Greetings!
Thanks Dinkeldog, Fennes, and Horacio!

I'm glad that you like the thread!
It's good to see that many of you have developed such complex themes in your campaigns! Very interesting stuff! As noted, the development of such themes in a campaign can create very dramatic stories, and propel the group in directions and serve to motivate them in different ways beyond merely killing and looting faceless enemies.
Certainly, those people who are uncomfortable with such themes are welcome to feel as they do.
I tend to think that such exclusion of such themes can be limiting, but then again, I'm not uncomfortable with such themes.
In classical literature, from the Trojan War, to the Greek Tragedies, through the Arthurian stories, as well as theological literature such as that found in the Bible, such themes are literally everywhere, and serve to not only teach lessons about the nature of humanity, but also to make for more interesting and dramatic stories.
Characters that experience rape, slavery, or madness have a very personalized motivation and interpersonal involvement that few other themes can match. With villains, such themes serve to distinguish and crystalise them in the campaign, and in the eyes of the players. Imagine a villain that is stark raving mad, afflicted with Megolomania, and a host of other neurosis, standing in opposition to the player characters? Such a character can have bizarre motivations, and even change their goals and methodoligies on a whim, driven by insane whispers that gibber in their shattered minds!
War, of course, can serve as a vehicle for personal change and growth, as well as a process for cultural, economic, and political change. The player characters must deal with many ramifications of war, even beyond the scope that they are directly involved with. Politics and religion can further involve the player characters in many difficult decisions, and complex relationships that defy simple solutions.
As for realism in the game, as opposed to *high fanatsy*--well, personally, I think that I run a grim and brutal world, with elements of high fantasy throughout. In my view, stripping the game of such real world realities restricts the depth at which characters can grow and explore. There are so much more developments and themes that can enrich a campaign besides merely killing monsters and looting treasure. Indeed, that remains a component, but to absent or exclude other concepts can serve to make the game more like a comic book, and less like a dramatic novel. Comic books can be fun, of course, but there are so many elements that they never deal with, traditionally speaking. Many characters--even villains--never kill people, and they always have clear and simple motivations, and their interpersonal relationships can be simplistic. Those things, over time, can erode a campaigns verrisimillitude, and can also become quite predictable. None the less, that kind of game appeals to many people evidently, but it would seem to be limiting as time goes on.
It can indeed depend on what kind of players that you have gaming with you, as to what kind of themes and elements that you include in the campaign. I don't have any people that have been raped, so it isn't some kind of taboo subject. I have some players that are trained psychologists, so the themes of Madness is an interesting one for them to deal with in various capacities. War of course, is very dramatic, and gets my players very involved. Slavery, torture, and so on, are merely consequences and logical attitudes and behaviors from villains in the campaign. The player characters dealing with such must often confront their own emotions over such things, and often they can gain a very educational perspective from such dramatic experiences. They can use such as a dramatic vehicle to explore the reactions, morals, and motivations of their own characters involved in such circumstances.
At the end of the day, though, such themes allow for more dramatic, realistic stories to be explored in the game. Naturally, the capacity to separate fantasy from reality is essential to a balanced perspective.

Fun must remain the chief goal though, and there can be a great deal of fun had in learning and growing as a player and as a character through diverse and dramatic circumstances.
Semper Fidelis,
SHARK