The killings started with the murder of infants and young children born with mental or physical disabilities. For this purpose, Brack created his first T4 front organization, equipping it with the impressive-sounding name of Reich Committee for the Scientific Registration of Severe Hereditary Ailments. Physicians, midwives, and hospitals reported disabled infants and young children to the public health service, which transmitted the reporting forms to the Reich Committee. Using these forms, physicians working for the Reich Committee selected the children for the killing program. The children were transferred to children's wards for expert care, which T4 had established at selected state hospitals. Parents often voluntarily surrendered their children because they were deceived through promises that new medical procedures would lead to a cure. Against those who refused, the Reich Ministry employed various forms of coercion. In the wards the children were killed through the use of medication, usually overdoses of standard barbiturates, but sometimes also through starvation. The physicians and nurses in the children's wards continued the killings, often accompanied by self-serving experiments, throughout the war.

Children with hearing impairments were included among those killed in the children's wards. After the war, the psychiatrist Hermann Pfannmüller, director of the Eglfing-Haar state hospital in Munich as well as the physician in charge of its children's ward, testified at the Nuremberg medical trial about the disabilities that brought children to his killing ward, including among them those suffering from "congenital blindness, deafness, dumbness." Pfannmüller's postwar successor as director of Eglfing-Haar reported that surviving case histories showed that deaf children were among those killed by his predecessor. He reached the following conclusion about "ten deafmutes from the Ursberg institution" killed at Eglfing-Haar: "Almost all were active, a few were mildly feebleminded, but others—considering their skill at work—possessed normal intelligence." He added that even when they were diagnosed as moderately feebleminded, that diagnosis was not reliable because it was probably due to their hearing and speaking disability.

Even before the murder of the children had been fully implemented, Hitler also ordered the killing of disabled adults, and gave this job as well to Brandt and Bouhler. The larger task to kill disabled adults was both easier and more complex. It was easier because only the institutionalized disabled were to be included. Unlike the far smaller number of infants and young children, the far larger number of adults could not be enticed to commit themselves. Further, any attempt to conduct roundups of the disabled, taking them from their homes by force, would have breached the wall of secrecy surrounding the killings and would have caused popular unrest in the middle of the war . In any event, the number of institutionalized adults judged disabled was sufficiently large to satisfy the killers; the rest could be dealt with after victory.

The system of selecting the disabled victims followed the scheme applied to disabled children. Backed by the authority of the Reich Ministry of Interior, T4 requested that all state hospitals complete a questionnaire for each handicapped patient. T4 approached the public through newly created front organizations, including the

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