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There is a relatively small but diverse set of people, projects, and organizations that share an especially strong concern with suffering. Some emerge from negative utilitarianism; others from what have come to be called suffering-focused ethics; still others from the study of sentience, valence, or animal welfare. Some investigate present suffering, others possible future suffering. Some work on animals, others on human beings, neurotechnology, artificial intelligence, institutions, or moral philosophy.
It is not easy, however, to know what to call this space.
The terminological problem is not trivial. Negative utilitarianism refers to a relatively specific family of moral theories and, moreover, contains a word—“negative”—that may convey an impression quite different from what is intended. Brian Tomasik has himself noted that negative utilitarian is an unfortunate label. Sentientism—roughly equivalent, in its traditional ethical sense, to the Spanish sensocentrismo—primarily answers a particular question: who should receive moral consideration. Hedonism characterizes a theory about the value of experiences, but it does not clearly convey the idea of giving special priority to the prevention of suffering, since it can direct attention just as readily toward positive valence. In ordinary language it also carries potentially misleading associations with self-indulgence, excess, or the pursuit of pleasure rather than with a serious theory of the value of conscious experience. Abolition of suffering describes a much stronger objective and is closely associated with the project developed by David Pearce.
Felicitarianism is interesting from a communicative perspective because it has more positive connotations and avoids some of the misleading associations attached both to “negative” and to “hedonism.” The term has historical antecedents in the Benthamite tradition, but it never became established as a general alternative to utilitarianism. For the problem considered here, it also directs attention toward happiness rather than toward the special priority given to suffering.
In recent decades, suffering-focused ethics has solved much of this problem within moral philosophy. It is probably the umbrella expression that has worked best so far: it encompasses different positions that share a special priority for preventing or reducing suffering. Yet it retains an obvious limitation: it contains the word ethics. A laboratory, an organization, a research program, a philanthropic strategy, or a technological project may treat suffering as a priority without thereby constituting an ethics.
One natural possibility is simply to retain suffering-focused. The difficulty is that the expression functions especially naturally as a modifier and seems to call for something to modify: suffering-focused ethics, suffering-focused research, suffering-focused initiative. It sounds less natural as the autonomous name of an intellectual or practical orientation.
Suffering-centered is another relevant candidate. The expression has already appeared independently in different contexts. Robert Arlinghaus, Alexander Schwab, Steven Cooke, and Ian Cowx used the expression suffering-centred approach in discussing fish welfare, while Katrina Roze Myers has more recently used suffering-centered ethics in work inspired by Schopenhauer. These uses do not appear to have crystallized into a general name for the space considered here, but they show that placing suffering at the center is a natural way of characterizing this type of orientation.
Yet suffering-centered, like suffering-focused, remains predominantly adjectival: suffering-centered ethics, suffering-centered approach, suffering-centered organization.
The candidate proposed here is Suffering First.
Suffering First has the considerable terminological virtue of being able to function on its own, substantively, as the name of an approach. From it, suffering-first can also be used adjectivally to describe an initiative, a research program, an organization, or a strategy.
Robert Daoust and Suffering as a Starting Point
The most direct conceptual antecedent found for this formulation appears in the work of Robert Daoust.
Daoust has spent decades working on the possibility of placing suffering at the center of a specific discipline. In an interview conducted by Sentience Research, he explained that in 1975 he reached a realization that would shape his later work: he could not find in our culture a central place devoted to studying the phenomenon of suffering itself, in all its variety. From there, he proposed both a theoretical discipline and a practical enterprise specifically directed toward suffering.
https://sentience-research.org/the-systematic-approach-to-suffering-an-interview-with-robert-daoust/
His proposal eventually crystallized into algonomy, a discipline devoted to the systematic study of suffering. Medicine studies diseases and encounters suffering; psychology studies certain mental states and encounters suffering; the social sciences study poverty, violence, or exclusion and encounter suffering. Daoust proposes reversing that perspective and making suffering itself the primary and transversal object of inquiry.
