Hey, I'm not looking for a medieval life simulator like some, just a fantasy action simulator, so the bar's not high. However, I don't need to use the phrase "cognitive dissonance," it just seemed more specific than saying "does anybody else find this weird or in need of a fix."
Lot's of good suggestions here, but most go further than I actually need. I don't necessarily want to punish a character for falling unconscious (or reward them for not falling unconscious); I like the idea of a timely heal bringing a downed fighter back from the brink so he can make the difference in one final push. I guess I'm just experiencing the side effect of missing negative hit points, although I definitely wouldn't want to bring them back. It seems like nothing else has really stepped in to fill that void where the excess damage past 0 matters for the monsters (other than the instant death rule).
I think exhaustion each time is a little punishing (since we only remove 1 level each day), but the death saving throws not resetting until a short rest does seem promising, and coupled with the threat of attacking a downed character might provide enough incentive to help mitigate the cogni..., I mean this one thing I find weird and want to fix.