Abstract: The methods used for mass extermination in the Nazi death camps originated and were perfected in earlier use against people with physical, emotional, and intellectual disabilities. This article describes the historical context of attitudes toward people with disabilities in Germany and how this context produced mass murder of people with disabilities prior to and during the early years of World War II. Several key marker variables, the manipulation of which allowed a highly sophisticated Western society to officially sanction the murder of people with disabilities, are examined. Important implications must continually be drawn from these sad events as we work with people with disabilities at the dawn of a new century.