World War II and became a court psychiatrist in Austria, with much of what he did only becoming public knowledge very late in his life. The clinic is also today known because of the children referred to it by Austrian psychiatrist Hans Asperger, whose possible role in the patient selection process in the Children's Ward came to light in the 2010s, making him a highly controversial figure in recent years. However, a 2024 analysis by Klaus Schepker and Christine Freitag, based on the examination of patient medical records and transfers, concluded that Hans Asperger did not violate professional medical ethics during the Nazi period, did not participate in or recommend child euthanasia, and that fatal decisions were made by other physicians responsible for patient transfers and reporting.
Background
Beginning in the spring of 1938, an extensive network of facilities was established for the documentation, observation, evaluation and selection of children and adolescents, whose social behavior, disabilities, and/or parentage did not comply with the Nazi ideology. The recording of these individuals often began in infancy. Doctors and midwives across the Reich reported mental and physical abnormalities in newborns and children to health authorities. In 1941 in Vienna, seventy-two percent of newborns were documented within their first year of life by the city's more than 100 maternity clinics. Anyone who came into contact with a health institution was systematically recorded into a "hereditary database" which included the patient's genetic information. Over 700,000 Viennese citizens were entered into this database. Genetic information was compounded with school assessments and with employer information and criminal records, when applicable.
Many within Vienna's healthcare system adhered to Nazi eugenics, and patients of all ages were funneled into specialized facilities, in which many patients were mistreated and killed. Throughout Germany and Austria, euthanasia centers were established, including Hadamar Euthanasia Centre and Hartheim Euthanasia Centre, for people with mental or physical disabilities. Children were not spared. Many children were "mercifully" sent to children's hospitals, and among the most prominent of these was the Kinderspital (Children's Clinic) Am Spiegelgrund in Vienna. Among the patients were those deemed "life unworthy of life". As part of the Steinhof psychiatric complex the Spiegelgrund clinic housed state sponsored pediatric euthanasia. Around 789 children died in the Spiegelgrund clinic while the Steinhof complex was responsible for the death of around 7,500 patients by the end of World War II. The clinic operated under the direction of the Führer's Chancellery and Ministry of the Interior where physicians conducted "all manner" of procedures on the vulnerable and disabled children which were often fatal. The Am Steinhof psychiatric hospital was established in the early 1900s, but from July 1940 to April 1945 it housed the Spiegelgrund Clinic. On 16 March 1945, the 2nd Ukrainian and 3rd Ukrainian fronts launched the Vienna offensive in an effort to take the city from Nazi forces. After a month of fighting, the Red Army captured Vienna. The liberation of Vienna by Soviet forces in the spring of 1945 resulted in the end of the Spiegelgrund clinic.
Aktion T4 and the children's ward The establishment of a children's ward at the Am Steinhof facility was not possible until the implementation of Aktion T4, a product of the Euthanasia Letter signed by Adolf Hitler. This called for the relocation of approximately 3,200 patients, or about two thirds of the patient population at the time, in July 1940. The order subsequently emptied many of the "pavilions", or buildings, within the grounds. The patients were taken, sometimes after a brief transfer to the institutions of or Ybbs an der Donau, to the Hartheim Euthanasia Centre, near Linz. It is likely that Am Steinhof served as a transfer point for patients of other institutions, as well. The gassing of patients at Hartheim began in May 1940; by the end of the summer of 1940, the 3,200 patients from Am Steinhof were systematically brought to the centre.
Both the patient selection process and the implementation of the action were carried out by the Commission of Berlin, assembled by Werner Heyde. The institutions themselves were informed only that large-scale transfers were necessary "for the defense of the Reich".
On 24 July, just weeks after the transfers began, the children's clinic, Am Spiegelgrund, opened its doors with room for six hundred and forty patients in nine buildings on the grounds. The curative education or special needs department of the Central Children's Home was relocated to Spiegelgrund, along with the department's so-called School Children Observation Centre. This is where children were evaluated to determine their educability.
Educability became a part of the patient selection process. Some of the children arrived perfectly healthy, in both mind and body, but were brought to the center due to delinquent behavior, poor upbringing, or unsuitable parentage. They were considered delinquents if they had run away from home or resorted to petty crimes; they were considered inferior if they were born out of wedlock or came from impoverished homes; they were considered "defective" if their parents were alcoholics or criminals. These educable children were not exempt from experimentation and punishment at the hands of their caretakers, since they were often seen as a burden on society. In this way, "the child euthanasia program came to medicalize social belonging, incorporating social concerns as eugenicist criteria."
