A review of Lineage II that shows Friday's date opines that the game presently revolves around little more than leveling, while the negative consequences of indulging in one of the title's more notable elements are outlined in the following passage:
Needless to say, the penalties for heedless player-killing are quite harsh. Going into town is very much a necessity, for the obvious reasons: buying equipment, rallying players into parties, and the like. If guards will attack you on sight, then you can do none of this. Further, the lower your karma rating is, the higher the chance of you loosing a valuable item upon a player-inflicted death. Redemption is no easy task; it is most easily achieved by killing monsters equal to, or above your experience level. More often than not, this is only possible if you're in a party of players roughly equal to your experience level. The thing is, your karma rating is immediately visible to all players -- very few of which will invite you to a party, if your name is rendered in bright red above your avatar's head.
The article's conclusion does concede that the game is possibly the least restrictive as regards inter-player combat, yet the final words aren't very recommending, and the overall mark is an unspectacular 6.5 out of 10.