@cretaceous_bob: Is there even a secret sauce to be found? Big games can offer all of the sauces, wonderfully varied and numerous and they aren't secret either. The rest is just a matter of where the compromises end up.
Consequences for instance are a wonderfully ambivalent thing, as a player I want choice, but I also want the right choice, meaning I don't want to be stuck with a "wrong" choice or with a wrong decision for a hunded hours. This means that the choices have to be somewhat obvious, arbitrary and viable, thus they aren't really choices at all: does it matter if I pick mace, sword or axe or does it matter if I select "Yes." or "Maybe" from the dialogue wheel? Isn't that exactly what we get in RPGs like this.
Even the choice and the ability to kill at random is a somewhat moot, not because of a sense of morality or fear of retaliation. Tragic NPC deaths and murders are actually sad, but mostly because one is left deprived of the stories that NPC could have told or quest he or she could have offered.
When it comes to choices we can't have it both ways, we are stuck! Stuck with either fake choice epics or real choice short/repeatable Spelunky-likes. Scaling difficulty was implemented to give the player choice... to go anywhere and do anything, rather than to make the game easy. You could spend 50 hours in Skyrim not having killed more than a handful of draugr, just by avoiding that tomb symbol on the mini map.
My hope is that multi core processors will allow for a simulation of a dynamic world along with the main game in the future, for moving people and animals rather than scripted and respawning ones. It has been done before in games like Stalker, Pirates! or Mount&Blade and it is wonderfully entertaining. Even Skyrim already has a more or less elaborate routine for every NPC, nomadic caravans and occasional funny clashes of scripted encounters and wildlife.