Two specific cases are highlighted by Czech, that of Herta and Elisabeth Schreiber (no relation). Asperger wrote in his diagnosis of Herta that, “Permanent placement at Spiegelgrund seems absolutely necessary.” Two months after being admitted to Spiegelgrund, and a day before her 3rd birthday, Herta died of pneumonia. At Spiegelgrund pneumonia was routinely induced by the administration of barbiturates over a long period of time. It cannot be asserted whether “permanent placement” was a conscious euphemism for murder, however, “It is clear that he did not expect Herta to return,” writes Czech.

Elisabeth Schreiber also died of pneumonia, shortly before her sixth birthday. Asperger’s evaluation of her concluded, “In the family, the child is without a doubt a hardly bearable burden […] 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.”

What is significant when judging Asperger is to consider that extermination was never explicitly referred to in written documents, at least not outside the smallest circles of the initiated. Mentioning the killing of patients in documents was a severe breach of code. Asperger’s expressions used in reference to Speigelgrund, “could hardly be understood as anything other than a recommendation for ‘euthanasia’ — provided he knew what was going on there,” writes Czech.

Asperger joined a number of organizations affiliated with the Nazi Party, including the National Socialist Welfare Organization and the German Labor Front. He also applied for membership in the National Socialist German Physicians’ League but never joined the Nazi party itself, unlike his colleagues at the pediatric clinic.

In light of his research, Czech states that “The fate of ‘Asperger’s syndrome’ will probably be determined by considerations other than the problematic historical circumstances of its first description — these should not, in any case, lead to its purge from the medical lexicon.”

Joseph Buxbaum of Mount Sinai Medical School, who is co-editor-in-chief of the journal said, “We are persuaded by Herwig Czech’s article that Asperger was not just doing his best to survive in intolerable conditions, but was complicit with his Nazi superiors in targeting society’s most vulnerable people.”

“The case of Hans Asperger provides a troubling example of the horror that can be unleashed when medical professionals allow themselves to become complicit with a brutal ideology,” said Steve Silberman, author of the book Neurotribes, and one of the reviewers of the study.

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Czech, H. Hans Asperger, National Socialism, and “race hygiene” in Nazi-era Vienna. Molecular Autism. Online: 4/19/2018. doi: 10.1186/s13229-018-0208-6.