I'm all for tongue-in-cheek as long as its tasteful. I'm all for blood as long as its not just blood for blood's sake. If I want a mindless game after a hard days work, I'm far more likely to play Lego Star Wars or Ratchet and Clank or something along those lines than I am to partake in something like Madworld.
A lot of what I've said probably sounds like I really dislike anyone who would play this game. I have no problem with people playing it, and I'm all for freedom of speech and expression. I just don't really like the fact that so much of our global society would play Madworld (or NMH, or any number of other gutsploitation games) before anything else. Maybe I'm just a complete prick, but it seems very banal to me.