Depends
It really depends on the tone someone tries to go for. There are writers that I have seen who do take a very serious approach to tickling fiction, but at the same time add a *wink* to the audience to keep things from getting TOO heavy-handed. Marauder and ShemthePenman are two guys who have done the best body of work that demonstrates this.
When people sit down to read fetish material, the goal is usually to enjoy themselves, not to feel uncomfortable. Say if someone wrote a story where one of the characters commits suicide: what happens if the reader has had direct experience with it? This once happy person who was trying to relax is suddenly attacked (unintentionally) by somethnig they were starting to like. Writers in general don't like to alienate their readers unless it makes a statement or acts as an experiment in literature.
But it is possible to be serious without being discomforting.
It's fairly simple: what you do is you darken the tone without enhancing the sense of danger.
1. Take the victim and take away their control of a situation in increments; this increases dread, which is more effective than shock.
2. Make the villain/tormentor impervious or indifferent to their actions. Sadistic villains are good, but if poorly handled, they become charicatures that the victim can't predict, but the reader can.
3. Make the torture unbelievably cruel, but creative. If the first torture is maddening, make sure the second one is even worse; the third incomprehensible. If the torture is prolongued, the reader gets as exhausted as the victim...that's a good thing.
All of these things make the tone of a story extremely dark because the victim is going to suffer horribly and there is nothing they can do about it; this is what readers like. Gets the adrenaline and the hormones pumping.
But if you introduce potential death and injury, the fun is over. That's not to say there can't be SOME kind of action, but the less serious it really is, the more enjoyable the story.
NOW...
The problem with including the factors you mentioned, like religion etc. is that it stops the story dead and starts emotional conflict. People in this community are notorious for their reactions to issues, and to bring that into the fiction would be a disaster.
The best bet would be to follow the example of the porn industry: they have their run-of-the-mill low-budget thrill tapes, and then there are the ones with the big budgets and high production values that come very close to looking like real films. They're both made to entertain, but one of them goes into more work, effort and detail to intensify the sophistication.
In tickling fiction, this is usually done by having a great story and a clever style. I've long grown tired of tickling stories with corny dialogue, ridiculous explanations (tickling serums? Get real!), and villains that reek of melodramatic Bond-film rip offs that you find on the direct to video wall. Sophisticated megalomaniacs who say things like "it's quite hopeless" and "laughter is like fine wine" are not threatening, and the ones who keep saying "my dear" should be put to sleep before they put the reader to sleep.
Tickling fiction could certianly use a break from corrupt law enforcement officials and psychotic Christian fundamentalists who use tickling to brainwash and condition young people. A real challenge would be tickling humor; something akin to Douglas Adams or Terry Pratchett.
Now THAT would be a refresher. Just don't look to me to do it...as much as I'd like to, I don't have the skill to pull it off. But I do believe that that type of writer is out there...they just have to come out and do it.