It curious to think how much better moral choices could be using the mechanics already in place.
I've always wanted to make a war game and at one point have this moral clash:
You're a medic and your army is trying to defend a city. It's a losing battle, your fellow soldiers stand no chance but are still desperately holding the line to buy more time for escape. In the city they're unprepared and attempting to evacuate the people and it's complete chaos, and at this point the enemy is breaking through in spots and mortars are coming down, so essentially ever second soldiers and civilians are dying.
Here's the problem:
You want to evacuate the city as fast as you can, which means coldly cramming everyone into the cars, separating families and not giving the sick, hurt, disabled, young, etc help. People will be crying everywhere, but the sooner they're out of the city the sooner their lives are guarantied, although who knows if they'll ever get past the trauma or find their families.
You can take more time so people get the assistance and supplies and reassurance they need, but while you're taking all that time helping them you're too busy to help others, and the mortars will pick them off.
Along with that there's something else that can top it off. As stated before, you're a medic, and you're not supposed to be in the city but at the front lines treating your comrads. At any time you can hop on a convoy to where you're supposed to be and help the battle, thus buying more time and saving the lives of your fellow soldiers. As long as you're not helping them you can have another soldier nag you on the radio to get over there, and if you take too long, he can become hysterical and plead with you because eventually they're gonna get caught by surprise and suffer very heavy casualties. If you still don't show up after that, he'll tell you to not even bother, they've already lost, then maybe throw in an insult about your cowardliness. They will be finished off and then you and the NPC's in the city helping with evacuation will be on their own to defend against the advancing enemies. All of this can climax with a side quest option of helping a scared little girl by escorting her to her house to grab a jacket and her teddy bear, then get her on a car that will take her to her mother, who was at the market when it happened. It'll be fun provided the deaths of people evoke emotion.