"He's beyond my healing ability..."

Well, I haven't made it through all the posts but I agree with several apporaches and disagree with a recurring idea that keeps cropping up.

The part I disagree with is people suggesting a "new rule" to deal with dying PCs / NPCs. The ediiton wasn't mentioned in the OP but I'll go with 3e since I'm most familiar with it. To which I say:

You have enough rules already.

I kind of agree with the sentiment that you shouldn't try this, but only in so much as - you should not try this as a DM IF YOU AREN'T PREPARED to answer the barrage of things your players might try. Just telling the players to "deal with it" might work once, but gets old if you are doing it on a regular basis. Your world becomes arbitrary and players feel less inclined to actually share in it.

I don't think a plot device (no matter how cliched) should be abandonded because it just doesn't fit the rules. It can fit the rules, and you as DM have all the tools to make it happen.

In cases of an assassination, posion/disease has been mentioned which will be pretty effective unless a player has the right spell handy. Further, if this is a high level assasination, your high paid assassin should know of any number of ways to get rid of someone permanently so Cure Light Wounds doesn't work.

You also always have the option, as DM, to make something new that fits within the rules without fundamentally altering them or completely tossing them out the window. A virulent disease/poison combination that putrifies the body as the victim dies leaving nothing to "heal". A poison composed of Ghoul Spit that kills someone and begins the transformation to "undead" making Raise and Speak with Dead less useful (but in agonized tones he can relay his final words...right before he tries to eat their brains). Maybe the victim was a wizard? Maybe a contingency Magic Mouth pops up to give his dying words, heh. Who knows.

Anyway, with magic involved there are plenty of ways to creatively apply the rules to create the plot device you want -without- mucking with the rules.
 

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I rather mean that the character, facing the actual damage, is not dealing with the "hit point" abstraction.

Yes, that I can agree with. The abstraction shouldn't prevent the characters from knowing. The character's lack of skills might, but that's a separate issue.
 

Also, as noted, if the damage is not hit point damage (say, it is ongoing Con damage caused by a creature's special ability), that is a clue as to the nature of the creature to be faced.
I liked your falling-from-a-tree example more, just because it very clearly shows that - for bog-standard D&D - injuries must exist that fall outside the rules.

(That's not a reason for you to think it's a better example - you probably don't have my interest in showing how it is not all that radical to look at the rules as something other than a physics engine for the gameworld.)
 


Another clear example is the poison needle trap. Clearly you are injured; you must roll a save. Clearly, that injury is below the threshhold of a single hit point.
Nice example - can't XP you yet, though.

Also, another example that feeds this troll! Because it provides a degree of precedent for some 4e class abilities, which permit delivering poison (or a comparable "rider" effect) even on a "miss".
 



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When the PCs came across a dying Half-Orc who was part of an adventuring group that died in some ruins, the Cleric healed him. I was originally going to do the whole "Dying Words" thing, but instead I had him thank and give the PCs advice and then leave to the nearest town.
 



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