Please use the Question Tags (instead of the Question Title) to state which Story Format you are using, it makes it easier to search for questions related to a particular story format and it reduces the unnecessary padding of the title.
You can use a Story Variable to track the current $karma of the Player, and what is commonly known as a "Link with Setter" (or a "Setter Link") to increment the story variable each time a decision is made by them.
1. Initialise the Story Variable to its default value within your project's startup tagged special Passage.
You use the (set:) macro to assign a default value to the story variable.
(set: $karma to 0)
2. Use "Setter Links" within your projects passages to update the current value of $karma.
You use a (link:) macro to display each potential option, a (set:) macro to change the current value of $karma, and optionally a (go-to:) macro to send the Player to the next relevant Passage.
You come across a person collapsed on the side of the road, do you...
(link: "See what you can do to help them...")[
(set: $karma to it + 1)
(go-to: "Help Collapsed Person")
]
(link: "Walk past the person...")[
(set: $karma to it - 1)
(go-to: "Keep Walking")
]
warning: The above TwineScript was written from memory and has not been tested, it may contain syntax errors.