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We're using the Unearthed Arcana Vitality rule. My level 3 Fighter has a 15 CON and a normal HP maximum of 28. Courtesy of a bad wubba wubba fireball, I'd been reduced to 0 HP and 9 Vitality.

Since then, I've received healing to bring myself up to 17 HP (all good so far, as my effective hit point max is 19) but now I want to use a Hit Die to heal further. This ordinarily wouldn't work because of my reduced HP maximum, but if roll higher than a 10, this might offset the Vitality loss.

The ambiguity comes from the wording:

Effects that restore hit points have no effect on vitality. However, a character with maximum hit points who receives healing instead restores 1 vitality for every 10 points of healing.

Does using a Hit Die to restore HP work for restoring Vitality?

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Effects that restore hit points have no effect on vitality. However, a character with maximum hit points who receives healing instead restores 1 vitality for every 10 points of healing.

Taking this one line at a time:

Effects that restore hit points have no effect on vitality.

This is the general rule - if a cleric heals you, or you spend hit dice, or a healer's kit is spent on you by someone with the Healer feat: your vitality will not go up.

However, a character with maximum hit points who receives healing instead restores 1 vitality for every 10 points of healing.

But then we've got an exception to the rule (remember - specific beats general).
If you're at your maximum hit points already... healing will restore 1 point of vitality for every 10 points of healing.

So for your example, as a fighter with 17/19 HP and 9/15 VIT, you could spend a hit die to regain 2 HP.
You could not spend a hit die to regain vitality, because you are not at your maximum hit points already.

However, after spending a hit die to reach 19/19 HP, you could spend another hit die to attempt to regain vitality - assuming you rolled at least an 8 on the die (adding your CON modifier would get the result to the requisite 10 for 1 point of VIT healing).

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    \$\begingroup\$ With this interpretation, a creature who is only missing 1 hp could be healed for a very large number of hit points (for example, 70 from a heal spell) and would regain 1 hit point and no vitality; wasting the other 69 healing. That is counterintuitive to me. \$\endgroup\$
    – Adam
    Jun 20, 2017 at 18:58
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    \$\begingroup\$ @Adam - I think this is one of the reasons it's an Unearthed Arcana rule - it's not fully unambiguously fleshed out. I would agree that excess healing should spill over into vitality, but at the moment it's simply not written that way. \$\endgroup\$
    – Speedkat
    Jun 20, 2017 at 19:21
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This works

The question to ask here is: when you heal by spending Hit Die, are you "receiving healing"? To which the answer is an easy "yes."

You spend your Hit Die during a short rest, which is 1 hour of light activity. During this time, you are presumably resting, licking your wounds, possibly asking a friend to help apply bandages on them, or stitching some of them up. There is even an optional rule called the Healer's Kit Dependency on DMG 266 to show that healing can be thought of as recovering via first aid.

You can narratively play out that your reception of aid from your party members, or even your own attempt to heal yourself, counts as "receiving healing." After all, it doesn't say "receiving magical healing," but rather just healing in general.

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Likely Yes.

The ambiguity here really hinges on how you interpret the phrase "receives healing". Spending Hit Dice during a rest indisputably restores HP, as per PHB p.186:

A character can spend one or more Hit Dice at the end of a short rest, up to the character’s maximum number of Hit Dice, which is equal to the character's level. For each Hit Die spent in this way, the player rolls the die and adds the character’s Constitution modifier to it. The character regains hit points equal to the total.

So by rolling Hit Dice you do "reveive" hit points, and should thus be able to use then to increase your Vitality.

Of course, you might interpret "receives" to mean the hit points must come from an outside source and not from natural healing (for example, from the spell Cure Wounds, or a Potion of Healing). This might seem a bit pedantic, but as far as I can tell there is some ambiguity in the RAW, so you should talk with your DM about any interpretation before moving forward.

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