An alliance for the alleviation of suffering in the world
The Introduction to Algonomy project consists in producing, on this website and eventually as a book, a document that presents a new work area dealing with knowledge and action about the phenomenon of suffering. As a discipline, algonomy may be defined as a branch of systematic knowledge where cumulative verifiable information on the whole range of theoretical and practical matters pertaining specifically to suffering, is sought, or used, in conformity with recognized scientific or academic methods.
Some preliminary work is offered on this page.
See also The Study and Management of Pain Require a New Discipline about Suffering, a paper presented by Robert Daoust at the Making Sense of Pain conference organized by Inter-Disciplinary.Net conference in Prague, 19-20-21 May 2012.
All major spheres of human activity deal in one way or another with suffering:
politics, religion, healthcare, social affairs, economics, law, art, literature, philosophy, ethics, the news media, environmental studies, education, science, history, war, crime, work, sport, interpersonal relationships, personal life, etc.
Suffering is implicated in other, more specialized fields too, although their overt objects of concern are something else. For instance:
medicine, social service, social security, insurance, economic development aid, human rights protection, animal welfare, judicial punishment, the practice of torture, disaster relief, certain parts of the biological or psychological or social sciences, etc.
So there are many areas of activity that deal with suffering in relation to something else, to the State, or God, or health, or welfare, or wealth, or justice, etc. In practice, however, no discipline deals with suffering per se as its primary focus. Consequently, suffering in the contemporary world is still essentially out of control, despite a pervasive concern over its existence across the millennia. This lack may be explained by the impossibility until now of tackling suffering within an overall framework that is specifically dedicated to study and action about it.
So here an idea is
proposed that is in one sense obvious, namely to develop,
alongside the other areas mentioned above, a whole new
sphere of investigation, an additional and quite different
approach to the world and its problems - a new discipline
dealing with suffering itself and with all that is related
It is suggested that the discipline concerned with suffering should be called "algonomy". The term comes from two ancient Greek words: algos, which means pain or suffering, and nomos, which evokes the notions of domain, management, and knowledge. It should be noted that the word "suffering" is used here in a broad sense and may refer to any pain or unpleasantness.
Algonomy is a framework that allows to deal with knowledge and action about suffering through a discipline that is proper to that phenomenon. Of course, it touches upon a large variety of domains, most particularly psychology, philosophy, religion, politics, health, justice, and the social services. However, algonomy clearly distinguishes itself from any other approach to suffering because it is concerned both specifically and universally with that subject, first and foremost : in other words, a theoretical or practical activity may be said algonomic if, "in principle", it deals with suffering itself, with the whole of suffering, and with suffering first. Thanks to these characteristics, algonomy allows us to go beyond three kinds of shortcomings against which other disciplines, for all their merits, are powerless when they deal with suffering.
1- First, other approaches are inappropriate or inadequate insofar as their specific object of concern is not suffering itself, as such, 'per se'. Only algonomy allows us to acknowledge the specific reality of suffering in all its guises.
2- Next, other disciplines are deficient or incomplete insofar as none of them deals in principle with everything that concerns suffering, physical or mental, human or animal. Only algonomy embraces within a common conceptual framework all forms of suffering, all causes, all remedies, all elements of the topic. If our goal is to understand and resolve the problems that the existence of suffering entails, these problems must be tackled not only one-by-one, or in narrowly defined contexts, but also in their entirety, in spite of the intimidating scale and complexity that this approach may represent.
3- Lastly, other fields of interest are misleading or inconsistent in the sense that when they deal with suffering, they always do so only in relation to their disciplinary specialty. There are countless people or groups who say that their concern is suffering, but in reality all of them are focused on concerns which are not suffering as such but rather, for instance, illness or hunger or injustice. Thus suffering has never hitherto been the specialty of anybody and therefore, per se, it has been awfully neglected. From the perspective of algonomy, all that is not first-and-foremost focused on knowledge and action about suffering represents a diversion, a deviation from what should be the primary and overriding interest.