His terminology is particularly significant. He defines the algospheric approach as a perspective intended to deal with:
“suffering itself, suffering first, and suffering as a whole.”
https://robertdaoust.org/syst-study/term.html
The expression captures with remarkable precision the idea of Suffering First.
The way this convergence was reached is also methodologically relevant. This article was developed with the assistance of artificial intelligence as part of an exploration of different ways of naming this conceptual space. ChatGPT proposed suffering-first as a candidate, and the subsequent search for antecedents led to Daoust’s work. That search does not claim to establish exhaustive historical priority, but it identified Daoust as the most direct and precise antecedent found. The use developed here should therefore be understood primarily as an extension of an intuition formulated by Daoust much earlier, rather than as a claim to terminological originality.
There is, however, a difference in scope. Algonomy aspires to become a scientific discipline and need not assume, as part of its own definition, that suffering is morally bad: its task is to study it systematically. Suffering First allows the same orientation to be extended to normative and practical domains such as ethics, philanthropy, applied research, technology, institutional design, or the creation of organizations.
From Suffering-Focused Ethics to Suffering First
There is a second, closely related genealogy that comes from moral philosophy. The expression suffering-focused ethics was coined by Brian Tomasik, according to Magnus Vinding. Tomasik was already using it in 2015 to refer to perspectives that give special importance to reducing suffering. Lukas Gloor and Adriano Mannino subsequently helped consolidate it as an umbrella term, while Magnus Vinding carried out one of the most systematic efforts to develop the framework and defend the reduction of suffering as a fundamental priority.
https://reducing-suffering.org/the-case-for-promoting-suffering-focused-ethics/
https://magnusvinding.com/2020/05/31/suffering-focused-ethics-defense-and-implications/
The breadth of the concept matters. Suffering-focused ethics need not be reduced to negative utilitarianism, nor need they hold that suffering is the only thing that matters. They may recognize other values and differ in the degree of priority they assign to suffering.
https://centerforreducingsuffering.org/research/introduction-to-suffering-focused-ethics/
Suffering First seeks to carry that intuition into a more general domain. Here, first primarily means normative or axiological priority: suffering matters in itself and receives special importance, rather than mattering only because it affects some other previously selected value.
This allows for different strengths of commitment. In a strong version, suffering could constitute the only intrinsic disvalue, with other goals acquiring merely instrumental value. In pluralistic versions, other things may possess intrinsic value while suffering still receives special priority. The term does not, by itself, imply utilitarianism, interpersonal aggregation, any particular metric of suffering, or absolute or lexical priority over every other consideration.
The word first also carries a secondary resonance that is consistent with this primary meaning. If suffering is the priority concern, it will naturally tend to appear at the beginning of the reasoning process: one asks where suffering occurs, what produces it, and what can be done to reduce it before committing to particular causes for their own sake.
suffering → where it occurs → what produces it → what can be done
This sequential sense does not independently define Suffering First. Rather, it makes visible a natural consequence of its axiological core. What is placed first in the order of importance will also tend to be what is examined first and what one returns to when priorities need to be reconsidered.
Nor is it necessary here to resolve exactly what should count as suffering, how different forms of suffering should be compared, or how much weight should be given to intensity, duration, probability, or number of individuals affected. Those are subsequent questions. The concept is intended to identify which variable receives priority, not to provide a complete theory of how that variable should be measured.
Some Initiatives Viewed Through the Lens of Suffering First
One way to test whether a concept is useful is to apply it to existing cases. The following examples allow Suffering First to be tested as a descriptive tool: to examine what place suffering occupies within very different initiatives and whether the concept helps distinguish those in which suffering itself has priority from those that reach suffering through another cause or value.
The aim is not to construct a rigid classification or to compare the effectiveness of organizations that differ radically in size, resources, and function. Nor is a binary boundary assumed between suffering-first and non-suffering-first initiatives. The question is whether the priority assigned to suffering constitutes a useful dimension for making sense of a space that otherwise appears highly heterogeneous when viewed only through its particular causes.
