I'm also in the "Dead is Dead" crowd. Knowing that my career is on the line makes me more cautious and realistic - no going in with guns blazing. It also makes you sweat a little after 15-20 missions when the Tommy's are raining down ash cans.
The only time I would use an earlier save is if the game or PC screwed up (e.g. got stuck on time compression and ran aground).
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