Dontod, the team behind teen drama Life is Strange, have taken a hard right turn with their next game, Vampyr. It’s action-packed, violent and just a little bit voyeuristic.

A hands-off demo of Vampyr arrived at this year’s E3 alongside a long, pre-recorded look at its combat system on YouTube. In motion, the game pulls liberally from the combat-heavy series Dishonored. But it also takes a thoughtful, nearly voyeuristic look at the inner struggles of a classic villain.

In Vampyr, players take on the role of Dr. Jonathan Reid, a World War I veteran practicing medicine in early 20th century London. The city is in the grips of the Spanish flu, which is somewhat complicated by the rise in canibalism. Not only are citizens dying from illness, they’re also prone to being turned into “skals,” a mutation that eats away at the mind while giving people a taste for human flesh. All along the Thames, in fact, skals lurk below the piers ready to leap out and devour passersby.

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But Reid has his own set of problems. There’s an order of vampire hunters hot on his trail, and in order to survive he must grow more powerful by feeding on the citizens of London. It’s up to players to determine who lives or dies.

Each of London’s several districts is supported by a web of relationships. In the demo that Dontnod showed behind closed doors in Los Angeles last week, one tiny part of that web centered around a kindly old widow living in poverty. There are two young men in her life; a homeless boy who she’s taken on as her ward and her own son. By talking to all three you learn that the homeless boy loves the old woman very much and that her own son is jealous of their relationship.

He’s also a serial killer. Not only does his mother know it, but she covers up for his crimes.

Morally, it would make sense to feed off the old woman’s son and rid this part of London of its resident murderer. But, as it turns out, the old woman’s blood is of much higher quality than her son’s. By feeding on the kindly old woman players can boost their stats faster, ultimately at the cost of fewer lives overall. The only tradeoff is letting a murderer go free.

After feeding, players must hide out to metabolize the new blood and allow their powers to increase. While they’re sleeping it off, characters react to their actions. The web of relationships changes while new and unforeseen consequences play out.

It’s a balancing act, the developers say, between the player’s own voyeuristic interests and the character’s needs. Killing off the wrong people or allowing the flu to take hold in a district can doom it to invasion by the skals. Once lost, all of the storylines, questlines and vendors in that part of London are gone for good.

Vampyr is expected this November for PlayStation 4, Windows PC and Xbox One.