To be sure, algonomy has also its pitfalls which must be guarded against. For instance, the new discipline may give rise to the temptations of totalitarian benevolence. Within algonomy everything is subordinated to its concern, but for those who practice the discipline there is a responsibility to make sure that algonomy is appropriately related to other concerns. Often times, acting on suffering may be a priority, but at other times something else may have to prevail. For dealing with the extremely complex question of the place that algonomy should have in the scheme of things, it is suggested here to use an approach such as the one put forward in the Encyclopedia of World Problems and Human Potential.
To sum up, algonomy is an innovative conceptual framework with the following key uses:
It is a framework for a methodical approach, useful for dealing with suffering in a general, universal, systematic, well-ordered, permanent manner, and for dealing with suffering as a primary object of concern, subordinate to no other.
It is a framework for theoretical learning, useful for studying all that pertains to suffering, as well as for developing skills that are related to this kind of knowledge.
It is a framework for strategic planning, useful for designing systematic action about suffering.
It is a framework for practical action, useful for carrying out interventions that are concerned with the phenomenon of suffering itself.
Methodology is necessary to algonomy in order to develop formally its conceptual basis and its methods. The word methodology here refers to the rationale and the philosophical assumptions that underlie a particular discipline, and that determine how methods (specific principles, practices, procedures) are deployed and interpreted. There can be no detailed guide on how to create a new discipline, but algonomists could probably draw many lessons from studies on how modern knowledge is pursued, or on how new fields are being developed (e.g. pain research, scientific study of consciousness, sociology of happiness...). For now, the main ideas that are proposed in algonomy methodology can be summed up as follows.
The nature of algonomy is a matter for people to explore, to invent, and to agree upon. This discipline is originally conceived as a comprehensive body of theoretical and practical knowledge. It appears to be a very large discipline, given its specific object, the phenomenon of suffering, and its field, the set of all things that may concern directly or indirectly that formal object. Every modern science, it should be noted, seems to be exceedingly large, or indefinitely expansible. At this time, embryonic algonomy can be handled by "general algonomists", but eventually the discipline, like others, will probably have to be divided into a number of specialized parts.
Recognition from the academic community will come to algonomy inasmuch as its "paradigm" helps to produce new theoretical and technical knowledge about suffering and its management. But prior to any demonstrative results, the following considerations may invite confidence in the new paradigm.
Algonomy considers suffering
the "specific object" of a "comprehensive" discipline.
the first time, suffering is dealt with as a whole and
intrinsic concern. Until now, this concern has generally
been subordinated to other preoccupations in politics,
economy, society, religion, morals, philosophy, medicine,
psychology, neurology, etc., and advances about suffering
have mostly followed from our interest in health, knowledge,
love, welfare, security, etc. In algonomy, there is a
reversal of perspective : suffering is not only specifically
and extensively considered, but it is also the chief
concern to which other preoccupations are subordinated.
Suffering, in its own
specificity, is the matter of
algonomy : it is not as such the matter of neuroscience,
psychotherapy, social work, or medicine because such
disciplines are primarily concerned with aspects of
suffering that are specific not to suffering itself, but to
neuron and brain, or mind and behavior, or social problems,
or health and illness. Hopefully, a general discipline about
suffering will allow, in knowledge and
action about suffering, new progress that
other fields cannot make possible.
Scientifically, algonomy considers suffering as
a conceptually defined phenomenon : events or things in the
real world are particular and unique, and it is the role of
science to turn them into conceptually defined phenomena or
facts that are general and comparable to one another. As a
conceptually defined phenomenon, suffering is a kind of
abstraction comprising temporal, spatial, subjective or
other types of attributes, but devoid of particularities
such as a date, a place, a specific individual's presence or
any other contingent condition of manifestation. This
abstractive process makes scientific knowledge possible,
because it makes it "verifiable". It may be reminded that
there is no truth in science, but only theories that at all
time can be proved or disproved. In the same line of
thought, it may be noted that all matters that may concern
suffering can be treated in scientific algonomy, but only inasmuch as
they are amenable to scientific verification. Religious or
philosophical viewpoints on suffering, for example, may be
approached from a scientific point of view by scientific
algonomy or other sciences, although they belong in their
specificity to religion or philosophy.
