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.

Nanoparticle-Assisted Immunoassays for Point-of-Care Testing - With Specific Interest in Minimally Interference-Prone Assays for Cardiac Troponin I

Cardiac troponins (cTn) I and T are the current golden standard biochemical markers in the diagnosis and risk stratification of patients with suspected acute coronary syndrome. During the past few years, novel assays capable of detecting cTn‐concentrations in >50% of apparently healthy individuals have become readily available. With the emerging of these high sensitivity cTn assays, reductions in the assay specificity have caused elevations in the measured cTn levels that do not correlate with the clinical picture of the patient. The increased assay sensitivity may reveal that various analytical interference mechanisms exist. This doctoral thesis focused on developing nanoparticle‐assisted immunometric assays that could possibly be applied to an automated point‐of‐care system. The main objective was to develop minimally interference‐prone assays for cTnI by employing recombinant antibody fragments. Fast 5‐ and 15‐minute assays for cTnI and D‐dimer, a degradation product of fibrin, based on intrinsically fluorescent nanoparticles were introduced, thus highlighting the versatility of nanoparticles as universally applicable labels. The utilization of antibody fragments in different versions of the developed cTnI‐assay enabled decreases in the used antibody amounts without sacrificing assay sensitivity. In addition, the utilization of recombinant antibody fragments was shown to significantly decrease the measured cTnI concentrations in an apparently healthy population, as well as in samples containing known amounts of potentially interfering factors: triglycerides, bilirubin, rheumatoid factors, or human anti‐mouse antibodies. When determining the specificity of four commercially available antibodies for cTnI, two out of the four cross‐reacted with skeletal troponin I, but caused crossreactivity issues in patient samples only when paired together. In conclusion, the results of this thesis emphasize the importance of careful antibody selection when developing cTnI assays. The results with different recombinant antibody fragments suggest that the utilization of antibody fragments should strongly be encouraged in the immunoassay field, especially with analytes such as cTnI that require highly sensitive assay approaches.