Zurai said:
If you have to tweak the game to make not having a cleric work, then yes, having a cleric (or healer, at least) is required.
I have been running this game for a number of years, and have never seen the 'heal-bot' approach in play.. no tweaking required, simply a different style of play that does not focus on CR +4 or higher encounters
There are a couple sides to this issue:
Side #1, the roleplaying aspect.
- Some people expect Clerics to have ties to a religion and diety, and those ties should be reflected by IC obligations and actions.
- Some people expectt Clerics not have IC obligations and actions tied to a diety/religion.
I am of the former crowd, and have banned from playing a Cleric in at least two groups for being too energetic about communicating my characters faith {despite the fact that I 'defeated' a couple of encounters single-handed through preaching the attackers into submission

}
I have also refused healing on the grounds that the characters actions and lifestyle were counter to my characters diety's goals.... which brings up a half of an issue that has yet to be raised here. Many posts above say the player of the Cleric has to align the character to fit into the party, but what about the Barbarian who has chosen to band up with a Cleric? That player also has a responsiblity to align thier characters actions as well.
Side #2: Healing and Hitpoints
The schizm here revolves around the 'I need to be at Max health or I will die' attitude. IMC, players expect to face a number of encounters while worn out and depleted on resources {like hit points, spells, etc..} To me its more heroic to struggle forward while injured than to hide until 'topped up'. YMMV
Side note, one of the best played Druid's I ever had the pleasure of running a game would ensure that his companions were sufficiently healed before the party was... perfectly IC for him, and his actions drew complaints from other characters {IC}.. the players {OOC} accepted his representation of the Druid's devotion to those animals called to him.