Let's Talk About Health, Damage, Wounds, Death and Related Mechanics

[500 Toads]

What games lean into consequences rather than simply counting wound slots of HP?

Quite a few, but in very different ways, perhaps?

For instance, in the Shadowrun series of games, wounds typically impose increasing penalties on all your actions. There have also been rules regarding damage to cyberware and bioware augmentations that can result from injuries. It's also often emphasized that characters tend to be outlaws in a very classic sense, of not actually having valid legal citizenship and identification documents; and that as such, need to be careful about finding medical professionals that are willing to treat them and not turn them in or report them to the authorities (and who also are sufficiently trustworthy that, say, the docs won't just euthanize the incapacitated with the intent to sell the corpses to organleggers, ghouls, etc). In older editions, more severe wounds could also result in vital organs being destroyed, making it rather more difficult to prevent you from rapidly dying and also meaning more time, expense and difficulty to fix you up if you do somehow survive the day. Magicians in particular also could permanently lose Magic rating from severe injuries, as well as resulting surgery to patch them up.

In something like Runequest, there's overall hit points as well as per-location hit points, and it's entirely possible for a hit location to be crippled, ruined or severed. If that happens to be your head, torso or abdomen, well... loss of any of those means instant death, even if your overall hit points haven't been zero'd. Having an arm maimed might not have been enough to kill you outright, but it can put you into shock where you cannot fight at all until healed.

In Classic Traveller, there are no hit points at all, and damage affects your physical attributes -- strength, dexterity and endurance -- reducing your ability to do anything dependent upon them, in addition to potentially rendering you unconscious or dead. Lose a large chunk of dexterity? Well, it's probably going to be harder to return fire with the rifle you're holding, and so forth.

In Delta Green, getting shot or stabbed isn't just going to reduce your hit points, but -- well, at least if you're not adapted to violence -- threaten your mental state. Cultist ambushed you with a shotgun? Sanity check. You're wounded? Sanity check. Wounded enough to fall unconscious, but lucky (maybe...) enough not to simply die outright? Sanity check if and when you ever regain consciousness. Find out that the injuries permanently maimed you? Sanity check. All these checks can result in quite a bit of sanity loss, so maybe you reach a breaking point and end up with a mental disorder of some sort -- maybe you've become terrified of loud noises, or you're suffering recurring nightmares that render it difficult for you to sleep, or perhaps you become intensely paranoid... If your agent had already been traumatized to the point of, say, trying to drown his problems with alcohol? Well, having an acute episode of drinking yourself into a stupor might also happen. And so forth.

 

[SableWyvern]

Quite a few, but in very different ways, perhaps?

Outside of D&D and very directly D&D-derived games, I'd say the majority of games use something other than "just counting wound slots of HP". You've covered most of the methods I can think of that I've encountered in traditional games -- the other major one I'd add are systems that deal with very specific injuries, usually tied to critical tables (such as RM and WFRP).

 

[Tonguez]

People keep using the word "consequences" as if it means something very specific in this context.

Is a shattered elbow (and all that that entails) a consequence? The fact that you're currently bleeding out? That your eye is destroyed? That your arm is currently entangled in your opponent's net? That you'll need two weeks of bed rest before you engage in strenuous activity? That you will have a very visible scar? If not, what are people referring to?

My answer to your question is Yes to all your examples, thats exactly what it means.

In FATE Accelerated you get 3 Stress, and 3 Consequences (Mild = 2 stress, Moderate = 4 Stress and Severe = 6 Stress

Stress = Attack roll - Defence roll

So imagine you are in combat with a Sahuagin who weilds a net and trident.|

You attack the Sahuagin and roll 4 the Sahuagin rolls 2 = 2 stress so it takes 2 stress
Then the Sahuagin leaps from the water and Attacks with its Net rolling +6, your Defence Roll is 2 so the Sahuagin inflicts 4 Stress
Since you only get Total of 3 stress you can absorb 2 but then must take a consequence for the remaining 2 - a Mild consequence is that "Your arm is entangled in the Sahuagin Net"

