Thanks for posting this game on Itchio!! Really enjoyed playing it :-)
The premise is creative- but the game could obviously use a bit of polish (menus, grammar/spellcheck, a quick guide on which keys do what). Further, I never felt terribly attached to any of the characters so killing one never seemed like a difficult choice to make, and consequently, killing myself always seemed like a silly choice I would never make.
I can see how the devs tried to touch on the "human" element of the patients with the scared mutterings of one of the patients when I turned the lights out. Not only was it really creepy, but it at least inspired a little pity in me. The game needs a lot more of that to make the decision seem as earth-shattering as it is meant to be.
Also, the guardian is creepy as fuck! Even if he never actually comes into the room, it would be great to use the environment surrounding the monitors a bit more to make it seem like he could come in at any time. Footsteps of him walking down the hall when he goes into a patients room, maybe knocking on the door of my office, etc.
Can't wait to see the final version of this game.