We did not intend to show any fetishes with this scene. We tried to portray that the action takes place in a rather cruel world. More brutal than it is commonly thought. Among other things, it is necessary for the player to understand the gravity of the consequences in future chapters of the game.
The second important point is the optionality of this scene. This scene is not mandatory and is encountered by the player only in some variants of the passage, in all of which the player was warned about the doubtfulness of his choice.
I understand that this scene may have caused (and probably caused) a lot of questions, as it was one of the final scenes of Chapter 4. However, I can assure you that there will be enough information in Chapter 5 that may change your view of what is happening in this scene.