That game ain't seeing the inside of this house, that's for sure. I'm not prissy about violence in a video game, but there has to be some element of good battling evil involved, not just nihilistic violence for its own sake. I also do not allow overly realistic violence, i.e. actual innocent people getting shot in a realistic way like in the game you describe. We had a James Bond game in here that was skirting the limits, in that although the people you shot were bad guys, they tended to squirm around and bleed entirely too realistically. In the fantasy games, something you kill generally evaporates in a puff of smoke, and it usually is not human.

Not sure I would put these two phenomena into the same category, but to be fair you didn't explicitly say that.