Here's the thing, games that use extreme violence just because it wants to shock the gamer and show that the game has balls is completely idiotic. If the violence is used out of the blue to shock gamers, and if the violence is unjustified and random for no reason (unless that is related to the plot) then that is also idiotic. But, if the violence is showed to explain something that nothing else can without the extra impact it needs. The Last of Us has some pretty damn violent scenes including a suicide and killing a brother. And the violence of killing the zombies. But, it was shown and integrated in the game because it was meant to show that the world is gone, shoved away for a new desolate future. Games like Metal Gear Rising: Revengance shows the main character tearing spines and consuming it, albeit a neon spine. That's supposed to be fun and it is. Just please don't use it out of character.