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[Cerebral Paladin]

My view of the essential nature of Paranoia can be summed up by:
You are a Troubleshooter. Your job is to identify Commie mutant traitors and shoot them. You work with other heavily-armed Troubleshooters. You are a Commie mutant traitor. Aren't you glad you're heavily armed, too?

So, switching that over to D&D sort of fantasy setting:
You are an Inquisitor. (This could be a secular or magical enforcement group, but the Inquisition has the right feel to me.) Your job is to kill heretical monsters-- people can be heretics (members of weird cults or secret societies with condemned beliefs) or monsters (creatures like werewolves, vampires, tieflings, doppelgangers, and other monsters that can infiltrate human society-- depending on feel, you might add elves or half-orcs to the list). The conceit of the game is that every PC is both a heretic (member of a cult/conspiracy) and a monster (instead of a mutation, characters all have a monster-type-- one might be a werewolf, another a doppelganger, etc.)

When characters die, raise dead magic is used to restore them-- the institutional church (or whatever) firmly believes that the raise dead ritual/spell/whatever restores people free of heresy and without any monster corruption. This is of course false.

The PCs then get sent by a senior Inquisitor on quests (read missions) and hilarity ensues. Magic items are of course highly valued and powerful, but unreliable and dangerous.

I have to admit that I'm tempted to throw something like this together for a con game. I'm not sure what game system to use though-- I think you'd want something lighter and faster (and more lethal) than most versions of D&D. Perhaps a very low-level group could work.