You want realism in a game with vampires, magic and talking animals?
We expect everything non-magical to be minimal logical. How would like to see someone die from an arrow shot on the foot? Without explanations!
When Rune of Illusion said that fountain of blood erupts from the victim in Vandal Hearts, I really started to see this as a bad idea. With a option, that´s what would probably happen, but I still want more violence in the games, I find that more dramatic.
Also there must be no options, if we select a "no blood option", usually the censored scene will make no sense. Do it or don't, konami must make the choice, not the gamer.