D&D 5E House Rule: Using Concentration to remain Conscious at 0hp. Feedback wanted!

[Talltomwright]

A key question comes down to your dm style. If a player is unconscious, do you generally target them to try and finish the job, or do you mostly move your focus to the next player?

If it’s the latter than you really don’t need much here, as a player who keeps acting is putting themself under great danger by doing so. I think the concentration save to stay up is fine, but you really don’t need more than that, as the normal death save failures from taking damage will already do a lot.

If you do target downed players regularly, than this is a great advantage, and then does need more counterbalance. I think exhaustion makes sense, but I don’t think diadvantage on death saves is needed, that’s overkill to me

Great, thank you. It's situational. I have absolutely had NPCs attack fallen PCs on death saves once they've seen the party has a healer but most of the time the NPC will move on; staying up definitely makes them more of a target. So we've got one vote for disadvantage on death saves but not exhaustion, and one for exhaustion but not death saves. I'm definitely hearing that both is too high a price!

You can achieve almost all of your goals by just removing death saves altogether.

And go straight for death at 0hp? I mean it would be simpler, I guess!

 

[Talltomwright]

I agree with your goals and currently also use a system that allows PCs to remain conscious at 0 HP. However I have a number of different changes, because the biggest hurdle I think you are going to have with your houserules are that you seem to still have 3 Death Saves And You Die, plus the normal rules for getting hit when at 0 HP. Which means even though the PC is conscious, three hits and they are dead (not even including any failed death save rules.) That might end up being deadlier than you want. Usually if someone drops unconscious the monsters will move on to an upright target and leave the dying person alone so they are only taking death saves... but if they remain on their feet, monsters will have no reason not to continue attacking them, which means they will die much faster (perhaps even fast enough that the PC won't even get their chance at their "Last Stand" action.)

For my rule system I circumvented that by replacing the 3 Death Saves with the Exhaustion chart altogether. Which means there are now 6 levels of failure before dying (level 6 on the Exhaustion chart being death) which allows PCs to get hit a few times without risk of immediate death. I also re-ordered the chart a little bit, plus added several other rules to create a full package.

If you are interested in them, I'm pasting them here... but mine are just one set out of many that other players have made, so go looking around the boards here or on the 'net and you should find some additional ideas to get the system together that you really want. Best of luck to you!

Rests

• A Short Rest is 10 minutes, during which you may spend hit dice to regain hit points and regain features that refresh on a Short Rest.
• A Long Rest is 8 hours of light activity or sleep, after which you regain all of your spent hit dice, regain all features that refresh on a Long Rest, and you lose your level of exhaustion if currently at Level 1 (creatures at any higher exhaustion levels do not lose any.) You do not automatically regain all hit points following a Long Rest.
  
  The effects of a Short Rest are included at both the beginning and end of a Long Rest. (I.E. you may spend any remaining hit dice you have at the beginning of the Long Rest to regain hit points, and then may spend any new hit dice you just regained following the Long Rest to regain more hit points.)
• An Extended Rest is 24 hours of uninterrupted bed rest in a safe location and counts as a Short and Long Rest. You regain all hit points, all hit dice, all class features, and may possibly reduce levels of Exhaustion you currently have. At the end of the Extended Rest another character may attempt a WIS (Medicine) check. A successful DC 10 check reduces your Exhaustion level by 1, a DC 20 check by 2 levels, and a DC 30 check by 3 levels.

Dying and Exhaustion

• When a creature reaches 0 hit points, they are Dying. They remain Dying until they are Stabilized.
• A Dying creature has the Incapacitated condition (instead of Unconscious) and at the start of each of their turns make Death saving throws with a DC 10 to succeed. (An Incapacitated creature can’t take actions or reactions but may still move.)
• Every level of Exhaustion a creature has raises the DC by 1.
• Each failed Death saving throw causes one level of Exhaustion.
• Death occurs at Exhaustion Level 6 as per the Exhaustion chart (and not 3 failed Death saving throws as normal.)
• A creature may regain hit points while Dying (via abilities, spells and items as normal), but that does not remove the Incapacitated condition, does not stop the rolling of Death saving throws, and does not adjust or affect their Exhaustion level. They are still considered Dying even though they are no longer at 0 HP.
• To no longer be considered Dying (and thus remove the Incapacitated condition and stop the rolling of Death saving throws) requires the target to be Stabilized.

