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You cant save Carley's life or Lilly's state of mind at all no matter what? it will always lead to Carley being shot (if you picked to save Carely at the Pharmacy of course) by Lilly and Lilly becoming a murderer out of her mind --- Xbox Live - nukkaniiick
I volunteered to shoot Duck on both of my playthroughs and she still killed herself. Really, unless you personally have a hand in a characters fate (like being given the choice to spare or kill someone), then chances are there isn't anything you can do to change it.