Technicals: Composition is a bit cramped. Focus (probably because of DOF) is a bit soft.
Feel: Is that a letter opener? ;) It just looks more like that than a knife. Doesn't do a whole lot for me (good or bad).
Score: 4
Strong and potent idea, but I can't help but think the warm skin tones contradict the mood this image is trying to convey. Black and white really would set this off. I like that you were able to create such a simple image that evokes a strong emoting and represents such a complex subject matter. It just needs a more fitting mood in my opinion, to make a really affective connection with viewers. 6 8o)