Stabilizing a Dying Creature

• A Dying creature that makes three successful Death saving throws or rolls a Natural 20 on a Death saving throw automatically Stabilizes.
• Another character adjacent to an Incapacitated character can attempt to Stabilize them by using an Action to make a WIS (Medicine) check with a DC equal to the target’s current Death save DC.
• Stabilizing a creature does not remove any levels of Exhaustion.
• A Stabilized creature has however many hit points they have received (if any) while Dying. A Stabilized creature who was not healed while Dying is still at 0 HP but can act normally.

Combat While Dying or Stabilized

• Any successful attack made on a Dying creature immediately results in one automatic failed Death saving throw.
• Any attack on a Dying creature that has hit points does not cause hit point damage but rather still causes an immediate automatic failed Death saving throw.
• An attack on a Stabilized creature causes hit point damage. If the creature is at 0 HP or the attack drops them back to 0 HP, it immediately ends the Stabilization and they are considered Dying again.
• A creature that begins Dying again has their successful Death saving throws reset to 0. Their Exhaustion level is at wherever it was previously.

Exhaustion Chart

• Level 1: Speed halved.
• Level 2: Max HP halved.
• Level 3: Disadvantage on attack rolls and saving throws.
• Level 4: Disadvantage on ability checks.
• Level 5: Unconscious.
• Level 6: Death.

That's a really good point about three hits before their next turn and they are dead anyway. Thanks for your alternative system! Will have careful read.

 

[LordEntrails]

Are you going to make any adjustments to abilities/features such as Relentless Endurance? What about Death Watch?

 

[Laurefindel]

I’d really appreciate some feedback on a house rule. There have been several posts over the years trying to do the same thing, but here’s my variation.

Dying over several rounds in a pool of your own blood isn’t the kind of ending I would like for my PCs, and it doesn't match the fiction I enjoy. I would like the option for them to go out fighting, or managing to avoid a TPK by sacrificing themselves to give one last healing spell to a comrade, or throwing themselves and the Big Bad into some lava. But the current death saves rules don’t allow for that.

My design goals are:

• To find a way for PCs to stay conscious to pull off the last heroic deed.
• For it to be a dangerous gamble, speeding up the character’s demise.
• For it to not break the game (for example, by providing a consequence free chance to neck a potion and carry on as if nothing had happened.)
• If the gamble pays off I want it to have a short-term negative consequence too.
• I want it to be as easy for players to understand as possible, by being simple and written clearly using 5e consistent language and familiar concepts.

So here’s my attempt:

Using Concentration in to remain Conscious at 0hp

When you are reduced to 0 hp you may choose to attempt to use Concentration to stay Conscious. If you wish to to do this make a Constitution saving throw, where the DC equals 10 or half the damage which took you to 0hp, whichever number is higher. You automatically lose Concentration on any other spells or affects. You can voluntarily end your concentration and go unconscious at any time.

Staying conscious places your body under great strain. At the beginning of every round in which you are conscious at 0hp you take one level of exhaustion and make a Death Save at disadvantage. (Normal rules for rolling a 1 or 20 apply.)

Staying conscious reopens your wounds. Whilst concentrating on remaining conscious you cannot be stabilized by any means (for example, by a medicine check, healer’s kit or Spare the Dying) except by being bought back to 1 hp.

Only successful Death Saves whilst Unconscious count towards the three needed to become stable.

Taking further damage places you in greater peril. If you take further damage whilst conscious you must make concentration checks in addition to taking failed death saves, as per the normal rules for concentration and death saves.