Scientifically, algonomy considers suffering as
an empirical concept, because it is a psychological process
that can be observed through the behavior or the functioning
of groups, individuals, bodies, brains, neurons… Suffering
can be measured and modified, augmented or diminished,
started or stopped. Objective correlations can be
established, and empirical knowledge can be developed.
Scientifically, algonomy considers suffering with a radical, typically scientific stance of objectivity. It does not value suffering negatively nor positively. Consequently, parts of algonomy that are evaluative (e.g. critical studies of theories), or prescriptive (e.g. developmental studies of antalgic factors), or even factual (e.g. inventorial collections), are scientific only inasmuch as "statements of existence of value" are used rather than "intrinsic value judgments". Criteria must be made explicit, in particular, when suffering is said to be good or bad, useful or useless, acceptable or unacceptable, avoidable or unavoidable, light or severe, etc. Authors of documents in scientific algonomy should mandatorily identify in a formal fashion what, how, and especially "whose" values or interests are taken as parameters in their work. Neutral objectivity in science has often been a heuristic device, and hopefully it will have the same serendipity with suffering. Besides, there is a place for ethics in scientific algonomy. The discipline itself cannot and should not have an ethical position, but students of suffering should have one! In short, scientific algonomy as a discipline has only one purpose : universal knowledge about suffering. By itself, it has no other goal, value, strategy, or program of action.
The definition of suffering in Wikipedia is probably as good as any other. See the article Suffering (as of 2012-04-13) :
"Suffering, or pain in a broad sense, is an experience of unpleasantness and aversion associated with harm or threat of harm in an individual. Suffering is the basic element that makes up the negative valence of affective phenomena."
In the same Wikipedia article there is the following section entitled 'Terminology', about words that are often used ambiguously when dealing with this topic :
The word suffering is sometimes used in the narrow sense of physical pain, but more often it refers to mental or emotional pain, or more often yet to pain in the broad sense, i.e. to any unpleasant feeling, emotion or sensation. The word pain usually refers to physical pain, but it is also a common synonym of suffering. The words pain and suffering are often used both together in different ways. For instance, they may be used as interchangeable synonyms. Or they may be used in 'contradistinction' to one another, as in "pain is inevitable, suffering is optional", or "pain is physical, suffering is mental". Or they may be used to define each other, as in "pain is physical suffering", or "suffering is severe physical or mental pain".
Qualifiers, such as mental, emotional, psychological, and spiritual, are often used for referring to certain types of pain or suffering. In particular, mental pain (or suffering) may be used in relationship with physical pain (or suffering) for distinguishing between two wide categories of pain or suffering. A first caveat concerning such a distinction is that it uses physical pain in a sense that normally includes not only the 'typical sensory experience of physical pain' but also other unpleasant bodily experiences such as itching or nausea. A second caveat is that the terms physical or mental should not be taken too literally: physical pain or suffering, as a matter of fact, happens through conscious minds and involves emotional aspects, while mental pain or suffering happens through physical brains and, being an emotion, involves important physiological aspects.
Unpleasantness is another synonym of suffering or pain in the broad sense. More technically, the term is used in physical pain science for referring to the basic affective dimension of pain (its suffering aspect per se), usually in contrast with the sensory dimension, as for instance in this sentence from Professor Donald Price: “Pain-unpleasantness is often, though not always, closely linked to both the intensity and unique qualities of the painful sensation.” Words that are roughly synonymic with suffering, in addition to pain and unpleasantness, include distress, sorrow, unhappiness, misery, affliction, woe, ill, discomfort, displeasure, disagreeableness.
A page in preparation concerning the usage and study of terms and expressions used in algonomy can be seen here: Terminology in Algonomy.
