It's not like Bethesda makes two versions of the game, one for the younger players, and one for the advlts.
They could input a 'content' filter which turns down the gore, but beyond that? No not really. If the game is going to get an M rating anyway, then they should make the game the way they want to make it.
No matter how awesome the story [and I do hope it's complex and awesome], if I'm playing a game where I am chopping at somebody
with a sword, they aren't just going to 'urk' and die as though from natural causes. It's an immersion breaker.
Same with six. six exists. It doesn't have to be forefront, but a mention here and there would be nice. Avoiding any and all allusions to it is also an immersion breaker.
Also. Toilets.
I could never figure out why the Imperial City in Oblivion had all those expansive sewers and no toilets, bathtubs, or sinks. O.o
But regardless of the actual subject, six, violence, or bodily functions, it bears a similar motif. It exists. Avoiding it entirely just seems odd.
Edit: I really can't type today, can I?