Death at 0 HP – a simple adjustment

On matters of survival, older rules are harsh : out of HP, you're dead. It's quick and makes sense : the character can't take hits anymore. But it makes for deadly games, where lethality is a big threat. I think that is desirable (in old-school, exploration-focused, horror-adjacent games), but can be tweaked.

(More than enough digital ink has been competently spilled discussing this very topic elsewhere, I won't reiterate much here.)

Newer rules (for a wide acceptance of "new") offer many ways of mitigating the actual risk of death, sometimes effectively eliminating it from the game. So they naturally change the feelings and expectations at the table, and for the classical OSR game, we don't want that. In addition, these rules sometimes become fiddly and burdensome in play.

So here's a quick-and-dirty idea to find a middle ground that is a bit more permissive than, say, Holmes, but remains firmly in the old-school camp.

When a hit (or whatever) brings you to 0 HP (that's a floor, even if a hit should bring you to negative totals), you're out for the rest of the fight (if in combat) plus the rest of the dungeon turns till the resting turn. You are probably hurt, wounded, and someone tends to you.

Once that passes, you regain the use of your standard abilities, saves, attacks, etc. but stay at 0 HP. The HP recovery then happens at the usual rate.

But if you further lose a single point of HP when still at 0, you die.

Simple, no ? Puts some pressure on the PCs while giving them a tiny bit more air to breathe. It simply interprets "out of HP" as "you can't take further hits, but aren't dead yet" instead of "you can't take further hits, because you took them all and now you're dead".

Another advantage is that it allows TPKs to not end with everyone dead, but everyone KO. The party can subsequently be captured by the enemies, or some other story plans like that. 

So : 0 HP means KO, with a penalty, and any further hits kill the PC. That's it.

Further thoughts :

- enemies who don't want to kill the PCs can do just that.

- the GM is still free to rule that some attacks or other dangers can kill instead of KO, and should warn their players about this. Typical examples : dangers or attacks triggering saving throws, like dragon breath, falling into lava, drinking virulent poison, etc.

Note : remember that, in old-school D&D, there are other rules in place to manage and mitigate the risk of death. Inheritance is one, for example. Some select magics can be used to resurrect or bring back a PC, or healing them abnormally fast. (As usual, it's more interesting if they need a quest and/or come with a price.) And Holmes explicitly says that it's possible to play with 2 PCs at once, which helps a lot too. Finally, hirelings and henchmen are there as replacements.

Hope this helps ! I've put it in practice (as much as I practice these days), and I must say that it works quite well.