Measurement and estimation are of prime importance for most rational activities dealing with suffering, and quantitative studies concerning suffering should be developed as an independent subdiscipline, which could be called algometry. A few preparatory notes for algometry are given here.
Bentham (1748-1832) has prompted much thoughts, in ethical
philosophy and in political economy, with his calculus of
pleasures and pains. Bentham mentions seven circumstances
that affect the value of an actual or potential pleasure or
pain : 1- its intensity; 2- its duration; 3- its certainty
or uncertainty (how sure are we of its existence?) ; 4- its
propinquity (proximity) or remoteness (is it present or more
or less future?); 5- its fecundity (how much sensations of
the same kind does it necessarily bring about?); 6- its
purity (how much sensations of the opposite kind does it
necessarily bring about?); 7- its extent (how many people
are affected by it?). Modern utilitarians, in their
computations, sometimes use hedons and dolors as units for,
respectively, pleasures and pains.
The International Society for Panetics has inquired into quantification
of matters related to the infliction of suffering (see
Quantification Research about Suffering at the ISP). The Society's founder, Ralph Siu,
has proposed a unit, the dukkha, for measuring suffering as
a product of three factors : intensity, duration and number
of persons affected.
questionnaires of various kinds (some are quite long) are
being developed in medicine for appraising physical pain in patients.
The most usual and simple device is the 5 or 10-steps scale,
which serves to communicate the intensity degree of a pain.
That scale can be numerical, verbal, or visual-analog. Pain
may be a purely subjective phenomenon, but its treatment has
to be objective; therefore, pain intensity is measured
according to "what the patient says", and thus the objective
behavioral data collected from what the patient expresses
become the basis of an objective pain measurement. Research
shows that this method is more reliable than any other for
assessing pain in patients. An important book in this area
is "Handbook of Pain assessment", by Melzack and Turk.
More concerned with suffering as such is the
Pictorial Representation of Illness and Self Measure (PRISM),
a simple quantitative method of assessing the perceived
burden of suffering due to illness.
field of psychophysiological measurement, various equipments
(e.g. stimulus gauges, reflex gauges, nerve impulse
recorders, electroencephalograms, computerized
tomography scanners, magnetic resonance imaging scanners) are used to
probe the measurable organic basis of physical pain or
psychological suffering. That field has a long history that
should be recapitulated as a part of algometrics. Some
important concepts are the dol (a unit of pain), the JND
(just noticeable difference), the Weber-Fechner law (the
amount of a perception is proportional to the natural
logarithm of the stimulus)… Generally, measurable aspects
that are most significant to algometry are intensity,
acuteness, dullness, aversion, duration, length, frequency,
recurrence… It may be noted that as a psychophysiological
phenomenon, suffering can be regarded under various aspects
relating to neurology, endocrinology, affectivity,
cognition, volition… Each aspects may require a special
algometric treatment. As to physical pain, several imaging
techniques, in addition to lab tests (blood, urine, spinal
fluid, biopsy, etc.), are used for investigating and
assessing its causes:
electroencephalography (EEG), tomography (CAT scan, MRI,
etc.), radiography, ultrasonography,
thermography, myelography, electromyography, etc.
Richard Ryder, on page 64 of his book Painism - A
Moral Modernity, mentions the following means for
measuring pain in animals (and possibly in infants or other
humans with limited communication capabilities) : behavior (such as screams,
approach or avoidance preferences), autonomic responses (such
as heart rate, respiration, galvanic skin response), level
of hormones (such as adrenaline, noradrenaline, cortisol),
level of pain-associated neurotransmitters, level of
endogenous opiates, and with a view to rating their painful
experiences for us, Ryder adds that animals can be trained to do
something (e.g. pressing a lever) to avoid unpleasant
situation or they can be given access to self-medication
with analgesics. See also the article
Dolorimeter in Wikipedia. Latest news, on
April 11, 2013, the New England Journal of Medicine
publishes an article :
An fMRI-Based Neurologic Signature of Physical Pain.
