Well, the gore factor doesn't matter so much.
Why so? Well, because, considering the possibilities of the engine, this can be made by users after it's released, as a MOD.
But, honestly, anyone here ever checked the ESRB rating for a game, and, if someone did, you took that seriously in any way? Those ratings are retarded. No kid is going nuts because a seagull just exploded on your canopy, broke the windshield and covered you with blood. There were cases of some assholes playing Counter Strike at school, but I don't think a game alone can do that to someone.
Just my point of view, of course.
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