That means

• The DM determines that your arm has limited use and you can't move away
• The Sahuagin can Invoke the entangled arm to gain a bonus to actions affected by your entangled arm
  • - this could be +2 bonus to its Trident Attack (it uses the net to pull you in) or it uses the net to pull you "Prone in the water" (create advantage)
• The Mild aspect remains until you take an action to deal with it (Overcome Sahuagin Net 4) or the end of the scene

A Shattered Elbow is a Severe Consequence (that lasts for the adventure), you cant use the arm and if you try to or an enemy exploits it then it could easily become a permanent Crippled Arm (extreme consequence)

Bleeding out could be anything, a moderate bleeding out means its a problem, but you have time to get it attended to, whereas Severe Bleeding Out means you are in immediate danger of collapse

2 Weeks Bed rest is Healing Aftermath (eg if you have a Shattered Elbow you might deal with it via 2 weeks bed rest to have it reduce to a Moderate "Arm in a Splint" or a Mild "dodgy elbow" consequence.)

Destroyed Eyes are interesting things - a Pirate might think "The Eyepatch is Badass..." whereas a GM might say "except for the Blind Side"

 

[Retros_x]

Do you realize that death saving throws ARE a timer, but with some built in wiggle to increase engagement and tension and make things less cut-and-dried? Avoids things like "We have eight turns before he bleeds out, no need to spend my action yet when I can hopefully knock down another foe."

Thanks for the enlightenment /s . My preferences emerged from years of playing different systems and wont be swayed by some patronizing comment. Also I never said anything about timers without variance. My current prefered system is SD where you roll a D4 and add CON. You have variance, but players can plan and make informed decisions. And a low CON character dies more quickly than a high CON character, which I like and which death saving rolls are missing (at least how they're implemented in 5e).

 

[BenjaminPey]

What games lean into consequences rather than simply counting wound slots of HP?

Otherscape and Legends in the Mist, explicitly, but you could argue all PbtAs do this.

The game loop of Otherscape and LitM is : Establish => Action => Consequences and back to Establish.
The basic roll has three possible results :
Failure (Consequences)
Mixed Success (Success + Consequences)
Success (no Consequences)

Establish
The Narrator...
• (Re)Describes the scene
• Highlights the stakes (why this scene matters)
• Introduces Challenges
• Makes Threats (actions initiated by Challenges)
• Asks the player(s) “What do you do?” and gives the spotlight to a Hero (different Hero each turn).

Action
The Hero in the spotlight describes their action.
The Narrator chooses how to determine the outcome (roll or not).

Consequences
The Narrator can deliver Consequences if
• A Threat was ignored (Challenge action materializes)
• The Hero’s action (roll) had Consequences
• The Narrator invokes a Hero’s weakness tag for Consequences (Hero marks Improve)
The Consequences can be narrative, or instanciated by giving/scratching a tag (any number of tags) or giving/
reducing a status (any tier).
The Hero may react.

As in all tag-based systems, Consequences are super easy to instanciate mechanically (but can, as always, be left to the narrative). Here, we see how, by making Threats, the Narrator highlight possible Consequences the players can avoid or stop from happening. The success provides a "narrative shield" against the Consequences the action was aimed to prevent.

In PbtA parlance, Threats made during the Establish phase are the soft moves, and Consequences are the hard moves that only the players action made possible (by failing, by generating mixed successes or by ignoring Threats).

 

[Reynard]

People keep using the word "consequences" as if it means something very specific in this context.

Is a shattered elbow (and all that that entails) a consequence? The fact that you're currently bleeding out? That your eye is destroyed? That your arm is currently entangled in your opponent's net? That you'll need two weeks of bed rest before you engage in strenuous activity? That you will have a very visible scar? If not, what are people referring to?

Those are all consequences, but I would not limit consequences of damage and/or failure in combat to wounds.

A consequence of a "failed save" versus a fire spell might be that you catch on fire. That doesn't just mean you take ongoing damage. it might mean that you are a danger to others or you might not be able to see. When I think of consequences, i think of something similar to temporary Fate aspects that can be leveraged using metacurrency: things that are True, for now. if it is True that you have twisted your ankle, the result isn't just that you movement is reduced. it means at a crucial moment, the pain might interrupt you or you have to leave behind a wounded friend or a heavy treasure in order to escape. That sort of thing. But they happen because the GM spent a token to invoke it, which costs the GM something. Think of it how in an action move the heroes get banged up but their injuries only matter at crucial moments.

