Firefighter Cancer and Disenfranchised Grief
Suzz Sandalwood | When policy responds to risk but not to loss, structural disenfranchisement persists.
Written by Suzz Sandalwood | Seeking Veritas Columnist | | Sankarsingh-Gonsalves Productions
“You can cover cancer in law. But if you don’t count the death, the grief stays unacknowledged.” -Suzz Sandalwood
Half measures of policy
In 2023, Ontario announced an expansion of its presumptive cancer coverage for firefighters. Thyroid and pancreatic cancers were added to the list of occupational illnesses presumed to be caused by job exposure. The language was celebratory. The tone was one of overdue recognition but behind the headline, the lived reality is more complicated.
Even as the legislative scaffolding shifts, the psychological and cultural architecture surrounding occupational illness and death remains deeply fractured. Firefighters continue to get sick and some die from cancers that research has long linked to chronic toxic exposure. Their families continue to receive inconsistent recognition symbolic, financial, and ceremonial for those losses and even with improved coverage, many are still forced to enter a bureaucratic proving ground while grieving. In theory, expanding presumptive legislation is progress. In practice, it exists in tension with the deeper moral injury of how these deaths are handled or not handled at the cultural level.
“Is this institutional reticence driven by a fear of legal liability or fiscal accountability?”
I work with grieving families of first responders and I’ve witnessed how grief can be distorted by the systems meant to support it. It’s not only the death that families are forced to carry, but the institutional indifference that can follow. When a first responder dies, whether by violent tragedy or long-term occupational exposure, the loss should be treated with equal gravity. But that’s not how the policies are written. In many jurisdictions, current policy frameworks offer robust financial benefits, psychological services, and public honors to families of first responders who die in the line of duty, especially in high-profile, violent circumstances. Yet when firefighters die from occupational cancers, disease directly linked to toxic exposures on the job, the same level of institutional recognition and support often does not follow. These families must navigate delayed or denied compensation claims, piecemeal psychological support, and limited access to grief resources. They are often forced into the role of advocate while grieving, having to prove that the death “counts” as line-of-duty.
This disparity is not accidental; it is the result of policy gaps, narrow definitions of what constitutes a “line of duty” death, and a lack of unified standards for occupational illness in first responders. This is where the disconnect lies. It sends the message to families that there is acknowledgement that the job can make someone sick but if their loved one dies as a result of that illness its not the same. Having to tell a family member that their loved one’s death by cancer does not qualify them for grief supports is not easy to do.
This issue raises questions about the systemic motivation behind what is named as line of duty death. Is this institutional reticence driven by a fear of legal liability or fiscal accountability? Does a shift from vague acknowledgment of "risk" to explicit attribution, saying, for instance, that being a firefighter caused this cancer, threaten to destabilize the legal and bureaucratic scaffolding upon which these systems rely? The reluctance to fully name and validate the cause of death in these cases risks not only perpetuating disenfranchised grief but also obscuring the moral and ethical obligations owed to those who serve. We must ask: who benefits from this silence, and at what cost to those left behind?
Grief not named is still grief
This is what we call disenfranchised grief. Grief that lacks social permission, institutional support, or public validation and while the language is clinical, its effects are anything but. Mourning is not just a person, but a breach in meaning and rupture between sacrifice and recognition. It is here where we begin to see the deeper issue: our systems are not grief-literate. They are risk-literate. They are liability-literate.
Cancer doesn’t follow that narrative arc. It often unfolds off-scene. Off-duty. It looks too much like aging, like illness, like something that could be “just life.” But it isn’t just life. It’s exposure. It’s inhalation. It’s the accumulation of carcinogens absorbed across thousands of calls. It’s death by a thousand unfiltered shifts. You can cover cancer in law. But if you don’t count the death as line of duty, the grief stays unacknowledged and access to support is often absent for those left behind.
Next in 911 Community
Sometimes the stark realities of first responder life settle into silent corners, yet ever-present. It’s essential we keep these conversations going because those who serve our communities need to know they are not invisible, not alone. They need to be seen, truly seen.
From my articles, a thread has emerged it may seem; a theme highlighting struggle, pain, and suffering. These realities exist in overwhelming measure but I am aware they do not tell the whole story. There are those who thrive, who carry a fierce love for this work. I witness it in the wide-eyed hope of new recruits and in teams whose exposure to trauma is lighter, whose passion is eager. But, everywhere in these jobs, the risk lingers.
In my next article, I invite you into a more intimate space, into the mind of someone who wants to become a police officer: my son. Here, pride and fear intertwine in a way many parents know all too well, wrestling with the undeniable truths this world holds.
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About the Author: Suzz Sandalwood is an Advanced Certified Clinical Trauma and Addiction Specialist and a Certified Grief Counsellor and is a former writer for Psych Central. She has extensive professional and lived experience in first responder, addiction, and grief communities | Connect with the author: https://suzzsandalwood.com
This is a powerful reflection and it exposes the deep disconnect between policy reforms and the lived realities of grieving families of firefighters who slowly die from occupational cancers.
I have always admired firefighters. They are running towards the disaster while everyone else is running away from it. But it sounds like their families are still left navigating fragmented systems that force them to prove their loss “counts,” while enduring institutional indifference that denies them full recognition and support.
It sounds like this failure to name these deaths as “line of duty” does not sound like policy oversight but rather a moral failing. Or am I missing the point here?
I guess the question is how do we get our systems that are really good at risk management and liability to become aware of grief over time? How do we get them to honor the "full cost of service" when it doesn’t fit a dramatic script of heroism that often leads in the headlines.
Grief literacy training is very absent in many of these spaces that policy informs. I wanted to write this article because I have had to have those difficult conversations with loved ones that tell them they don’t qualify for some supports and highlight the fact that this needs to change but as mentioned in my article i wonder if that open up some liability issues. So much to unpack on this topic for sure and much works needs to be done.