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Indeed, we could, and many old school games did. It was common to joke about silly D&D and strength helping one land a hit (& the argument is always "armor, toughness, etc is overcome). Even other old TSR games would use "dexterity" for modifying chances to hit in melee combat, and not just...

They don't, no, but the circumstances of taking damage & dishing out damage are a bit different & by no means automatic. one certainly might need their BBG to say, dispel, cast a protection or movement effect, or heck, even a non damaging attack. You won't get either effect some rounds

option 2 it's got some issues, sure, especially compared to masochism, (why is everything italics now?) but (finally) unless you are in 3.5e it's probably fine. Otherwise place some caps (+10 for 100+ seems good) & make sure any item of it has some evil tags/issues Used by a high level big bad...