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Lady of Sorrows guide us

If or when you get to the Gauntlet of Shar there is a plate that lets you spill blood as an offering. If you interact with it first, Shadowheart will insist on spilling her own blood. You'll score some bonus friend points if you initiate the interaction and let her spill her own blood. You don't get the increase in approval if you select Shadowheart and let her spill blood from the start.

Keep in mind there are multiple plates, allowing for more than one increase.