Games

An indie game called OneShot from the Undertale knockoff genre has only one choice that matters, but god damn what a horrible choice, particularly since a child has to make it. And by the way, the game is called OneShot because it's designed to be played exactly once. If you want to play again, you have to mess with some files to do so.

Depends on the kind of games you enjoy.

While not particularly about consequences of decisions, I highly recommend Frostpunk. It always feels like any decision is about trying to choose the less horrible one, but without ever knowing if it will work out or not. The atmosphere of that game is just superb.

Detroit: Become Human fits the bill perfectly! It's a great game with some of the hardest choices you'll ever make in a game period.

Banner Saga

Yes, your grace, is a great short game

I haven't finished it, but I'd say Vampyr makes you make some difficult choices

Just answer our increasingly difficult questions.

Trolley problem: One track is one person, the other is 10

Next level

Okay well now the one person is your mom, and the 10 are 1 year olds you don't know

Next level

Okay the one person is your best friends mom and the 10 are young kids from your immediate or extended family

Next level

Okay the one person would cure cancer tomorrow, and the 10 are friends or family

...

I’m not sure I’ve seen it posted here, a little older, but the TellTale Walking Dead games are killer. You make full choices that affect your game later. Tons of fun, not a ton of action gameplay but the stories told are next level IMO