The game presents the players with a finicky moral puzzle: committing too many evil acts feeds the Enemy Within (the animalistic urge that vampires call the Beast), endangering your Karma Meter and threatening to transform you into an unthinking monster, but the nature of vampirism and vampire society makes being a saintly do-gooder not only difficult but dangerous, and in that precarious balancing act - 'Monsters we are, lest monsters we become' - lies much of the challenge of the game.
In this game, players take the roles of vampires (aka the Kindred, aka the Damned), undead beings gifted with eternal (un)life and superhuman power, but forced to endure compulsive bloodlust and the manipulations and predations of seemingly all-powerful elder vampires. White Wolf, the game's publishers, subverted many tropes of roleplaying games from the late 80s by making the player characters monsters (as opposed to heroes who hunt them) and installing a Karma Meter that makes violence a dubious solution in many situations. The tabletop roleplaying game that started the Old World of Darkness line.