A Close Call with Negative Hit Points

Demascus is no slouch when it comes to swordplay, especially when he can remember his previous incarnations (when he was almost unbeatable). But that was then. Now, an ambush by a drow hunting party has knocked our hero unconscious.

He’s lucky that Carmenere the cleric is on hand with a healing spell. If Carmenere has a powerful enough spell, Demascus might not only survive, but he could be back in the fight in mere moments.

If the above scene plays out in a D&D game, the edition in which it occurs makes a big difference as to how likely Demascus is to survive. That’s true for a whole host of reasons, including the fact that in early editions, once you dropped to 0 hit points, you were dead. Later, the concept of negative hit points was incorporated into official rules, which allowed characters to linger a few rounds while unconscious and dying. The character could then be saved by a comrade with a handy potion of healing or a cure light wounds spell.

In the current edition, the number of negative hit points available to a character is larger than ever, to say nothing of the healing surges. Both of these elements have increased character survivability (some would argue too much).

But 4th Edition also introduced the concept of healing while at negative hit points that goes something like this: Any time you receiving healing, no matter how many negative hit points you have, you calculate the healing you receive as if you had 0 hit points.

For my question, I want to set everything else aside and focus on the idea that healing always brings a character to consciousness.

The reason the rule was introduced was because the designers hated it when a cleric spent her entire action healing a comrade in a previous edition, only to roll a 1 on the healing die. A dying character at –6 hit points is now at –5 hit points (though probably at least stabilized). A few more bad healing rolls might mean that character sits out the rest of the fight and sucks up the cleric’s actions in the process. In addition, it’s just easier to dispense with having to add positive numbers to negative hit points.

It can be argued, however, that the above rule is too favorable to a dying character, too “gamist” at the expense of simulation, and really anti-intuitive, breaking the rules of regular math which, come on, aren’t all that difficult. Ultimately, it could be argued that “always heal up from 0” is just not in accord with every previous edition of D&D.

What do you think?