I feel that the player(me) is often punished by being guilt tripped into the good choices when helping the downtrodden.
"Oh you got our only family heirloom, grandmas ring, back from the bandits, we can give you 100 gold and be super-broke and to survive we have to prostitute our children or something horrible like that."
"(god damn it) Keep the gold."
"We can at least give you 50 gold and skip the important medication for our crippled child who might die, but maybe it is a blessing to be relieved of our horrible existence."
"(god damn it) Keep the gold."
bling -gets 30% more exp for the quest, actually needed gold to get health potions-
It would be interesting to see an RPG with that Dickensian misery where many NPCs are just playing up their misery to cheat and scam the naive hero/player clad in +2 gold armor, running that scheme until even the most bleeding heart player(me, again) gets tired of it and goes "fuck you bastards, I'll take the gold, check the drawers for more, tip the cripple out of the wheelchair because I bet he can walk aaaaaand I'll take that cauldron just to spite you."