See also the AlgiScan (article
video), a device that allows an objective measure of
nociception in anesthesia and reanimation. See also
Reading Pain in a Human Face : "Can you tell which
expressions show real pain and which ones are feigned? A
study found that human observers had no better than a 55
percent rate of success, even with training, while a
computer was accurate about 85 percent of the time."
In the field of clinical psychology, a number of tests might
be used for assessing psychological suffering. The category
Clinical psychology tests at Wikipedia includes for
Beck Hopelessness Scale,
Hamilton Rating Scale for Depression,
Zung Self-Rating Anxiety Scale...
), etc. There are also
affect measures such as the Positive Affect Negative Affect Schedule (PANAS).
In the fields of healthcare and health economics, measures
like QALY (quality-adjusted
DALY ( disability-adjusted
Justice, insurance, actuarial science,
risk management are fields where suffering may be
quantified. In particular, evaluations of suffering are
routinely done by the courts for assessing
damages. See for instance
How do insurance companies and juries assign values to
pain and suffering?
Suffering in groups of individuals is sometimes tentatively
quantified by using social indicators (e.g.
The Human Poverty Index,
The Index of
Social health), statistics on problems related to
suffering (such as illnesses, deaths, crimes, human rights
violations...), questions addressed to a sample of a
population in a survey poll (like surveys about happiness),
indexes made up with various data (e.g.
The International Human Suffering Index,
Calvert-Henderson Quality of Life Indicators,
Gross national happiness -- Here is a list of other
current well-known indices: Social Progress Index, Human
Development Index, Millennium Development Goals,
Multidimensional Poverty Index, OECD Better Life Index,
Bhutan Gross National Happiness, Happy Planet Index), etc. Thus, Gallup Poll, using
Cantril Self-Anchoring Striving Scale, may come to an
estimate such as
More Than One in 10 "Suffering" Worldwide. The
Organisation for Economic Co-operation and Development
The Global Project on Measuring the Progress of Societies
which has a wiki called
on the subject; an entry on
Subjective Well-being states, about the methodology of
subjective well-being measurement : "The most important
proof for the validity and reliability and therefore quality
of the methodology is that the answers to subjective
questions tend to correlate strongly with other indicators
of quality of life (e.g. frequency of smiling, evaluation of
a person's satisfaction through family and friends, number
of positive emotions). More recent evidence from
neuroscience confirm that answers to questions on subjective
well-being coincide with measured neurological activities."
See also articles in Wikipedia such as
from the latter on 2013-04-03 : "Thus,
any health intervention which has an incremental cost of
more than £30,000 per additional QALY gained
is likely to be rejected and any intervention which has an
incremental cost of less than or equal to £30,000 per extra QALY gained
is likely to be accepted as cost-effective. This implies a
value of a full life of about £2.4 million." Approximatively
the same amount for the statistical value of a full life may
be encountered in the weighing of alternatives in other
areas of public decision-making, such as road construction
planning.) Another approach yet is
which has such application as
Software That Knows You're Suffering: How SentiMetrix Sees
PTSD With Artificial Intelligence or
of micro and small sufferings are endured by everybody each
day. Medium sufferings can be quite frequent as well.
Even intense but unexcessive sufferings are not rare, as
shown for instance in sports. Dealing with those 'unexcessive'
kinds of pervasive sufferings in the same
framework as sufferings that are 'excessive' may well turn
out to be practically unfeasible,
strategically counterproductive, and morally unacceptable.
Distinguishing between excessive and unexcessive suffering is of
course a matter of qualitative appreciation or value (moral,
judgment, but it is clearly also a matter of applied
Eventually, in order to have a clear view of suffering in
the world, an algometric epidemiology should be developed.
One of the uses of this specialty could be to provide a
periodical inventory of countable cases of excessive suffering
that can be identified at various scales (global, national,
local...) and in various areas (health care, social
services, economic security, legal system, etc.).
are still other aspects of suffering that need to be
measured : its consequences, causes, remedies, contextual
factors, costs, benefits, foreseeability, measurability,
diminishability, augmentability, and other economical,
social, ethical, political, strategical, or technical
aspects that can be relevant to its study or action about it.
