Not really, just the time for healing would be extended. AD&D was 1 hp per day + a bonus for a full week IIRC. Four weeks was complete recovery.
1) You have noticed that 5e doesn't do that, right? The game we are talking about.
2) I have played games where an injury takes a moth to recover from. The most common "solution" found when that happened was... making a new character. Because the game in question was taking place on a day by day schedule, there were things for the PCs to do every day, and being forced into a hospital where you could do nothing for a month... essentially meant your character had to be written out of the story, because you could no participate.
3) A minotaur can be the first encounter of a mid-level area. SO, you can start the adventure, get in one fight, then be hospitalized for a month while the rest of the party... stares longingly at the adventure site they were about to get to experience?
So, I stand by my assessment. That would fundamentally change the game we are playing.
50-foot falls have 50% survival IRL, so heroic PCs and action heroes, yeah... less so.
Okay, so? That is aggregate data. Every time an adventurer falls off a building and survives, three monsters are shoved off a cliff and die. Now that fall height has a 25% survival rate.
Just because the IRL rate of people who accidentally fall a great height means that half of them die and the majority are heavily injured does not mean that any given PC needs to die, or even think they would die.
Well, buildings can't "fall thousands of feet", nor can ecosystems, but the closest equivalent would be an earthquake, or an avalanche ("bring the falling ground to the village" idea), which can also wipe out villages and restructure an ecosystem.
Right, again, this is why to me, Lava is a different category of event. Falling is something that just happens whenever a living being is near an edge. Lava, whirlwinds, Avalanches, Earthquakes as devastating natural events that cannot be stopped by human engineering. Unlike a handrail on the edge of a surface.
That is why I am fine with uncapped damage for falling (eventually, it is deadly to everything) but for Lava... if you move into a 5ft square with Lava you are just going to die.
Well, you don't need special rules. We have our critical damage houserule, but RAW with critical hits would have worked, too. But you still need those rolls for attacks and damage. There's always a chance a PC will miss (albeit small considering advantage) or damage will be low from a "non-lethal strike".
If you want to be more generous and not bother with rolls, that's your choice obviously. But would you do the same to a sleeping PC? Gobilns successfully stealth by the PC sentry and get up to the PCs who are sleeping, thinking they are safe. The goblins (don't roll) and auto-kill the PCs before ganging up on the sentry PC (now they are rolling) resulting in a TPK? Nice.
Oh, well, there you go. I don't favor the PCs. The same rules for all, and no handwaving away encounters when they favor the PCs and not against them.
Of course I favor the PCs. I have infinite resources, infinite time, infinite health and can deal infinite damage... why wouldn't I favor them? The entire game exists for them and has no purpose without them.
The PCs who sneak into the bandit camp have learned of a threat, came up with a good plan for that threat, and succeeded in an approach to that threat that avoided direct combat. To then put them in a situation where they need to roll twice more, and have a high chance of turning all of that work into a direct combat... All I would be doing is telling them that next time, they should just charge in weapons drawn, because it will have the same outcome.
Meanwhile, as the DM, I could justify a squad of invisible stalkers sent by a villain who had a divination the PCS would be trouble, who suffocates and murders them... basically whenever I feel like it. The PCs would have no idea the threat existed, no plan to deal with the threat that they don't know of, and just one day die for no discernible reason. And if you want to try and find a way to explain how your group could deal with that, I could do any number of other things.
But, the goal of the game is not to kill the PCs. So I wouldn't even care to try and kill them in their sleep most of the time. It isn't interesting or challenging to do so.
Sorry, I thought that was already dealt with... players metagame hit points as resources, always. They go into a fight at full hp with confidence unless it is an obviously dangerous foe. It is basically the threat level of the encounters. An easy fight doesn't require max hp to feel confident of success, but a hard encounter without full hp will result in more caution -- do they have enough resources (hit points), to deal with this threatening force?
But this is exactly the thing you called out as the problem with fall damage RAW. That the Players would metagame that they could survive the fall.
So what is the difference?
Oh, fine. Well, you would feel it was a bad idea, given your favoritism for the players. If a PC has decent hit points, few creatures will drop them that far negative in a single hit. If the PC has been injured and is very low on hit points, great! Now be cautious!!! Don't keep fighting at 5 hp like you did at 50! A critical hit for 20 hit points while at 50 is hard, but at 5 becomes instant death.
Since creatures don't make death saves and often are just considered "dead at 0", this gives the PC an extra buffer without letting them just rely on the death saves and knowing at 5 hp, they can't suddenly go to -50 (their normal hit point maximum).
Right, but this isn't about fighting at 5 hp.
Storm Giants are CR 13. They deal ~30 damage per swing, and swing twice per turn. IF you can only hit -15, then fighting a Storm Giant with less than 90 hp could be a death sentence. Or, to put into perspective Any properly leveled wizard or sorcerer is at risk of instant death even at full health, and any class with a d8 HD who has taken more than 5 damage (as they would average 94 hp) would be in the same boat.
And sure, "maybe don't fight the same way you would always fight", or "monsters should be scary" but you are setting up a situation where a level 13 party vs a CR 13 storm giant is courting death in a way that feels against the spirit of the game. Because once the monsters start averaging twenty or more damage on a single hit, and they get mulitple attacks, suddenly, you are in a situation where you cannot risk having less than 40 hp during any point of the fight, because a stray crit will be instant death.
1) That's his choice. Deal with it.
2) Obviously, that was simply my advice on how to avoid it. Instead of disappointment in a cake-walk scenario, they learn about opportunities missed.
You didn't really get the point of the example at all. The point was to highlight that players are cautious. Hyper cautious. Cautious in ways that aren't always logical. Which is why I feel like a rule like this would be detrimental to those groups.
Great. I'm fine with more of a mindset, "I have to risk it in order to blah blah blah and save the day."
Niche or not, it wasn't my suggested scenario. In fact, I can't ever recall it coming up in a game I've run or been in. Involuntarily falling, yes. Voluntarily without magic/precautions? No.
Then why were you worried about the metagaming earlier? If it doesn't happen, why is it something you see as a problem?