 

[BenjaminPey]

When I think of consequences, i think of something similar to temporary Fate aspects that can be leveraged using metacurrency: things that are True, for now. if it is True that you have twisted your ankle, the result isn't just that you movement is reduced. it means at a crucial moment, the pain might interrupt you or you have to leave behind a wounded friend or a heavy treasure in order to escape.

You should defo look at LitM for things like that.
The only thing missing is the meta-currency aspect (City of Mist and its two heirs worked hard to avoid this).
Otherwise, if you twisted an ankle, then, well, you have the twisted-ankle tag, until you do something to cancel it or it's not relevant anymore, and it will come up (narratively and mechanically) anytime the fiction needs it.

 

[SableWyvern]

Those are all consequences, but I would not limit consequences of damage and/or failure in combat to wounds.

A consequence of a "failed save" versus a fire spell might be that you catch on fire. That doesn't just mean you take ongoing damage. it might mean that you are a danger to others or you might not be able to see. When I think of consequences, i think of something similar to temporary Fate aspects that can be leveraged using metacurrency: things that are True, for now. if it is True that you have twisted your ankle, the result isn't just that you movement is reduced. it means at a crucial moment, the pain might interrupt you or you have to leave behind a wounded friend or a heavy treasure in order to escape. That sort of thing. But they happen because the GM spent a token to invoke it, which costs the GM something. Think of it how in an action move the heroes get banged up but their injuries only matter at crucial moments.

To me, those things are still "consequences of damage". If you have a twisted ankle (damage), you're slower, more likely to trip rushing down stairs, and may have to leave behind a wounded friend or heavy treasure in order to escape -- no special resource is typically required to make those things true in my games.

But some more narrative version, along the lines of what you describe, is indeed the what I initially thought people may have been referring to when they spoke of consequences, although I also wondered if it included things totally divorced from injury. For example, being humiliated by your foe's superior skill, giving in to taunts or losing confidence so that your magic sword no longer responds to your needs.

 

[BenjaminPey]

A consequence can be anything, there's no reason to limit oneself to harm and wounds. You can be humiliated, exhilarated, joyful or overwhelmed. It's not even limited to your character. Your sword can be broken, your bag can be emptied, your path can be blocked and the road can be slippery. And of course, it can be projected to others. Your brother can be missing, your friends can become wary of you and your king vengeful.
Some of these don't need any mechanical heft to be perceived, but some do. Hence, the power of tags.

 

[SableWyvern]

A consequence can be anything, there's no reason to limit oneself to harm and wounds. You can be humiliated, exhilarated, joyful or overwhelmed. It's not even limited to your character. Your sword can be broken, your bag can be emptied, your path can be blocked and the road can be slippery. And of course, it can be projected to others. Your brother can be missing, your friends can become wary of you and your king vengeful.
Some of these don't need any mechanical heft to be perceived, but some do. Hence, the power of tags.

Your brother being missing or the road being slippery can certainly be consequences, but they would be fairly unusual as consequences of engaging in combat.

The way being blocked (to the PCs) certainly sounds like one possible outcome of an unsuccessful combat but, again, it would be pretty unusual if it's blocked as a consequence of combat.

"Wait, if we get into a fight here, the King might be vengeful," seems like a pretty reasonable statement and I could imagine many reasons it might be true (although it's still not something I'd be looking for a combat or injury system to help me with -- it's, instead, something that might happen in any game, irrespective of the mechanics involved in resolving the actual combat).

"Wait, if we get into a fight here, my brother might go missing" is quite the head scratcher and suggests a particularly unique set of pre-existing conditions that aren't really about combat or the result of alternative wound systems at all.

If these are things people want or expect as consequences of or within combat (as opposed to as consequences of specific chains of events, in or outside of combat, logically leading to these outcomes), we're certainly playing very different styles of game.