A valuable innovative text in this respect is Anthony
Remedial Capacity Indicators
Versus Performance Indicators.
A talk with Daniel Gilbert : "What does it take to study
something scientifically? One word: Measurement. If you can
measure something, you can study it scientifically. Can we
measure a person's subjective emotional experience? You bet.
People can tell you with both words and actions what they
are experiencing (...) and these reports are the essential
data on which the science of experience is built. (...)
optometry is another one of those sciences that is built
entirely on people's reports of subjective experience. The
one and only way for an optometrist to know what your visual
experience is like is to ask you, 'Does it look clearer like
this or (click click) like this?' On the basis of your
answers, the optometrist is able to create a lens that
corrects your vision quite precisely. Indeed, without your
report of your subjective visual experience, optometry would
be impossible. No 'objective test' — no eye test, no blood
test, and no brain test — can provide this information."
How to Measure Anything, by Douglas Hubbard, offers
insights and methods that might be valuable for an algometry.
Another argument against measuring
suffering, besides the subjective aspect of the phenomenon
its first-person only accessibility, is that
no two sufferings are alike, or that at least there are
categorically distinct kinds of suffering which share no
commensurable aspects. Against that argument, scientific
postulates that suffering, defined as a specific psychoneural phenomenon, is a real concrete thing which exists in
space and time, in a given number of nervous systems: as
such, it can be
modified, augmented or diminished,
started or stopped.
In a 1946 article On the theory of scales of measurement,
psychophysicist Stanley Smith Stevens claimed that all measurement in
science was conducted using four different types of scales
that he called "nominal", "ordinal", "interval" and "ratio":
four levels of measurement
should certainly be used in algometry. Also of interest,
from the same psychophysicist, is
Stevens' Power Law, a proposed relationship between the
magnitude of a physical stimulus and its perceived intensity
or strength, which is widely considered to supersede the
Finally, a thorough review of the literature about quantification and mathematization related to suffering should be a permanent feature of algometry.
Collecting and classifying are usually among the first activities that are done within a new discipline. It is necessary to collect facts, ideas, documents, and to classify them methodically for convenient retrieval and handling. In algonomy, lists as exhaustive as possible should be set up concerning people or animals who suffer, kinds of suffering, causes of suffering, people and organizations who cause suffering, solutions or strategies relative to suffering, people and organizations who contribute to stop, diminish or prevent excessive suffering, documents having to do with suffering, and many other topics. See a page in preparation : Collecting and Classifying in Algonomy.
It is important in algonomy to develop a bibliographic subspecialty dealing with documents that can be found on paper, or on the Internet, or on other media, and that are relevant to knowledge and action about suffering. See a page in preparation : Bibliography in Algonomy.
Introduction à l'algonomie
Ce projet consiste à produire un document qui présente les premiers éléments d'une nouvelle discipline appelée provisoirement algonomie. L'algonomie peut se définir comme une branche du savoir systématique où des connaissances vérifiables et cumulatives concernant toute la variété des matières théoriques et pratiques qui touchent spécifiquement à la souffrance, sont recherchées, et utilisées, en conformité avec des méthodes scientifiques ou académiques reconnues. La méthodologie de la nouvelle discipline fait apparaître que l'étude algonomique de la souffrance relève d'un nouveau paradigme concernant cet objet, qui dès lors peut être considéré comme spécifique, premier, empirique, et digne d'un traitement aussi objectif et exhaustif que possible. Le terme souffrance désigne toute douleur, au sens large, et quelques notes sont offertes sur la terminologie en algonomie. Quelques notes préparatoires sont présentées concernant l'étude quantitative de la souffrance ou algométrie. La collection (des faits, des idées, des documents) et la classification en algonomie sont abordées en ce qui concerne les sortes de souffrance, les gens ou les animaux qui souffrent, les causes de souffrance, les gens et les organisations qui contribuent à produire la souffrance, les solutions ou les stratégies relatives à la souffrance, les gens et les organisations qui contribuent à arrêter, à diminuer ou à prévenir la souffrance excessive, ainsi que d'autres sujets. Enfin, une bibliographie algonomique est en cours de développement.
