Raph Koster made a point in his book, some punk Brazilians made it into a playable game. It´s Tetris meets Torture. The idea was, gameplay and content can be totally divorced, such that a classic puzzle game, loved by many millions, could be made into a metaphor for torture most foul. A clever idea, but only when played does the point come home.
Does this mean that the gap between system and theme is total? Nah. It just means there´s frightening untapped potential for phantasm, for the other side of flow, where the system starts to manipulate your mind instead of your mind manipulating the system. Tetris has great flow, and with the right skin, a sort of haunting effect as well.
Torture as a taboo subject, to me, is pretty banal, and the reality of it is always worse than the digital version. Nothing should be off limits, not because freedom of speech is a right, (see the last ten minutes of It´s Bad For Ya by George Carlin for more on that subject) but because it takes so many questions off the table that have potentially useful answers. Same goes for rape, since we´re in uncomfortable territory already. Here´s what I mean, forget about how you could re-skin established game designs to be about pederasty or whatever, think about how you could design new abstract systems in a way that would lend themselves well to new kinds of meaningful experience. The themes lent to by these new designs, borne by a generation of designers who see the matrix, aided by specimens like this, can vary from the horrible to the sublime. That´s irrelevant. It´s the system.
How about that scream when you score a Tetris!?