Jeez this topic moves fast!
Yeah, it works great in shooters, but they don't have a skill system to support. In an RPG you need to decide if you want to put points into your pistol skill, your shotgun skill, or some diplomacy skill and play to the style you pick. With that sort of combat system, though, you just practice and get good at the headshots and put all your points into other things. Whether you've got an old pea shooter and no skill or a +10 plasma rifle and your ranged skill maxxed out, the head shots will make them the same.
Though, now that I look at it… maybe they've got a bit of a hybrid going? They do have critical areas to hit sometimes and that clearly has to be done via your twitching. Perhaps the skills will only be used to access more complex weapons while your twitch abilities (and weapon stats) will be used to figure out damage and hit rate?
Regarding realistic PnP combat… ugh. I saw that in Rolemaster and it's criticals. They're fun when attacking but terrible when some friggin' kobold gets lucky and puts an arrow through your windpipe. The only way I saw to get out of that was to limit the criticals to crippling-but-not-too-deadly. (Or just not doing any combat.)
PnP doesn't have the bottomless, full party ressurrection powers of a save game system, though, so I don't think it applies here.
P.S. PC Gamer reports that you will be able to turn off the damage numbers flying around.
P.P.S. I really want to see how other classes work out. The video says there aren't classes but I'm hoping there's various different careers other than "hired muscle." Can you play as a rock star? A reporter? The end made it sound like there was a path into the corporates.