Unethical Roleplaying...

So I watched the movie "killing of a sacred deer". First of all this movie is just twisted and fudged up! Anyways,in the movie the husband is a doctor and him and his wife are about to have sex. The wife asks "local anesthesia", husband agrees and wife lays their pretending to be under anesthesia and the husband has his way with her. Both friend and I were like WTF,that's weird. Obviously its just a kink of his (maybe hers as well) but my friend brought up a good point. She said if he didn't have his wife ( an outlet) to act out his urges and suppress them,would he actively do this to one of his patients?

So my question is this...How do you feel about Roleplaying in scenarios like this? Is it a healthy/innocent kink ,an unethical kink? Somewhere in between? Idk why but I'm really puzzled on this one lol...Part of me thinks its innocent fun but part of me also thinks these thoughts are perverted and morally unacceptable.