The reason it is only a suggestion is that you could quite easily write a print function that ignored the options value. The built-in printing and formatting functions do use the options value as a default.
As to the second question, since R uses finite precision arithmetic, your answers aren't accurate beyond 15 or 16 decimal places, so in general, more aren't required. The gmp and rcdd packages deal with multiple precision arithmetic (via an interace to the gmp library), but this is mostly related to big integers rather than more decimal places for your doubles.
Mathematica or Maple will allow you to give as many decimal places as your heart desires.
EDIT:
It might be useful to think about the difference between decimal places and significant figures. If you are doing statistical tests that rely on differences beyond the 15th significant figure, then your analysis is almost certainly junk.
On the other hand, if you are just dealing with very small numbers, that is less of a problem, since R can handle number as small as .Machine$double.xmin (usually 2e-308).
Compare these two analyses.
x1 <- rnorm(50, 1, 1e-15)
y1 <- rnorm(50, 1 + 1e-15, 1e-15)
t.test(x1, y1) #Should throw an error
x2 <- rnorm(50, 0, 1e-15)
y2 <- rnorm(50, 1e-15, 1e-15)
t.test(x2, y2) #ok
In the first case, differences between numbers only occur after many significant figures, so the data are "nearly constant". In the second case, Although the size of the differences between numbers are the same, compared to the magnitude of the numbers themselves they are large.
As mentioned by e3bo, you can use multiple-precision floating point numbers using the Rmpfr package.
mpfr("3.141592653589793238462643383279502884197169399375105820974944592307816406286208998628034825")
These are slower and more memory intensive to use than regular (double precision) numeric vectors, but can be useful if you have a poorly conditioned problem or unstable algorithm.