well...
The length of the Middle Ages is always debatable (I've struggled with this at length, having a degree in this very subject.) For ease of use, I reference it as a period of 1000 years, from 500 to 1500. Loosely, this is from the last dregs of the Western Roman Empire being swept away to the Renaissance in full bloom.
The culture in asoaif is definitely medieval in nature, stemming from the same roots (Valyria=Rome), but not yet at the height of culture found in the Renaissance.
So, saying that the peoples of Westeros have been living in this "awful" state for a few centuries isn't outrageous at all.
And trust me, life wasn't just bad in the Middle Ages. It's bad all the time. I don't need to tell you this. Just watch the news. Sure, advances have been made in the standard of living, but to say people were MORE morally bankrupt back in the Middle Ages than they are today is ridiculous. As someone earlier noted, the alignment of Lawful Good is EXTREMELY rare.
And just to reiterate: people swear every day. More people swear than don't. And in today's world, people swear MUCH more often than we see the characters in asoiaf swear. It's not a constant stream of meaningless obscenity like I hear every day. Needless to say, the same goes for sex. People are into some weird crap out there, and having been exposed to this knowledge, reading about the exploits of incestuous twins and a small dwarf don't bother me. They also don't titillate me in a cheap way. I read those passage, enjoy them, and move on. They serve the story. They expand on the character much more than if Martin had simply stated, "And then Tyrion called Shae to his bedroom and shut the door. The next morning...".
People are, by nature, morally grey. It is much interesting to read about a character who you are SURE is irredeemable, and then rejoice when you see that this is not the case, that there is still some good in them (Vader, anyone?). Who is by and far readers' favorite POV now in the series? Jaime, of course. Because we found out there's more than meets the eye to this guy. I believe Sandor Clegane falls into the same category, even though he doesn't have a POV (yet).
And it also irritates me when people claim that Tolkien's world is black and white, good guys vs. bad guys. Though Tolkien doesn't even approach the ambiguity of Martin's characters, there is still wonderful diversity in his masterful creation. I'll just list a few, and THINK about these characters, and tell me if you truly believe they are "guys wearing white" or "guys wearing black". I sure don't: Galadriel, Aragorn, Boromir (duh), Frodo, Sam, Gollum, Feanor, Thingol, Melkor, Thorin, Turin, and the list goes on and on. And this is considered by most to be high fantasy! Please.
Give me moral ambiguity any day of the week. So much more fascinating. It makes me work when I read. Rather than stifling my imagination, it forces me to alter my perceptions, to really think about a characer before I decide I want to root for them. When I know who the hero is, and who the bad guy is, then I get bored. And even better, when you finally decide who you want to root for, he/she usually ends up getting killed! I LOVE IT!!!
Martin is THE single best fantasy author working today, IMNSHO. If there were more like him, the sci-fi/fantasy section in the bookstore wouldn't be the laughing stock it is today.
Eryndur