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History is instructive even when the lessons learned cannot be easily transposed to a new time and place. The aim of this paper is to describe psychiatric reforms implemented one hundred years ago in Germany and how, contrary to their intention, they resulted, with changes in economics, politics and ideology, in disaster for psychiatric patients. The conclusion for our time is that the new and seemingly expedient need always to be questioned. If nothing else, the paper reviews an important era in the history of our profession.

Objectives: To update Canadian psychiatrists on recent information from newly discovered Berlin archives about the actions of physicians, especially psychiatrists, during the era of National Socialism in Germany and to encourage introspection about the role of the medical profession, its relationship with government, and its vulnerability to manipulation by ideology and economic pressures., Method: This is a selective review of the literature on the collaboration of physicians, especially psychiatrists, in the sterilization, experimentation, and annihilation of patients with mental illness before and during World War II., Results: Directed to value the health of the nation over the care of individual patients and convinced that a hierarchy of worth distinguished one person from another, German psychiatrists were enlisted to commit atrocities during the Nazi period., Conclusions: The values of care and compassion can be eroded; this knowledge demands constant vigilance.