I wish there would be no need for a level cap. It all depends what level your character can reach. For me it´s no fun if the game get´s to easy because of my level, like in BG2 with "Throne of Bhaal" installed.
I went with ESRB-friendly Realism.
I want a mature game, where bad things can happen, all you mentioned and even worse. But I don´t necessary need to see them all.
I can´t say Yes or No, for that to decide I don´t know enough of the world the game plays in.
But I´m not against firearms, especially if there is a race or class for which it would be believable to use them.