It goes right into Lack of Empathy...she doesn't really seem to comprehend just how many people she's hurting in her mad quest to keep everyone safe.
The idea of having concrete growing inside of you is bad enough, but the concrete piercing organs and the flesh containing them? Plus, you can't even remove it. Simply put, you are doomed to have an anomalous, cold object perpetually stabbed in your body. Turns out the only way it can come out is the same way it came in, so it was definitely fortunate Delsin had the ability to copy other Conduit's powers. So as you could probably tell, the Akomish do get better.
Or how's about before that when he first sees his brother is a Conduit, himself? Although he doesn't fully show it, he's probably terrified that his brother has suddenly gotten powers and Delsin, himself, is not only scared but, at first, doesn't have control over it.
Delsin's laugh of joy from the newfound power doesn't help, evil karma or not. Another creepy laugh of joy occurs after he got shot by a Drug Dealer and finds out he has a fast regenerating power.
The tribe relies on two people, one of them they're suffering to protect, to find the cure to their ailment, that they have ''concrete'' growing inside them. And if they fail or get captured, they're going to suffer a slow, agonising death.
Consider the encounter that Delsin had in the tunnel on the way to Seattle. There are non-Conduits who are so paranoid about "Bio-Terrorists" that the slightest hint that somebody might be one that they'd shoot to kill immediately. Yes, Delsin's arms were smoking, and yes, he was a Conduit, but imagine if circumstances had been different. What if a normal person with a partially burnt piece of clothing (or something else vaguely implying powers) ran into the same people, only to trigger the same reaction? The poor soul would have been gunned down out of sheer paranoia.
The Evil Ending. Delsin quite literally dives headfirst over the Moral Event Horizon when he's disowned by the Akomish, performing an Orbital Drop on them and killing them all.
Most of the Evil Karma stencil pieces are mean-spirited in nature, but some verge on outright disturbing:
An old man about to mow over the heads of buried D.U.P. troops, reminiscent of the head-chopping machine from the film Caligula.
A bear feasting on the bones of a slain D.U.P. trooper.
For Hero players, during the fight with Augustine on the island, when some D.U.P. soldiers storm the field after Augustine briefly flees. Almost no matter what you do, Delsin's attacks will dust whoever he hits with them in much the same way the Evil versions of his Smoke attacks would. It's a good, if horrifying, look at exactly how much Delsin is holding back under normal circumstances. Furthermore, if you somehow manage to knock down some of the soldiers and try to simply incapacitate them? Non-Standard Game Over - Mission Failed. That's right - you aren't even ALLOWED to be a good guy for this one. Mr. Rowe is pissed, and when Mr. Rowe is pissed, no-one gets out alive.