I think people should stop and think before they start using the MPAA standard to critique the ESRB's rating. If anyting the MPAA is far more screwed up than the ESRB could ever hope to be. Watch This Film Is Not Yet Rated to see for yourself. They're biased toward indendpendent films, have double standards against gay sex over straight, and allow the most hedius violence to get an R while steamy non explicit sex scenes get NC-17. I'd really hope the ESRB wouldn't look at the MPAA to check itself, and instead just go on it's own standards.
Manhunt 2 is the most violent game ever made, according to some like Matt at IGN it's far and away the most violent he's ever seen. Whether it matches up to the worse of R rated slasher fair is probably subjective, but even if it doesn't it's AO rating is likely deserved.
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