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T4 used starvation, lethal injections, embolisms and, eventually, carbon monoxide to carry out the murders. By 1940-1941, it was an open secret in Germany. Cardinal Galen preached against it in Church, and families refused to allow members to be taken to the killing centers. Hitler put the program on "hold" because of the publicity and the adverse effect it was having on the morale of the troops at the front, who worried they'd be killed if they came back severely wounded. Hitler intended to resume the program after the war.

Suggested reading: "The Nazi Doctors" by Robert Lifton. This book traces the evolution of German "medical" theory and practice from the eugenicists of the '20s right through the "Final Solution" in the death camps (I didn't know that all the selections made when the trains arrived were done by the DOCTORS on the camp medical staff.).