treating the character a truly and fully healed has been the standard position of 4E fans for the past few years of debating this topic
Now suddenly (after years of debates...) a third option is being presented.
I don't know where you get these "standard positions" from. And this "third position" has not suddenly sprung from nowhere. For as long as I've been playing 4e and posting about it (ie early 2009) I've made the point that a PC at full hit points and full surges may still, in the fiction, be injured. But those injuries are not impeding his/her performance, nor lessening his/her ability to draw on vigour, determination etc. (I'd be surprised if you can't find it discussed somewhere in the big thread from 18 or so months ago that Mercurius started, about "Why 4e is not as successful as it could be".)
I mean, it's an obvious implication of the 4e mechanics that this is one possible interpretation of hit point and healing surge loss and recovery.
But the problem is 4E *DOES NOT* have these four states.
I could grab a character sheet up in the middle of a 4E game and show it to you and it would be completely impossible for you to tell if a character was in state (2) or state (4). They are mechanically indistinguishable.
And even that isn't really saying it right. It isn't that they are indistinguishable, it is that they are one and the same.
I can pick up an AD&D character sheet and from the sheet, it would be completely impossible for me to tell if a PC is injured or not! All I can tell is that they have lost hit points.
To know whether or not the hit point loss was (i) being cut but pushing on, or (ii) a near miss that simply scratched instead of skewering, or (iii) a total miss that required serious exertion to avoid, I would have to actually be present at the table and follow the narration. Good heavens! Who would have thought that would be relevant to settling the content of a shared narrative space in an RPG?
(Alternatively, a player might note on his/her sheet: cut to forearm. And a 4e player might equally do the same.)
You can say "this guy is wounded". But if one model treats the wounded guy as being absolutely in ever way identical to a fully healed guy and just asks you to act otherwise <snip parantheses> and another system treat a wounded guy as being in some way different than a perfectly healed guy, then it is reasonable to consider the second system to be superior.
Yes, I can pretend anything I want. My ability to pretend and you ability to pretend are things we both bring to the table. A game system brings a mechanical model to the table. I want a model that does a decent job of getting things correct.
The issue isn't about "pretending" to be wounded. It's not about "acting otherwise". It's about, whether or not in the shared fiction, a particular character is wounded. This is completely orthogonal to the question of whether or not those wounds have any effect in the action resolution mechanics.
Furthermore, from the fact that the action resolution mechanics for suffering and recovering from the effects of injury don't care about the difference between an injured and an uninjured PC who are both neverthless at full hp and full surges, it doesn't follow that it is irrelevant to all action resolution.
In an AD&D game, for example, the narration of some hit point loss as a cut, a scratch or a dodge might matter to a subsequent determination of the percentage chance of contracting a disease after rummaging through an otyugh lair. In a 4e game, the narration of the PC as injured or uninjured might matter to the subsequent resolution of a social skill check or skill challenge - a PC who has been narrated as uninjured, for example, might have to make a tricky Bluff check rather than a straightforward Diplomacy check to persuade a monastery to take him/her in as a traveller in need of respite.
Fictional positioning is not solely a matter of what is on the character sheet.
But one of those effects is the reduced capacity to absorb future wounds. You are missing that part.
A wounded character is less capbale of absorbing more damage before succumbing.
What is the status of this claim, or of the above-quoted claim about "correctness"?
If you are making it as a claim about game mechanics, than it may be true for some versions of D&D, but is not true for FireLance and Balesir's suggseted version of 4e.
If you are making it as a claim about actual human physiology, than I don't believe it to be correct at all. If I am cut, then provided that I have recovered from any blood loss (eg by drinking some water, eating a bit and resting overnight) my ability to "absorb" future wounds is not impeded at all. If I have a broken toe, or a broken nose, my ability to "absorb" future wounds is not impeded at all. Even a subsequent blow to my face or my foot - which aggravates the existing pain - is one that (on the mooted model) I am able to push through (drawing on my reserves of grit, vigour, determination etc).
(I would add, the whole notion of "absorbing" wounds is one that only has meaning within a certain sort of game model. Real life people take wounds, and thereby become wounded, but they do not "absorb" wounds.)