L'algonomie : un cadre de travail pour s'occuper de la souffrance
Toutes les grandes sphères de l'activité humaine ont affaire à la souffrance, d'une manière ou d'une autre:
la politique, la religion, les soins de santé, les affaires sociales, l'économie, le droit, l'art, la littérature, la philosophie, l'éthique, l'actualité, l'environnement, l'éducation, la science, l'histoire, la guerre, le crime, le travail, le sport, les relations interpersonnelles, la vie personnelle, etc.
D'autres champs, plus spécialisés, s'occupent particulièrement de la souffrance, bien que ce ne soit pas là leur objet d'intérêt premier. Tels sont par exemple:
la médecine, le service social, la sécurité sociale, l'aide au développement économique, la défense des droits humains, le bien-être animal, les sanctions judiciaires, l'infliction de la torture, les secours en cas de catastrophe, certaines parties des sciences biologiques ou psychologiques ou sociales, etc.
Donc, il y a plusieurs domaines d'activité qui s'occupent de la souffrance par rapport à autre chose, à l'État, ou à Dieu, ou à la santé, ou au bien-être, ou à la richesse, ou à la justice, etc. À vrai dire, cependant, aucun domaine ne s'occupe de la souffrance en tant que telle, en tant qu'objet d'intérêt principal. Conséquemment, si la souffrance dans le monde est toujours aussi mal maîtrisée, à ce qu'il semble, malgré une préoccupation extrêmement répandue à son égard depuis des millénaires, c'est peut-être parce qu'il a été impossible jusqu'à présent de travailler sur elle dans un cadre d'ensemble qui lui soit propre.
Alors, une idée évidente se propose ici, qui est de développer, aux côtés des autres domaines mentionnés ci-dessus, une toute nouvelle sphère de travail, une façon supplémentaire et tout à fait différente d'aborder le monde et ses problèmes, un nouveau domaine d'activité portant sur la souffrance même et sur tout ce qui la concerne de près ou de loin.
Il est suggéré d'appeler « algonomie » la discipline qui s'occupe de la souffrance. Le terme est formé de deux mots grecs anciens: algos, qui veut dire douleur ou souffrance, et nomos, qui évoque les notions de domaine, de gestion et de connaissance. Il est à noter que le mot souffrance est utilisé ici au sens large pour désigner toute douleur ou tout désagrément.
L'algonomie est un cadre de travail qui permet de traiter la connaissance et l'action sur la souffrance selon une discipline propre à ce phénomène. Elle touche bien sûr à une grande variété de domaines, plus particulièrement la psychologie, la philosophie, la religion, la politique, la santé, la justice et les services sociaux. Cependant, l'algonomie se distingue clairement de toute autre approche en ce qui regarde la souffrance, car elle seule s'occupe spécifiquement et universellement de ce sujet, d'abord et avant tout : en d'autres termes, une activité théorique ou pratique peut être dite algonomique si, "en principe", elle concerne la souffrance même, toute la souffrance, et d'abord la souffrance. Grâce à ses particularités, l'algonomie permet de dépasser trois sortes de défauts que les autres disciplines, malgré tous leurs mérites, présentent nécessairement quand il s'agit de souffrance.
1- D'abord, les autres approches sont inappropriées ou inadéquates, parce que leur objet spécifique n'est pas la souffrance elle-même, comme telle, 'per se'. Seule l'algonomie permet de reconnaître en fait la réalité propre et entière de la souffrance.
