Modernin moraalifilosofian unohdettu klassikko

Kirjallisuusarvostelu

The Rejection of Prioritarianism

Since the late 1990’s, a group of moral doctrines called prioritarianism has received a lot of interest from many moral philosophers. Many contemporary moral philosophers are attracted to prioritarianism to such an extent that they can be called prioritarians. In this book, however, I reject prioritarianism, including not only “pure” prioritarianism but also hybrid prioritarian views which mix one or more non-prioritarian elements with prioritarianism. This book largely revolves around certain problems and complications of prioritarianism and its particular forms. Those problems and complications are connected to risk, impartiality, the arbitrariness of prioritarian weightings and possible future individuals. On the one hand, I challenge prioritarianism through targeted objections to various specific forms of prioritarianism. All those targeted objections are connected to risk or possible future individuals. It seems to me that together they give good grounds for believing that prioritarianism is not the way to go. On the other hand, I challenge prioritarianism by pointing out and discussing certain general problems of prioritarianism. Those general problems are connected to impartiality and the arbitrariness of prioritarian weightings. They may give additional grounds for believing that all prioritarian views should be rejected. Prioritarianism can be seen as a type of weighted utilitarianism and thus as an extension of utilitarianism. Utilitarianism is morally ultimately concerned, and morally ultimately concerned only, with some kind of maximization of utility or expected utility. Prioritarianism, on the other hand, is morally ultimately concerned, and morally ultimately concerned only, with some kind of maximization of priority-weighted utility, expected priority-weighted utility or priority-weighted expected utility. Thus prioritarianism, unlike utilitarianism, is a distribution-sensitive moral view. Besides rejecting prioritarianism, I reject also various other distribution-sensitive moral views in this book. However, I do not reject distribution-sensitivity in morality, as I end up endorsing a type of distribution-sensitive hybrid utilitarianism which mixes non-utilitarian elements with utilitarianism.

From statin efficacy to everyday effectiveness: Studying the gap in between.

Statins are indicated for preventing cardiovascular disease events. Patients with diabetes have a risk of major cardiovascular events double the risk of their peers without diabetes. Thus, clinical treatment guidelines recommend statins for the management of diabetic dyslipidemia. The evidence base for statin use in cardiovascular disease derives from the randomized controlled statin trials designed to prove statin efficacy under ideal conditions, among a homogenous study population meeting strict trial eligibility criteria. This thesis was implemented as four pharmacoepidemiological statin studies using register data on realworld statin users. The overall purpose was to evaluate the trends, patterns and effectiveness of statin use in everyday life. More specifically, nationwide secular trends in statin use in Finland were analysed, especially among patient groups which had been underrepresented in the statin trials. Furthermore, the benchmarking statin trials in diabetes, the Heart Protection Study and the Collaborative Atorvastatin Diabetes Study, were evaluated for their representativeness for real-world diabetes care with the emphasis placed on adherence to statin use. The association between good adherence and the incidence of major cardiovascular events in the real-world was further investigated in diabetes. These studies demonstrate that statin initiations increased from 1995 to 2005 in Finland. The increase was most pronounced among those aged at least 75 years and was observed already before the publication of rigorous trial data conducted in elderly subjects. Thus, statins seem to have been initiated in clinical practice also going beyond the strict trial eligibility criteria. Nonetheless, low adherence to statin use among the real-world patients with diabetes was found not only to limit the representativeness of the trials for clinical care but also to attenuate in all likelihood their benefits in the real-world. In fact, good adherence to statin use was found to associate with a decreased risk for major cardiovascular events in patients with diabetes. In conclusion, these studies highlight the importance of good adherence to statin use in clinical practice in order to obtain the full therapeutic value demonstrated in the statin trials. Simply increasing the number of statin users will not alone suffice in sharing our common resources appropriately.

Antiphonarium (MS A.ö.II.29, Ilmajoen antifonarium)

Complete critical and codicological description of the book and its contents available in the Codices Fennici -database.

Metrics for Predicting User Behavior and Experience in an Interactive Storytelling System

In much of the previous research into the field of interactive storytelling, the focus has been on the creation of complete systems, then evaluating the performance of those systems based on user experience. Less focus has been placed on finding general solutions to problems that manifest in many different types of interactive storytelling systems. The goal of this thesis was to identify potential candidates for metrics that a system could use to predict player behavior or how players experience the story they are presented with, and to put these metrics to an empirical test. The three metrics that were used were morality, relationships and conflict. The game used for user testing of the metrics, Regicide is an interactive storytelling experience that was created in conjunction with Eero Itkonen. Data, in the forms of internal system data and survey answers, collected through user testing, was used to evaluate hypotheses for each metric. Out of the three chosen metrics, morality performed the best in this study. Though further research and refinement may be required, the results were promising, and point to the conclusion that user responses to questions of morality are a strong predictor for their choices in similar situations later on in the course of an interactive story. A similar examination for user relationships with other characters in the story did not produce promising results, but several problems were recognized in terms of methodology and further research with a better optimized system may yield different results. On the subject of conflict, several aspects, proposed by Ware et al. (2012), were evaluated separately. Results were inconclusive, with the aspect of directness showing the most promise.