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Everything in the game is directed at the player, be it a sex scene, swearing, or brutal violence. It's all a presentation of the product for you to consume and digest. So when you spill that NPC's guts because he looked at you cockeyed, or blow that merc's brains out because Renegades gotta Renegade, it's all for you. And unlike swearing, sex and nudity, it offers it in bucket loads, and is virtually impossible to avoid.
Have not played Renegade, though I almost punched Admiral Gerrel for nearly killing my team and sounding like Loghain.
I use the Gore settings when available, as pixelated blood splatter is not my thing. As for the actual violence, perhaps I have become desensitized from watching old Westerns, cartoons, and Tarzan films, but it does not bother me as much as profanity.