What could I do to help my players feel like their choices matter?

[Saintheart]

The feeling I've got here, and it's only a feeling, is that you're trying to run a morality play in circumstances where the players' particular morals thus far haven't made a lick of difference to them personally.

What were their choices at the point of freeing the doctor? They could either leave a weird possessed person they knew next-to-nothing about in his cage, or they could remove the guy from his cage and take him back to face some form of justice. He's not their counsellor or an associate of the party, he hasn't killed anyone they know, he's basically just some possessed guy. There was no indication of any personal risk they took in freeing him, it's just a "Ha ha, you know that decision you made around a complete stranger you just met and had no idea what to do with? Guess what, your coin toss came out wrong, he's going to destroy the world."

This, to my mind, is bad roleplaying. "Sometimes you have to make a choice without knowing the consequences of those choices, or having all the information" is fine as a principle in real life, because in real life we really are often put in a situation where we don't have complete knowledge or a sense of the consequences -- but real life is not roleplaying any more than a MMA tournament is an actual streetfight. Both are abstractions, approximations of reality at best.

In roleplaying, my view would be that principle should be rephrased as: Sometimes you have to make a choice without knowing the consequences of those choices, or having all the information, but never both at the same time.

You can have all the information pertaining to the choice but not know the consequences of that choice, or you can know the consequences of your choice but not have all the information pertaining to that choice, but players really are left in a meaningless spot if they don't know the consequences of their action and they don't have all the information by which to make the choice ... because they have no real agency. Whichever way they go, they had no way of making any sort of informed decision on the choice, so the choice means nothing. It is DM railroading because they can't see down the alternate timeline that might have been had they gone down the other path - not without breaking suspension of disblief, i.e. by the DM saying "Good job, if you'd gone through Door B you would have destroyed the world". In that situation, from the players' perspective it's no different than if you'd just said "Right, you choose Door A, the world blows up". No agency, no real choice.

In a roleplaying game, you can't (EDIT: shouldn't) expect people to make a choice unless they fully know the consequences of their actions. Moral choices are choices out of our value systems, and unless you have a solid chunk of information to place against your values, the choice is meaningless, and certainly not moral.

Moreover, in a roleplaying game, moral decisions are never going to come out unless you balance a decision against actual risk to their character. I see no evidence the characters have actually risked anything personally in dealing with this potential threat and/or the moral issue he represents. The players have no idea that they have unleashed a SuperDemon with an ECL several multiples higher than theirs. Again, no agency, no choice.

It might be a different story if SuperDemon says he just wants to restart his family and announce he's going to set off and murder a family of farmers, and will "deal with" anyone who gets in his way. Then you have the characters making a moral decision if they decide to intervene, because that will require them to consider their characters' (which is to say, the players') moral values: is that paladin going to at least stand in the demon's path and say no, even if it means the death of SuperDemon's innocent family or whatnot?