- Robert Daoust / Algonomy — suffering first. His program proposes making suffering the primary and transversal object of research. His formulation “suffering itself, suffering first, and suffering as a whole” is the most direct conceptual antecedent of the usage developed here.
https://robertdaoust.org/syst-study/term.html - Center for Reducing Suffering — suffering as a priority. Its research begins explicitly from perspectives that assign primary importance to preventing suffering and connects that framework with the prioritization of causes and interventions.
https://centerforreducingsuffering.org/ - OPIS — intense suffering. It identifies the prevention of intense suffering among sentient beings as a highest ethical priority and develops different areas of activity from that starting point.
https://www.preventsuffering.org/about/ - Brian Tomasik / Essays on Reducing Suffering — suffering. His work has played a major role in consolidating the contemporary orientation toward reducing suffering and in introducing the expression suffering-focused ethics.
https://reducing-suffering.org/the-case-for-promoting-suffering-focused-ethics/ - Magnus Vinding — moral priority of suffering. He has developed suffering-focused ethics particularly systematically as a broad framework capable of encompassing different moral positions.
https://magnusvinding.com/2020/05/31/suffering-focused-ethics-defense-and-implications/ - David Pearce / Hedonistic Imperative — abolition of suffering. His program proposes using biological technologies to progressively eliminate negative experiences.
https://www.hedweb.com/ - Sentience Research — reducing suffering through the study of sentience. It states that its primary objective is to reduce involuntary and unnecessary suffering and uses research on sentience as a means of identifying more accurately where suffering may exist and how it might be reduced.
https://sentience-research.org/about/ - Far Out — chronic suffering. It explores forms of chronic suffering as problems potentially susceptible to neurobiological intervention.
https://farout.bio/ - Center on Long-Term Risk — extreme future suffering. Its primary ethical focus is the reduction of involuntary suffering, with much of its research directed toward risks associated with advanced artificial intelligence.
https://longtermrisk.org/about/ - Welfare Footprint Institute — affective experiences. It quantifies the duration and intensity of positive and negative experiences and uses these measures to compare effects on welfare.
https://welfarefootprint.org/2025/04/11/defining-affective-experiences/ - Animal Ethics — moral consideration of sentient beings. Suffering has great importance, but shares the starting point with questions of moral consideration and criticism of speciesism.
https://www.animal-ethics.org/about-us/ - Wild Animal Initiative — wild-animal welfare. It begins with a previously delimited population and field and develops science intended to understand and improve the welfare of wild animals.
https://www.wildanimalinitiative.org/mission - International Association for the Study of Pain — pain. It begins with a specific class of negative experience and organizes research and relief around it.
https://www.iasp-pain.org/about/history-mission-vision/ - Spanish Association Against Cancer — cancer. Its purpose explicitly includes alleviating and preventing the suffering caused by a previously delimited disease.
https://www.contraelcancer.es/es/sobre-nosotros - Médecins Sans Frontières — medical humanitarian assistance. It prevents and alleviates suffering within a domain defined by medical needs and humanitarian crises.
https://www.msf.org/who-we-are - Amnesty International — human rights. In its opposition to the death penalty, suffering matters, but the argument is also structured around the right to life and the prohibition of cruel, inhuman, or degrading punishment.
https://www.amnesty.org/en/what-we-do/death-penalty/the-death-penalty-your-questions-answered/ - Derecho a Morir Dignamente — autonomy. The relief of suffering appears within a broader framework of freedom to decide about one’s own death.
https://derechoamorir.org/ufaq/a-que-se-dedica-dmd/ - OMCT and IRCT — torture. They begin from a particular practice or its victims and develop strategies of prevention, protection, rehabilitation, documentation, and justice.
https://www.omct.org/
https://irct.org/about-the-irct/ - Red Cross and Red Crescent — humanitarianism, life, and dignity. The prevention and alleviation of human suffering form a central part of the principle of humanity, within a broader humanitarian framework.
https://www.icrc.org/en/our-fundamental-principles - GiveWell — doing as much good as possible. It seeks cost-effective interventions to save and improve lives, but its stated objective is broader than assigning specific priority to suffering.
https://www.givewell.org/about/values
These cases suggest that Suffering First is more useful as a dimension than as a binary label. Some initiatives come very close to giving intrinsic priority to suffering while leaving their specific causes relatively open; others begin from a previously selected disease, population, practice, or value; many combine both logics.
