The abuse of psychiatry in Nazi Germany 60 years ago was the abuse of the 'duty to care'. Its scale was enormous; 300,000 people were sterilized and 100,000 killed in Germany alone and many thousands further afield, mainly in eastern Europe. This episode occurred in a country with a high reputation for its medicine, including psychiatry, and for its interest in the ethics of medical research. The economic conditions which preceded the violent political upheaval had led to increasing concern about 'the burden on the State' of the mentally ill and disabled. These preoccupations are still with us today. There may still be lessons to be learnt from the Nazi episode.