>>719719734 (OP)
I think they can, but the trolley problem is not one of them. It is inherently a what-if situation, the moment you actually run through the scenario it falls apart because there are no actual consequences and no actual decisions made.
The problem with morality systems in video games is a well-studied one: the evil option is practically always a joke and/or only there to lend meaning to the good choice (which everyone is practically expected to make). Don't quote me on this but I think it was a KotOR dev who said they simply did not put much effort into the dark side options because they were basically only picked as a part of an over the top only evil choices run. Might have been someone else.
I'm pretty sure even cartel assassins mostly pick good guy options in video games.