I was reminded strongly of "Blue Lacuna" when I played this. But this is worse. Death is everywhere - literally and figuratively. I'm sickened and horrified and the game enhances this by presenting a public view and the true private one, allowing players to see how far things have degenerated.
I liked the conversation menus. I don't know why people hate them so much. I really enjoy them, as well as interfaces where possible topics get listed. I can never come up with things to ask about on my own or invariably miss something.
I'm still trying to process the game. Would I recommend it? Yes, but only to those who I know have read and can stomach things like this. I don't know how this game improves my perspective on life, but maybe it sheds light on my own moral code. As far as I'm concerned, the PC has no excuse and I feel no sympathy. Just because an act cannot be helped does not make it okay. It is still a bad act, even if the origin is understood. I pity the illness, but not the person, since they know they are doing wrong.
This game moves smoothly and deserves to be played. But since it does deal with a pretty traumatic real world scenario, I think it's important that people considering playing it assess whether something like that would cause serious harm because it hits too close to home. I cannot say I enjoyed the story, but did enjoy the exploration of the settings. Good mirroring in them, and that makes it work from a literary standpoint.