Biography of Karl Kleist
Karl Kleist studied at Strassburg, Heidelberg, Berlin, and Munich, where he obtained his doctorate in 1902. During the years 1903-1908 he worked in the nervous clinic at Halle an der Saale, the neurological and psychological institute at Frankfurt am Main, as well as in the anatomical laboratory of the Munich psychiatric clinic. He was chief physician at the psychiatric clinic in Erlangen 1909-1916. Here he was habilitated for psychiatry and neurology in 1909, becoming ausserordentlicher professor in 1915, and in 1916 accepted an invitation to Rostock as ordinarius, moving on to the same tenure at Frankfurt am Main in 1919. His work concerns general psychopathology and brain pathology, special clinical psychiatry, endogenous defect psychoses, and Involutionsparanoia.
On July 25, 1933, Hitler’s government enacted a law, amended December 7, 1933, making compulsory sterilization mandatory in cases of hereditary disease, including hereditary mental disease. The law defined hereditary disease as including: congenital mental deficiency, schizophrenia, manic-depressive insanity, hereditary epilepsy, Huntington's Chorea, hereditary blindness, hereditary deafness, and severe hereditary physical malformation. In severe alcoholism sterilization was at the discretion of the "courts of hereditary health"
Professor Kleist stated on June 10, 1945: "I never thought much of the sterilization law. Its justification in the manic-depressive group was always questionable, to say the least. Apart from the fact that the whole set-up as it was organized implied an unnecessary expenditure, it was medically unsound because it discredited the patient as a human being and it discredited his whole family. I had an extensive practice as an expert in sterilization cases, especially in cases of appeal to the higher courts of hereditary health "Erbgesundheitsobergerichte" - and I have always tried to protect the patients from sterilization. The only instances in which I regarded sterilization as justified was in Huntington’s choreas, in severe mental deficiency, and in severe cases of epilepsy".
Dr. Kleist was then asked whether he knew the total annual figures of those sterilized for neuropsychiatric reasons in Germany. He stated that the overall figures were not divulged and that he therefore did not know them; the statistics were in the hands of special medical officials. The neuropsychiatrist in charge of patient merely proposed sterilization and they frequently never learned themselves whether their proposal was carried out or not after the case came before the court of hereditary health. In the early years after the law had been passed, there was a great wave of proposals for sterilization, and masses of patients were brought before the courts of hereditary health. These courts were not thorough and passed practically everyone brought before them. If the patient or his relatives objected, they could appeal to a higher court. Dr. Kleist himself served on such a higher court ("Erbgesundheitsobergericht"). As a member of this court, Dr. Kleist always urged caution and reserve. Gradually, sterilization fell fairly generally into disuse. The only one in Germany who remained enthusiastic was the Nazi psychiatrist Ernst Rüdin, who was named by Hitler as the "Pioneer of Racial Hygiene. Rüdin had spearheaded the Nazi death machine into existence, including its 1933 Sterilization Law for those deemed "unfit" or "unworthy of life";
The practical procedure in neuropsychiatric hospitals was as follows; after the admission of a patient a report had to be made whether he was suspect of hereditary mental or nervous disease. If this suspicion became verified in the course of further observation, a proposal for sterilization had to be submitted to the court of hereditary health. From then on the matter was in the hands of the courts, which were then to order the performance of sterilization at a special surgical sterilization centre.
Dr. Kleist submitted statistics as to the number of proposals for sterilization made by his clinic. Compared to the total number of admission, the incidence of proposed sterilizations was never high or significant at his clinic; it fell off sharply at the beginning of the war, and proposals for sterilization ceased completely since the budget year of 1942/43 (which begins in Germany April 1, 1942). Dr. Kleist felt that in addition to general and theoretical considerations, the shortage of physicians and surgeons during the war was an additional factor in making the sterilization law fall into disuse in Germany during the war.