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Galen began to criticize Hitler's movement in 1934. He condemned the Nazi "worship of race" in a pastoral letter on 29 January 1934, and assumed responsibility for the publication of a collection of essays which fiercely criticized Nazi ideologist Alfred Rosenberg and defended the teachings of the Catholic Church. He was an outspoken critic of certain Nazi policies and helped draft Pope Pius XI's 1937 anti-Nazi encyclical Mit brennender Sorge. In 1941, von Galen delivered three sermons in which he denounced the arrest of Jesuits, the confiscation of church property, Nazi attacks on the Church, and in the third, fiercely condemned the state-approved mass killing in the involuntary euthanasia programme of persons with mental or physical defects (Aktion T4). The sermons were illegally circulated in print, inspiring some German Resistance groups, including the White Rose.

Following this, in September 1943, another condemnation was read at the order of von Galen and other bishops from all Catholic pulpits in the diocese of Münster and across the German Empire, denouncing the killing of "the innocent and defenceless mentally handicapped and mentally ill, the incurably infirm and fatally wounded, innocent hostages and disarmed prisoners of war and criminal offenders, people of a foreign race or descent"