From pallbearer to psychiatrist: How childhood loss propels one of Canada’s leading medical ethicists

Mar 9, 2022

John Maher was eight years old when doctors discovered his best friend had a brain tumour. Two years later, John served as an honorary pallbearer, and while that designation meant he would not actually lift his friend’s coffin, he’s carried the emotional lessons ever since.

“That event really shaped me,” Maher, now 59, told me, the first time he has shared the story of childhood trauma in a public forum. “ I learned to look beyond the disease. This is a person.”

Maher is no stranger to the public spotlight. He’s sought it when doing so seemed necessary to pursue causes that are core to how he views the intersection between mental health, medicine and ethics. It was one such pursuit, opposing the expansion of medical-assisted death to those with mental illness, which earlier this year led him to virtually address the Canadian Senate and write an opinion piece published by The Globe and Mail.

But he had never before discussed for a public audience the death of a friend at such a tender age, a loss that influenced career choices that eventually led him to one of two Assertive Community Treatment teams at CMHA Simcoe County Branch. His friend’s death left Maher asking big questions about the purpose of life, and he sought answers studying philosophy at the University of Ottawa. Soon his focus narrowed on what would become a lifetime passion, medical ethics, first obtaining a Master’s degree from the University of Western Ontario.

He would then study medical ethics for another four years as a Ph.D. student at a UWO program that was brand new, and much of the focus then was on increasing the autonomy of patients. His particular focus, not surprisingly, was on childhood cancer at a time when those providing care systemically deceived children about their disease and prognosis.

Maher left the post-graduate program in 1984 and started the Trillium Childhood Cancer Support Centre for children and families across Ontario.  Among other programs, he started and led Camp Trillium, which offers recreational programs to children with cancer and their families to normalize their experiences and enhance their quality of life.

In 1987, Maher was a founding board member of the Canadian Candlelighters Childhood Cancer Foundation  — now Childhood Cancer Canada – an organization created by a woman, Edwina Eddy, whose 17-year-old son died from leukemia 11 years earlier. She was a passionate advocate and led a march on Parliament Hill to rally support for research.

In 1989, Maher became the assistant director of the National Cancer Control Task Force, a federal government body set up to restructure and reorganize cancer services across Canada. He spent three years breaking down silos and supporting collaboration. His next jobs were as Executive Director of Cancer Canada, a national lobby organization, and then founder and Executive Director of FACE AIDS, a pediatric AIDS support organization.

But while advocacy helped him to navigate politics and would remain a driving force for him, in 1992 Maher decided to go back to school to become a medical doctor. He went to McMaster University with the idea that he wanted to become a pediatric oncologist to manage treatment for kids much like the friend he lost decades earlier. But those plans changed when he was required to do a stint as a psychiatry resident. Until then, he had a deeper appreciation of physical ailments, but not psychosocial ones. “I grew to love it,” he said.

Maher went to the University of Ottawa as a resident with a special interest in psychosocial oncology and became a psychiatrist. It was that last choice that brought him to an ACT team more than 18 years ago, and CMHA in Barrie 6 years ago. While that responsibility is immense, he finds ways to continue to lead and advocate for the causes that are near and dear to him.

Maher is the editor-in-chief of the Journal of Ethics in Mental Health and the president of the Ontario Association for ACT & FACT teams, which advocates for ACT Teams and those they serve, individuals with serious and persistent mental illness who need interventions in their communities. And it was wearing those hats that Maher spoke to a Senate committee on Feb 3 to oppose extending medically assisted death to those with mental illness. “Canada offers MAID but not universal palliative care, disability supports or mental health care,” he told the Senators.

“Do we congratulate ourselves for our compassion in giving people an easier way to die while depriving them of the resources they need to live? How can this legislation be justified while the health rights of Canadians are ignored and unprotected? Is this what free choice looks like in Canada?”

“Of the Canadians who attempt suicide, only 23% will try again and only 7% complete suicide. Most suicidal thinking is ambivalent. We must not have legislation that will lead people to death who otherwise would have healed or coped. Offering an easier path to suicide is an ethically indefensible inducement. You can’t offer a sanitized gun in a white coat.”

Written by Jonathan Sher