According to Michael Burleigh's book Death and Deliverance, he was married to a Jewish woman and left his post in Freiburg after National Socialists came to power.

[4] Hoche begins his relatively short text by reminding readers that in the society of the day (1920s Germany) deaths caused by doctors were, in some cases at least, actually taken for granted.

Hoche talks about euthanasia as proposed by Binding, arguing that if killing a person would lead to other lives being saved, it would be justifiable (Consequentialism).

Hoche argued that anyone born with this condition could never have developed any emotional relationship to their environment or family, whereas a person who had lived normally for most of their life would have had this possibility.

Hoche argued that the "mentally dead" are easily identified, they have no clear imagination, no feelings, wishes or determination.

Binding and Hoche's book, along with those by Alfred Ploetz, Rupp and Jost, directly influenced the Nazi T-4 Euthanasia Program of the 1930s.

Hoche argued that the state can be seen "as an organism, as a human body which—as every doctor knows—in the interests of the survival of the whole, gives up or discards parts which have become valueless or damaging".

Hoche believed his ideas would be widely accepted only after "a change in consciousness, a realisation of the unimportance of a single person's existence compared to that of the entirety... the absolute duty of bringing together all available energy and the feeling of belonging to a greater undertaking".

Smuggling himself into an autopsy as an assistant to investigate the effects of electricity on the human central nervous system, Hoche connected a hidden motor to the body to see if he could make it move.

Eventually, after the state prosecution gave him special permission, Hoche was able to experiment on bodies within two minutes of their execution by guillotine.