I would love feedback on whether this meets my goals; how can I make sure it’s fair, simple and clearly expressed?

Looks good, but some things could be consolidated for simplicity (oftentimes, simpler rules are more effective than realistic ones).

Something like: When you start your turn at 0 hp, make a death save (at usual DC). If successful, you can choose to fail the save to remain conscious. Repeat each turn.

Warning: I speak from experience here. Any houserule allowing downed PCs to remain conscious leads to quicker and more frequent PCs death, because they get hit again since they remain a threat.

 

[Talltomwright]

Are you going to make any adjustments to abilities/features such as Relentless Endurance? What about Death Watch?

Thanks for raising these. I think Relentless Endurance still stays a strong feature - no roll needed, no exhaustion, no risk of death saves, so I don't think this rule nerfs it too much. I might make Death Ward a third level spell in my campaign but it still seems useful. Protecting these two spells/features might be an argument for keeping the exhaustion element of the house rule?

The other similar abilities are Zealot Barbarian's 14th-level feature Rage Beyond Death and Samurai Fighter's 18th-level feature Strength Before Death. It would make them seem less unique at the table, but they would still be much more powerful than taking the Concentration to Remain Conscious Option. Although it would be interesting to hear if anyone thinks it does nerf those unfairly?

Looks good, but some things could be consolidated for simplicity (oftentimes, simpler rules are more effective than realistic ones).

Something like: When you start your turn at 0 hp, make a death save (at usual DC). If successful, you can choose to fail the save to remain conscious. Repeat each turn.

Warning: I speak from experience here. Any houserule allowing downed PCs to remain conscious leads to quicker and more frequent PCs death, because they get hit again since they remain a threat.

Simplicity is definitely what I'm striving for! Thank you, auto death save would definitely streamline things and put a hard cap on two rounds of activity.

That's useful feedback - the primary function is to allow the last ditch effort to save others/defeat the BBEG not self-preservation so I'll make sure the players are aware of the likely outcome. Sometimes just posing a distraction and taking a few more blows that might otherwise go for your friends is enough to save the rest of the party (at the cost of your own life.)

 

[LordEntrails]

Here's what I think is simpler way;

• Roll under your Con to take a single Action on your turn (easier than remembering how much damage made them unconscious, and rewards high con characters)
• Taking such an action incurs one failed death save (simpler than another roll)

And I think it achieves your goals.

 

[Talltomwright]

So, to summarise so far:

I've got to make sure not to inadvertently nerf other abilities land spells like Relentless Endurance, Death Ward, Rage Beyond Death, Strength Before Death etc. so I still need to penalise the choice to stay conscious. On the other hand, some people think exhaustion is too punishing and some that death saves at disadvantage is too punishing.

Several of you think the rule is not simple enough.

I think I'm erring towards the arguments for simplicity and less rolls. I do think I want to reward high CON characters by making it a more likely choice for them, but I don't want spellcasters to be punished by losing concentration. I also think I do want to keep the penalities high as I'm offering the PC a chance to turn the tides they might not otherwise have. I also think 1 point of exhaustion is a fair swap for the opportunity to drink a potion so I don't think self-healing is broken.

My current thinking is to strip away the Concentration element apart from one CON save and flip disadvantage death saves to autofails, limiting the PC to a max two rounds of action (probably much more if they get hit, although at least they aren't prone for melee attacks at advantage or incapacitated for those pesky auto-crits).

So my current offer is:

Staying Conscious at 0hp

When you are reduced to 0 hp you may choose to attempt to stay Conscious. If you wish to to do this make a Constitution saving throw, where the DC equals 10 or half the damage which you took, whichever number is higher, otherwise you fall unconscious. You can also voluntarily go unconscious at any time.

Staying conscious places your body under great strain. At the beginning of every round in which you are conscious at 0hp you take one level of exhaustion and an automatic failed Death Saving Throw instead of rolling.

