The essay explores postwar efforts to prosecute Nazi medical personnel for their participation in Operation T-4, a program administered by Hitler’s personal chancellery in Berlin that created six killing centers for the murder of the disabled. After the war T-4 crimes faced judicial punishment. The focus is on several of the most important trials: the U.S. Army prosecution of staff members from the Hadamar mental hospital, the American prosecution of the “Doctors’ Trial” at Nuremberg, and several leading euthanasia cases held in West German courtrooms through the 1960s. Possible pre-trial biases and predispositions of the judges account for the verdicts in these trials.