Well those choices would be good to make as long as you don't overdo them. I like your second example better as the first btw, eventhough games usually don't have a big enough impact on me to really care if an npc is dead or not. But if you could make me care, that would be incredible.
I think the second example is still too much about strangers, and 5>1 (not to forget the fact that fat people usually die sooner)
Maybe a good moral dilemma would be to choose between something that is usefull to you. For example a master blacksmith that will make the best weapon ever for you or 5 children from your hometown. (These kids might grow up to be usefull in your town or might even become blacksmiths)
But the way I see it, it would be really hard to have dilemmas that really make you think about moral and ethics. I think I would be thinking about the advantages that I would get out of it.
So good luck making us care <img src="/ubbthreads/images/graemlins/winkwink.gif" alt="" />