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The Pathfinder version of Psychic Reformation removes the XP cost that was present in the 3.5 version, and replaces it with a sort of pseudo-negative level cost instead. One part of this cost is that, if a character makes changes to levels lower than their last, they have their current and max hit points reduced by 5 per level difference.

If a character has less that 5 hit points per level, can a Psychic Reformation kill them? For example, a Wizard with a 12 Con will only have 4.5 hit points per level. If a Psychic Reformation is used on this wizard to change all of his levels, will the wizard be stuck at negative maximum hit points?

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Yes.

Having current HP less than zero knocks you out, and less than the negative of your Con score kills you. Nothing in Psychic Reformation, or any of the rules that apply to it, provides for any exceptions.

Therefore, for example, a Wizard 10 with 12 Con and (normally) 45 max HP who gets PR used on him to swap out the first feat he ever took (assuming full health before the PR) now has max and current HP of -5. He's dying, and unconscious. If stabilized, he can wait out the penalty and wake up tomorrow, otherwise he'll probably bleed out. If his buddy, who's also a Wizard 10, but with 10 Con and 35 usual max HP, tries the same thing, PR will drop him to -15 hp, killing him outright; that guy, if he really wants to swap out that first feat, better find a PR manifester capable of augmenting it enough to eliminate the penalty.

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  • \$\begingroup\$ ... or a buddy who can cast d20pfsrd.com/magic/all-spells/b/breath-of-life ... \$\endgroup\$
    – minnmass
    Commented Feb 17, 2015 at 0:25
  • \$\begingroup\$ @minnmass Only if your group rules that dying wipes out the penalties from PR, which is entirely unclear in RAW (RAW gives shockingly little information on what, exactly, dying entails. By a sufficiently strict reading, being dead doesn't really impair you in any way, just go on living your life.) If your group doesn't rule that death cures all ills, then breath of life would bring you back just long enough to die again, and all you get for your troubles is one more actual negative level to deal with when rez'd for real. \$\endgroup\$
    – Matthew Najmon
    Commented Feb 17, 2015 at 0:33
  • \$\begingroup\$ Huh: I hadn't seen d20pfsrd.com/gamemastering/conditions#TOC-Dead - restoring the dead "also restores the body either to full health or to its condition at the time of death (depending on the spell or device)". Either way, BoL probably wouldn't do anything: no actual damage to heal. \$\endgroup\$
    – minnmass
    Commented Feb 17, 2015 at 1:05

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