As games became more realistic , issues of questionable content arose . The most notable early example is '' NARC '' , which through its use of digitized graphics and sound and its adult-oriented theme quickly became a target of the press . These same issues arose again when '' Mortal Kombat '' debuted , particularly with its home video game console release on the Genesis and Super NES platforms ; due to Nintendo 's strict content-control guidelines , that system 's version of '' Mortal Kombat '' was substantially re-worked to remove any ' extreme ' violence . In response to these issues ( and in parallel to similar demands made upon the music and movie industries ) , the ESRB was established to help guide parents in their purchasing decisions . 1993 's '' Doom '' caused quite a stir , with its detailed 3D graphics and copious amounts of blood and gore . The 1996 game , Duke Nukem 3D , was accused of promoting pornography and violence ; as a result of the criticism , censored versions of the game were released in certain countries . In the 1999 Columbine shootings , violent video games were for a time directly blamed by some for the incident , and labeled as " murder simulators "
Columbine shootings
Columbine High School massacre
Video game culture