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Sex is even handled tougher in the USA. While films like "Der letzte Tango in Paris", "Basic Instinct", "Crash" or "Eyes Wide Shut" contains very explicitly nude scenes, games with even only hints would get a "M-Rating" which limits the distribution. Factor 5 originally build in a easter egg in Lair. The Cheat "Hot Coffee", in reference to the scandal around GTA:SA, was playing a short movie of a coffee machine. That had to be removed from the game, because it was undercutting the authority of the ESRB"

The Hot Coffee thing is really lame of the ESRB, but otherwise this argument falls flat since I'm sure all the films he metnioned have R ratings.

As for Hostel II vs. Manhunt 2...I don't think it's that easy to compare them. For starters, one could argue that the film ratings board didn't do its job and Hostel II should be rated worse than R. Should the ESRB really bow to whatever the MPAA decides is appropriate?

Not to mention other arguments people have made here that acting out murders is different from watching them.

And last but not least, many of these films have been censored too. Saw III was rated worse than R seven times before it was censored enough for the MPAA to finally give it an R rating.