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- Alternative Character Interpretation: Before William is abducted by Hoffman, he mistakes a security guard for an invader and shoots him. The guard apologizes just before Hoffman subdues William. Did the guard apologize for unintentionally scaring his boss, or because Hoffman forced him to assist in William's kidnapping?
- Anvilicious: The film was released right in the middle of a bad recession and a heated debate on healthcare, and it shows in the types of people that Jigsaw targets this time around. The opening trap features two bankers who gave loans to people they knew couldn't pay, and the main game's victim, William, is an executive at a health insurance company with a notoriously stingy policy who is forced to make some fantastically gory life-or-death decisions for his co-workers before getting killed by the widow and son of a man he denied coverage. One scene goes outright Author Filibuster; in a flashback in William's office, Jigsaw states that it's hypocritical to attack the government for trying to take life-and-death decisions away from doctors and their patients when the health insurance industry does this regularly by denying coverage.
- Ass Pull: The Reveal that the main game isn't William's. In all trap plots before and after this one, the people forced into the game are the ones being tested, with even Jeff from Saw III having to injure himself physically and emotionally to save the people in the traps, and the set up for this one even feels similar to that, with William having to decide who lives and dies amidst his staff while maiming himself to save them, representative of how his policy hurt others. Instead, the game is apparently Tara and Brent's, despite the two doing nothing but sitting in a cage watching William. It also isn't even clear what Jigsaw is testing them for, since while the obvious idea is if they'd be willing to forgive William after he doomed their husband/father to die due to his policy, the idea falls apart when neither forgive him, but while Tara can't bring herself to kill him, Brent can, killing William while the two of them face no repercussions. It's made especially baffling by the fact that this is a game John designed, and yet Brent isn't punished for being a "killer", unless you count him being clearly traumatized by the incredibly gruesome death he subjected William to.
- However, while his fate is left ambiguous, the fact that Brent isn't at the Jigsaw Survivors Group meeting in the following film, whereas his mother who has no blood on her hands is, may point to an indication that he was subject to legal punishment due to this crime.
- Fan Nickname: People (fans of the franchise and non-fans alike) are far more likely to refer to Brent as "Rodrick" rather than his actual name, courtesy of his actor being Devon Bostick and the fact that his name is rarely said and hard to catch in the film itself.
- Harsher in Hindsight: John goes after William and his associates because they prevented his insurance from covering a potentially revolutionary new cancer treatment that could've saved his life. Saw X reveals that this treatment was all a scam, and its creators were con artists who cried persecution from Big Pharma whenever anybody tried to expose them or crack down on them. William and his co-workers may have been motivated by penny-pinching corporate greed, but they were otherwise trying to help John, and prevent him from wasting his (and their) time and money on snake oil.
- Improved by the Re-Cut: Much less prominent in comparison to the other films, as whereas their Director's Cut/Uncut versions are considered superior to the theatrical ones (with Saw IV having an inversion), fans are notably split over whether or not this film's Director's Cut did better than the theatrical version. Mainly because in spite of the typical addition of new details that are well-received, the ending adds a connection between the two outcomes that happen despite them being completely unrelated (namely, the Acid Room's trigger also starting the timer for the Reverse Bear Trap 2.0), which most of the fanbase considers to be unnecessary and plot-hijacking.
- Memetic Mutation: Due to Devon Bostick's role as Brent, it's not uncommon to find jokes about Rodrick Heffley (his most famous role that came about a year later) being in a Saw movie. These jokes range from saying Jigsaw is testing Rodrick, to calling the movie Saw VI: Rodrick Rules.
- Narm Charm:
- Few would call Costas Mandylor's performance in the film worthy of Shakespeare, but he's also having a ball hamming it up as one of the most obviously evil characters in the series.
- While Josh's Final Speech to William is definitely over-the-top, it's one of the only times in a Saw movie that a trap victim gets to have their say before they bite the dust, making it strangely badass in a way.
- Retroactive Recognition:
- Wynonna Earp is one of the people killed on the Shotgun Carousel.
- Brent is likely Devon Bostick's most infamous role before he played Rodrick Heffley in Diary of a Wimpy Kid and its first two sequels, since it led many people in the Internet to joke that they don't remember Brent's scenes from Diary of a Wimpy Kid or that "Rodrick went insane" (since Brent kills William at the end of Saw VI).
- The Scrappy: Brent for his horribly annoying and murderous behaviour. Not even having recently lost his father makes him in any way endearing or likable.
- Surprisingly Improved Sequel: Saw VI was regarded by fans and critics alike as a huge improvement over the two previous films, and a worthy successor to the original trilogy.
- Unintentional Period Piece: A major part of the film's backstory is William using a bit of Loophole Abuse to terminate the policy of a customer with a potentially fatal heart defect, all but consigning him to death, as his pre-existing medical condition will render it virtually impossible for him to get coverage from anyone else. The year after the movie was released, the passing of the Patient Affordable Healthcare Act made it illegal for insurance companies in the United States to deny coverage on the basis of pre-existing conditions. Unfortunately, the broader issues of greed and dysfunction in the American healthcare system remain as timely as ever.
