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Message: <blockquote data-quote="DEFCON 1" data-source="post: 7533086" data-attributes="member: 7006">The effects will be probably more dead characters, for one.  On the whole I believe players are loathe to retreat or stop fighting, so if you allow them to keep fighting even after reaching 0 HP, I suspect more often than not they will use that extra round to keep swinging, rather than do the sensible thing of disengaging and retreating to then heal themselves up.  Then all you need is one monster with Multiattack and two hits later the character is dead.  Because while you as the DM can usually justify a monster leaving a body they just downed to go attack someone else (letting the unconscious PC roll death saves in peace)... if the PC remains standing and fighting, the monster will have no reason not to keep attacking it.  Two hits...  WHAM-WHAM, goodbye PC.That being said... I have also toyed with the idea of letting PCs remain active at 0 HP, but I also replaced the 3 deaths saves table with a modified Exhaustion table.  Which means it takes 6 failures to die, rather than 3 (however of course, the levels of exhaustion apply during the battle and remain afterwards even following healing healed to 1 HP.)  For those characters, it would take several more hits to kill them.  Which is a little more sporting, but does make their decision hold more weight because they are suffering some pretty penalties after the fact should they survive.</blockquote>