Staying conscious reopens your wounds. Whilst remaining conscious you cannot be stabilized by any means (for example, by a medicine check, healer’s kit or Spare the Dying) except by being healed for 1 or more hp.

Damage that you take still takes gives you a failed Death Save (two for critical hits) and staying conscious makes you more likely to be attacked by enemies.

(That last bit is, strictly speaking unnecessary but at least my players can't say I didn't warn them!)

 

[Stalker0]

So my current offer is:

Staying Conscious at 0hp

When you are reduced to 0 hp you may choose to attempt to stay Conscious. If you wish to to do this make a Constitution saving throw, where the DC equals 10 or half the damage which you took, whichever number is higher, otherwise you fall unconscious. You can also voluntarily go unconscious at any time.

Staying conscious places your body under great strain. At the beginning of every round in which you are conscious at 0hp you take one level of exhaustion and an automatic failed Death Saving Throw instead of rolling.

Staying conscious reopens your wounds. Whilst remaining conscious you cannot be stabilized by any means (for example, by a medicine check, healer’s kit or Spare the Dying) except by being healed for 1 or more hp.

Damage that you take still takes gives you a failed Death Save (two for critical hits) and staying conscious makes you more likely to be attacked by enemies.

(That last bit is, strictly speaking unnecessary but at least my players can't say I didn't warn them!)

This is even more punishing than your last version. Exhaustion and a death fail is very nasty. This means that staying up, one crit from an enemy will kill your player straight up.

 

[Talltomwright]

So, to summarise so far:

I've got to make sure not to inadvertently nerf other abilities land spells like Relentless Endurance, Death Ward, Rage Beyond Death, Strength Before Death etc. so I still need to penalise the choice to stay conscious. On the other hand, some people think exhaustion is too punishing and some that death saves at disadvantage is too punishing.

Several of you think the rule is not simple enough.

I think I'm erring towards the arguments for simplicity and less rolls. I do think I want to reward high CON characters by making it a more likely choice for them, but I don't want spellcasters to be punished by losing concentration. I also think I do want to keep the penalities high as I'm offering the PC a chance to turn the tides they might not otherwise have. I also think 1 point of exhaustion is a fair swap for the opportunity to drink a potion so I don't think self-healing is broken.

My current thinking is to strip away the Concentration element apart from one CON save and flip disadvantage death saves to autofails, limiting the PC to a max two rounds of action (probably much more if they get hit, although at least they aren't prone for melee attacks at advantage or incapacitated for those pesky auto-crits).

So my current offer is:

Staying Conscious at 0hp

When you are reduced to 0 hp you may choose to attempt to stay Conscious. If you wish to to do this make a Constitution saving throw, where the DC equals 10 or half the damage which you took, whichever number is higher, otherwise you fall unconscious. You can also voluntarily go unconscious at any time.

Staying conscious places your body under great strain. At the beginning of every round in which you are conscious at 0hp you take one level of exhaustion and an automatic failed Death Saving Throw instead of rolling.

Staying conscious reopens your wounds. Whilst remaining conscious you cannot be stabilized by any means (for example, by a medicine check, healer’s kit or Spare the Dying) except by being healed for 1 or more hp.

Damage that you take still takes gives you a failed Death Save (two for critical hits) and staying conscious makes you more likely to be attacked by enemies.

(That last bit is, strictly speaking unnecessary but at least my players can't say I didn't warn them!)

Correction: If they can go unconscious at any time then they could pass their save, stay up, not be prone and incapacitated and so harder to hit, and then go unconscious just before their turn to avoid the auto-fail death save and exhaustion. I've ammended it to 'can voluntarily go unconscious at the end of your turn.'

 

[Talltomwright]

This is even more punishing than your last version. Exhaustion and a death fail is very nasty. This means that staying up, one crit from an enemy will kill your player straight up.

True. I'll go away and ponder it. Feels like I'm more likely to break the game by offering the players too powerful a new option, but at the same time there's no point in having a rule if it's not appealing enough to ever be used.