When you say 'hurt' you, what do you mean? That you're character's going to be punished ie you die?
That is not the case if that's what you fear. Events will be different depending on your decisions, but that's about it.
For instance, on my first playthrough, I met up with my employer a number of times in a restaurant. On the second playthrough, I think I only met her there once at a key scene.
It certainly adds to replay value. There are at least 2 endings, if not three, but that will all depend on the information you have at the end, all of which I think can be gathered at any given time.
A flawed yet very entertaining game.
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I'd highly recommend it!! It's so scary what really happened in asylums!
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Now I really do want the game. Would you say you need to have read the books to find the game that accessable? I'm currently watching a copy on ebay.