2- Ensuite, les autres domaines d'activité sont insuffisants ou incomplets, parce qu'aucun d'entre eux ne s'applique en principe à tout ce qui concerne la souffrance, physique ou mentale, humaine ou animale. Seule l'algonomie réunit sous un même cadre de référence toutes les formes de souffrance, toutes les causes, tous les remèdes, tous les éléments de la question. Si le but est de comprendre et de résoudre les problèmes relatifs à la souffrance, il faut aborder ces problèmes non seulement un par un ou en groupes limités, mais aussi dans leur ensemble, malgré l'ampleur et la complexité intimidantes que cela peut représenter.
3- Enfin, les autres champs d'intérêt sont trompeurs ou incohérents, parce que lorsqu'ils s'occupent de la souffrance, ce n'est toujours qu'en fonction de leur intérêt premier ou central. On trouve d'innombrables personnes ou organisations qui disent s'occuper de la souffrance, mais toutes à vrai dire poursuivent une activité spécifique qui est autre que cela, si bien que la souffrance n'a jamais été jusqu'à présent la spécialité de personne. Elle a donc été en ce sens terriblement négligée. Pour l'algonomie, tout ce qui n'est pas centré d'abord et avant tout sur la connaissance et l'action à propos de la souffrance représente une diversion, une déviation, un détournement de ce qui devrait être l'intérêt premier et central.
Assurément, l'algonomie a aussi ses défauts avec lesquels il faut composer. Par exemple, elle peut donner lieu à des tentations de bienfaisance totalitaire. Pour elle, tout se subordonne à son objet, mais pour ceux qui pratiquent cette discipline, la responsabilité s'impose de relier de façon appropriée l'algonomie à d'autres préoccupations. Agir sur la souffrance représente souvent une priorité, mais parfois c'est autre chose qui doit primer. Pour traiter cette question extrêmement complexe de la place que devrait avoir l'algonomie dans l'ensemble des choses, il est suggéré ici d'utiliser une approche comme celle qui est préconisée dans l'Encyclopédie des problèmes mondiaux et du potentiel humain.
Pour résumer, l'algonomie comme cadre de travail offre des innovations apparemment indispensables:
Un cadre d’approche méthodique pour s’occuper de la souffrance d’une manière générale, globale, systématique, ordonnée, permanente, et pour s’occuper d’elle en tant qu’objet d’intérêt premier, subordonné à aucun autre.
Un cadre d'apprentissage théorique pour étudier tout ce qui touche à la souffrance, ainsi que pour développer les habiletés qui se rattachent à cette sorte de savoir.
Un cadre de planification stratégique pour concevoir une action globale systématique sur la souffrance.
Un cadre d’action pratique pour effectuer des interventions qui portent sur le phénomène même de la souffrance.
The following is taken from the journal of the Canadian Pain Society, Pain Research & Management, Volume 14, Number 2, March/April 2009. It is a letter to the editor, by Robert Daoust, page 173. The original text can be found on the Internet.
Letter to the Editor
Re: Craig KD. Knowledge translation and the science of pain. Pain Res Manage 2008;13:464.
Bonjour docteur Craig,
Your editorial about knowledge translation prompts me to send you this message.
I believe the problem of pain science knowledge translation has a political dimension that should be confronted head-on. It is a problem of resource distribution that could be compared, for example, to the one that prevails in nutrition science, in which solutions to hunger are well known but can only be implemented through politically adequate resource distribution.
What modern politics is still lacking, in my view, is an approach to suffering (algonomy; http://www.algosphere.org/indexen.htm) that could inform social-economic management. There is a need for a science of suffering (algoscience; http://www.algosphere.org/intro/index.html), and psychology as well as pain science should be more aware of that need. Your editorial uses the words suffer and suffering, it raises the question of how pain is conceptualized and it states that there is a great need for integrative, even speculative, reviews and theoretical analyses. I would like us to go further — to clarify the link between pain and suffering, to recognize that because pain is an unpleasant experience, it is therefore a kind of suffering, to perform not only reviews and analyses but also to create the new science of suffering that must be created.
If you ever hear of someone who might be interested, able, and available for that kind of creation work, please let me know!
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