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More and more developers are taking a non-linear approach to games, offering players a large degree of freedom. RPGs are most associated with using a multiple-choice structure; this might take the form of branching narratives, with decisions made throughout the game affecting the story, or with one choice at the end of the game that affects which ending players get.

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That said, there are also many horror games that present players with difficult moral choices. The weight of these decisions is, more often than not, amplified by the severity of the dangerous and terrifying situations players are thrown into. These are some of the best horror games where consequences must be carefully considered, as few paths lead to happy endings for everyone.
This list is ranked by the games themselves, rather than their decision-making elements.
Spoiler Warning: Some entries include specific dilemmas that players must face during their playthrough.
10 Amnesia: Rebirth
Decisions No Mother Should Ever Have To Make
Amnesia: Rebirth follows Tasi, a young pregnant drafter who has crash-landed in Algeria. Searching for safety, she comes across underground ruins where disturbing memories resurface and monsters emerge from the shadows. Eventually, players will come across the ruler of the Other World, Empress Tihana.
At the end of the game, players are given a choice. They can give up Tasi’s sick daughter, Amari, to the Empress in order to save her, escape together and face potential suffering, or kill the Empress – ending the mass torture yet killing both Tasi and Amari in the process. Amnesia: Rebirth overall has a compelling take on the desperation that often accompanies motherhood.
9 Pathologic 2
Some Sacrifices Must Be Made For The Greater Good

Pathologic 2 is an open-world RPG. The player takes on the role of a doctor, returning to his hometown after being contacted by his father, only to discover that it is being ravaged by a plague and society is collapsing. Players must try to survive while also saving the townspeople.
When everyone’s lives are in the player’s hands, decision-making is much more high-stake. Each dialogue option and act has an impact on the world; players must choose who to cure and treat, which, by design, means deciding who will suffer and die. This can be particularly hard after investing time getting to know the characters.
8 Vampyr
Explores The Cognitive Dissonance Of A Vampire Doctor

There are many games with vampire protagonists, from platformers to MMOs to shooters, though few are as atmospheric as Vampyr. The game, set in 1918 London, follows Dr. Reid who, once a field medic and phlebotomist, has awoken with an ironic lust for blood. In a combination of detective work and combat, players must find the source of the vampire epidemic.
As a bloodsucking doctor, players must regularly pick between helping citizens or killing them to become stronger. This feeding mechanic is interesting as choices can potentially prevent players from completing certain questlines and negatively impact “district statuses”. This really allows players to lean into the role-playing aspect of the game, and adhere to their own moral compass.
7 Darkwood
Players Must Take Into Account Unpredictable Outcomes
Darkwood is a top-down survival horror game where players must try to escape a forest that is slowly overtaking the land, mutating everyone and everything in it. If escaping the many dangers that emerge at night wasn’t enough, the map is procedurally generated, making navigation significantly more difficult, especially on replays.
Throughout the game, players will choose who to help (or not), with the consequences of doing so almost entirely unpredictable. What might, at first, seem merciful could very well have dire knock-on effects. Likewise, some choices that feel wrong might benefit the player. Unfortunately, there is no-one there to advise them.
6 SOMA
Raises Complicated Philosophical Questions

While many survival horror games place emphasis on combat and resource management, SOMA takes more of a stealth approach, paying special attention to atmosphere. Players must navigate an underwater facility littered with hostile robots, uncovering shocking truths that shake their perception of themselves and the world around them.
The in-game decisions don’t necessarily alter the story, which takes some of the pressure off, but they are thought-provoking nonetheless. Players are confronted with questions about consciousness and identity, made all the more poignant as AI is becoming more and more prominent in the real world.
5 Spec Ops: The Line
What Happens When There Are No Right Choices?

While Spec Ops: The Line is not an obvious choice in this list, it is a game with some extremely dark themes. In a time when horror is becoming more and more saturated with spooky clichés like evil poltergeists and menacing monsters, it’s refreshing to see games that take a more subtle approach. Spec Ops: The Line is not a traditional horror title packed with supernatural gimmicks.
What begins as a third-person shooter with a run-of-the-mill rescue mission gradually becomes a psychological horror that exposes the visceral reality of war on a more individual level. Players are consistently forced to make horrific decisions that will leave them haunted, no matter what call they make.
4 The Walking Dead
Survival Always Comes With A Cost

The Walking Dead takes place at the beginning of a zombie outbreak. While the nature of the context makes for many heart-wrenching moments, the game excels at storytelling, managing to combine action, horror, and character development into a neat episodic horror-adventure.

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The in-game choices aren’t always low-stake; deciding who to trust or help can be a matter of life or death for other characters. From choosing who gets to eat rations all the way to choosing whether to kill or spare the protagonist, the whole experience is an emotional ride where guilt, grief, and doubt all play a part.
3 Until Dawn
High-Pressure Decision-Making That Can Determine Who Survives

Supermassive Games began their development journey with relatively PG games like Start the Party and Walking With Dinosaurs, but branched into horror with the 2015 title Until Dawn. This was the first Supermassive title to experiment with multiple, branching narratives.
Set on the eerie Blackwood Mountain, players control eight reunited young adults who soon find themselves prey to both supernatural and human threats. Players are faced with many decisions that influence the characters’ relationships as well as the trajectory of the story, and are forced to pick between self-preservation and empathy.
Collecting totems gives players a glimpse of potential future events, which might influence their choices.
2 Silent Hill 2
Coming To Terms With Guilt, Or Not

Silent Hill 2 is renowned for taking the franchise deeper into the psychological horror realm, with the town itself becoming a reflection of the protagonist’s psyche. Players control James Sunderland as he searches for his wife, Mary, while also grappling with grief and remorse. While his actions are inexcusable, many players find themselves sympathizing with James as a layered protagonist.

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Although players don’t explicitly make choices, they can decide how to play the game to influence the ending. Each moment in the game is an interesting exploration of the complications of life, with players ultimately determining whether James deserves to move on or succumb to his guilt.
1 Resident Evil 7
Can Love Conquer All?
Resident Evil 7 makes delightfully gruesome use of Southern Gothic tropes; the plantation surrounded by swamps, the cannibal Baker family, and the protagonist’s morbid curiosity all merging to create a grotesque backdrop for the franchise’s slasher-esque direction.
One of the hardest decisions in the game is whether to save Zoe, who has been Ethan’s guide, or Mia, his wife. While it might seem like a straightforward choice, with Mia being the whole reason for Ethan’s foray into the perilous Louisiana, leaving Zoe (who hasn’t been trying to kill him the whole time or working for a crime syndicate) doesn’t feel right either.
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