When Something Else Comes First
A large part of human activity reduces suffering without necessarily placing it at the core of the initiative. The Spanish Association Against Cancer provides a particularly clear example: its purpose includes alleviating suffering, but the domain is already fixed by cancer. The path can be represented as:
cancer → consequences → suffering
whereas a suffering-first initiative might proceed in the opposite direction:
suffering → possible causes → perhaps cancer
Something else may also come first in the form of a value. Amnesty International opposes the death penalty within a human-rights framework; Derecho a Morir Dignamente places autonomy at the forefront; Animal Ethics combines the welfare of sentient beings with questions of moral consideration and speciesism.
The distinction also does not map neatly onto the opposition between consequentialism and deontology. There may be consequentialist positions centered primarily on happiness, preferences, or total welfare, as well as pluralistic or deontological positions that give suffering unusually high priority. Suffering First is intended to identify what occupies the normative core, not to assign a complete ethical theory automatically.
The Marginal Improvement Test
As long as different values lead to the same decisions, their differences may remain hidden. A practice may produce extreme suffering, violate rights, and be considered unjust at the same time. Very different perspectives may therefore converge in rejecting it.
Gradual improvements make it easier to identify what actually occupies a position of priority.
Imagine a highly painful method of execution that is replaced by progressively less painful methods. From a suffering-first perspective, and holding other consequences constant, each reduction in suffering constitutes an improvement. From a perspective whose central foundation is the right to life, that improvement may be welcomed without substantially altering the underlying opposition to the practice: a less painful execution is still an execution. Amnesty International, for example, opposes the death penalty regardless of the method used.
Something similar occurs in the use of animals. If their conditions gradually improve, a perspective focused primarily on their experiences will recognize each genuine reduction in pain, fear, or stress as an improvement ceteris paribus. A perspective centered on rights, freedom, exploitation, or speciesism may value those improvements without regarding the underlying problem as resolved.
This does not mean that a suffering-first approach must always support partial reforms. An improvement that reduces suffering immediately might stabilize a harmful system for longer and ultimately produce more accumulated suffering; the opposite might also happen. The issue therefore requires a distinction between an axiological question—whether less suffering is better, other things being equal—and an empirical and strategic question—whether a particular intervention will ultimately produce less suffering once all its consequences are considered.
Two people may therefore share the same normative priority while defending different strategies because they rely on different causal models. Suffering First does not by itself prescribe a strategy; it identifies what receives priority when strategies are evaluated.
What Comes First?
Suffering First attempts to provide a simple name for an orientation that already appears under different formulations and that Robert Daoust expressed with particular clarity in proposing to address “suffering itself, suffering first, and suffering as a whole.”
The expression is not intended necessarily to replace suffering-focused ethics, suffering-focused, or suffering-centered, nor to claim a new ethical theory. Its possible usefulness is more modest: to provide an autonomous name for perspectives and initiatives in which suffering matters in itself and occupies a position of normative priority. That this priority may also lead one to begin by asking where suffering occurs and what produces it is a natural consequence of that axiological core.
The question the term seeks to make visible can be stated very simply: What do we want to put first?
Terminological note
In this article, Suffering First is used as the name of the proposed approach or orientation. When the expression functions as a compound adjective in English, it is written suffering-first, with a hyphen and lowercase letters, as in suffering-first initiative. In English titles, the same adjective may appear as Suffering-First following title-capitalization conventions. These different forms therefore reflect grammatical function rather than different concepts.
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