Um...Have you been to the toll house? And blood is everywhere in the game. You kill something, it forms pools of blood for days. Risen Road to the east is a horror zone. What about the Hag's lair?
What they don't have is Critical Hit Cam Intense violence like Skyrim with swords jabbing through guts and such, but whateves. The point is, lots of violence already. Just not super close up.