toucanbuzz
No rule is inviolate
I've seen too many combats with characters bouncing up and down, from 0hp, getting a Healing Word to give a handful back, getting knocked down again. There is no sense of fear to going into combat....
I've been using a homebrew for the last 3 years in response to this called Vitality, which replaces Death Saves, and more accurately reflects what HP actually represents (your ability to avoid real damage vs. vitality which represents the actual damage your body takes). If someone, in reality, was hit by giant's clubs or dragon's breath or even swords on a routine basis, they'd be a mess within a few weeks unable to move or walk.
If you've played 2E AD&D (-10 hp) or D&D 3rd (diehard), this will sound familiar. Remove Death Saves from your game and replace with below:
- At 0 hp, instead of a Death Save, a player may opt to gain the Unconscious or Staggered Condition.
- Any future damage taken in either condition goes to Vitality.
- If a melee enemy opts to knock you unconscious, you cannot choose.
- Vitality: this represents the actual damage your body can take. A 20th level fighter still dies when a sword is shoved in his stomach, just as much as a 1st level character.
- Vitality is your 1st level hit points and only changes if your CON score changes.
- Unconscious:
- Take 1 point of vitality damage & make a DC10 death saving throw at end of your turn. Success = stabilized. Failure = at the end of each of your turns, take 1 point of vitality damage. Natural 1 = take 1d4 instead.
- This condition ends if you have hit points.
- Staggered:
- Gain 1 Death Point.
- You may continue to take Actions on your turn.
- If you ever have 2 Death Points, gain a Lingering Injury (DMG p272).
- At 3 Death Points, you die but may, at DM discretion, use your dying act to impact a pending d20 roll (heroic death).
- A staggered character has disadvantage on all rolls, has no movement (e.g. must use Dash action to move), and all enemies have advantage against any abilities used by the character (other than items, such as wands).
- This condition ends if the player has hit points.
- Healing:
- Hit points heal as usual.
- Vitality heals at 1 + CON modifier per long rest, minimum 1. You can only regain Vitality if your HP is full.
- Magical healing only repairs Vitality if hit points are full, and even then, only at 1 for every 10 points of healing that could be done (e.g. a healing potion at max heals 10 hp, or 1 Vitality, but a healing word of 1d4+4, max 8, does absolutely nothing for vitality).
- Regeneration is always counted as at least a full 10.
- You lose 1 Death Point every Long Rest.
It sounds like a lot at first, but it's really simply drawing up on 2E AD&D (revised) and D&D 3rd ideas of what happens when you reach 0 hp. This cripples the "whack a mole" syndrome and makes the real damage linger a bit. Even going unconscious will add up. It's done wonders for our games.