Known officially as the Infant Centre, Building 15 was designated as a Children's Ward, the second of its kind in the Reich after Brandenburg an der Havel. The ward would report any supposed genetic or contagious diseases to the central healthcare office in Vienna, which would determine if "treatment" were necessary.
Patient records were evaluated by professionals to determine whether a patient should be euthanized, allowed to live, or observed pending a final decision. One preserved example of the evaluation records belonged to an adult patient, "Klara B.", institutionalized at Steinhof, who was among the 3,200 patients evicted in the summer of 1940. Highlighted in red pen are the terms Jew (German: Jüdin) and her diagnosis of schizophrenia. The red "+"s on the bottom left of her form mark her for euthanasia. She was transferred from the Vienna facility to Hartheim, where she was gassed on 8 August 1940, at the age of 31. She and other institutionalized Jews faced unfavorable odds. Of the approximately 3,200 patients, around 400, or 12.5%, were Jewish, when the Jewish community constituted just 2.8% of Austria's national population in 1933.
Those who remained behind or who were later brought to Am Steinhof were in no less danger than those who were removed. The death rates among patients at Am Steinhof increased annually between 1936 and 1945, from 6.54% to 42.76%, respectively. As the death rate climbed, the patient population naturally decreased. In 1936, there were 516 reported deaths; in 1945, there were approximately 2300.
Despite the regime's attempts to keep Aktion T4 a secret, the public was in some measure aware of increasing death rates among the institutionalized patients. In July 1940, Anna Wödl, a nurse and the mother of a disabled child, led a protest movement against the evacuation and murder of institutionalized children. Family members and supporters sent many letters to high-ranking officials in Berlin. They also protested outside institutions, but police and the SS soon put an end to the demonstrations. The Austrian Communist Party, the Catholic and Protestant Churches and others formally condemned the killings, and on 24 August 1941, Hitler was pressured to abolish Aktion T4. The abolition, however, did not stop the murders. Other child euthanasia programs, particularly Action 14f13, quickly and quietly took its place. Anna Wödl's protests proved to be in vain; while her son, Alfred Wödl, was spared a transfer to Hartheim, he was murdered in the Children's Ward at Am Spiegelgrund on 22 February 1941, with the official cause of death being listed as "pneumonia". His brain was kept for research and housed in the hospital until 2001, when his remains were finally laid to rest.
Experimentation and child euthanasia Although Nazi leadership lacked scientific training, they sought legitimacy from science and biology to justify eugenics and ethnic cleansing. Nazis coined several terms for those they deemed unfit; for example, the terms , which translates to ; , meaning ; and , which means . To strengthen the Nazi regime and Germany as a whole, utilizing euthanasia to select against individuals who would not produce strong and productive offspring was seen as a merciful gesture.
The children who were sent to euthanasia centers such as Am Spiegelgrund were selected on the basis of medical questionnaires. Physicians were told to report children with conditions such as intellectual disability, cerebral palsy, Down syndrome, any deformities, bed wetting, learning disabilities, along with many other things that would lower their ability to strengthen Hitler's superior race. If a child had any sort of mental or physical condition, their questionnaire would be sent to Hitler's Chancellery, who would recommend "special treatment" despite having never met the children. The victims of Am Spiegelgrund were subjected to torture-like experimental treatments as well as punishments for a variety of offenses. Survivors Johann Gross, Alois Kaufmann, and Friedrich Zawrel described and testified to several of the "treatments", which included electroshock therapy, a so-called "cold water cure" in which Zawrel and Kaufmann recall being repeatedly submerged into freezing bath water until they were blue and barely conscious and had lost control of their bowels; a "sulfur cure", which was an injection that caused severe pain in the legs, limiting mobility and ensuring that escape was impossible; spinal injections of apomorphine; injections of phenobarbital; overdoses of sedatives, which would often lead to death when the children were exposed to extreme cold or disease; observed starvation; and efficacy testing of tuberculosis vaccines, for which children were infected with tuberculosis pathogens.