Fantasy is...by definition...unrealistic in its architecture. It is an exercise of the mind and mostly one of escapism.
But Fantasy is also literature and writers tend to draw from outside inspiration as you yourself admit. Some even wish to comment on those inspirations with their work. In the case of PoE those inspirations seem to be questions of discrimination and dehumanization, of leading a meaningful life in the face of past actions, for religious people even of past lives.
Why do I use the word "seem"? Because discussing literature is a matter of interpretation, which goes so far as that a literary work can have an effect on an audience not even intended by the author. Think of Orwell's 1984 and what an audience can take away from it after the Snowden leaks. Orwell has been dead for 65 years.
Terry Pratchett, on the other hand, has only recently left this reality on the back of a big white horse. And what did he have to say about Fantasy literature? He calls it the oldest form of literature and fundamental to our understanding of the world.
Problem A: Some people don't see video games as literature.
Problem B: Some people don't see literature itself as meaningful. [insert debate here]
But if you see video games as literature and you attest to literature in general having the capability of being meaningful,....
...you cannot single out the Fantasy genre and every single work having been created in it as well as every single Fantasy author as being inconsequential when the concept of literary genres itself is shaky and makeshift at best.