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I am currently attempting to create a campaign, inspired both by West Marches, and earlier editions of D&D (mostly OD&D and 1e AD&D), but still keeping the 5e rules that my group are familiar with.

One of the ideas I have had to get the 'deadly' feel of those earlier editions is to remove the death saving throw system and just have characters die when they drop to 0 hp. Newly rolled up characters would of course start at level 1.

I started my current, ongoing 5e campaign at level 5, as the players said that they didn't want to slog through the early levels (as we had done in 4e). As a result, I have little idea of how deadly the game is (RAW) at the lower levels.

Could someone with experience of lower level play tell me what the effect of this house-rule would be? How often do 1st and 2nd level characters drop to 0 hp? Essentially, could a careful party survive and succeed at low levels with this change, or are encounters in 5e designed too much around the idea of death saving throws (resulting in too many deaths and TPKs)?

Brief Summary of How Encounters are Contructed in West Marches

West Marches is essentially a sandbox hex-crawl. Encounters are rolled for every x period of time, based on environment, how well the PCs are keeping watch, etc. The roll tables include a huge range of encounter CRs. However, the chances are weighed heavily in favour of lower CR fights rather than higher CR ones (i.e. you're more likely to be attacked by a wolf than a dragon). This means that the random encounters will, for the most part, be below the CR of the party.

Encounters tied to goals (dungeons, etc.) could be of the PC's CR, or higher, but it is their choice to face these challenges. The PCs can go anywhere, do anything, so they can wait until they feel ready to face any particular threat.

Finally, the PCs are encouraged to think of creative solutions to problems. You might roll up d4 men at arms on a roll table; this does not mean that 3 men come running at them to attack, instead, it could mean that 3 men are arguing over a cart of gold. The PCs could decide to attack, and steal the gold, but that would be their decision. Non-combat approaches to encounters are normally possible.

What is the West Marches?

The West Marches is a style of campaign in which there is little to no over-arching plot, just over-arching environment. The campaign has around 10 to 20 players. Groups of 4-6 form from this pool and approach the DM (me) with a certain goal in mind (e.g. investigate the tower).

It is expected that characters will die in combat (either through bad luck, or bad planning), and as a result, backstory and character plot hooks (etc.) are kept to a minumum. Instead, players discover who their characters are as they play. Characters are memorable not for what they did before arriving in the West Marches, but for what they have done in the West Marches.

Hopefully that proves useful to people wanting to answer in context, but without reading the link (as SevenSidedDie suggested).

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I have experience playing the low levels. I can briefly summarise the impact as follows:

  • It will make encounters much harder. With many characters dying in combat, and possibly a few total party kills as well.
  • This can be demoralising, but some players might be up for it.
  • But something perhaps easily overlooked is that it removes a wonderful suspense building mechanic from gameplay. With current rules, a character going down leads to a change in tactics to keep the party member alive. By removing death saves, this falls away. And the only decision is: Is it time to flee, or can we still win this?

Characters in our party are regularly taken down (which would mean death with the house rule) and require in-combat healing to bring them back into the fight. Failure to do so in some cases would probably have resulted in total party kills.

In your comment on Dale's answer you consider:

players were encouraged to retreat if the going got tough

The problem with this is that there's not necessarily enough time to make an escape. The fact is that even as it stands (without the house rule): "level appropriate" monsters have a decent chance of 1-shot killing most level 1 characters. (When I say decent chance, I'm not even talking about needing a critical hit.)

NOTE That a single CR 1 monster is considered level-appropriate for 4 level 1 characters.

Consider a Specter (CR 1): It does 3d6 damage with +4 to hit. This is only an average of 10.5 damage. But it's special ability states that if a CON saving throw is failed, the target's maximum hit-points are reduced by the same amount (and if reduced to zero, the character is dead).

Of course if you and your players are up for a much more difficult challenge, then then feel free to tweak accordingly.

However, changing the death-saves rule is not the only way to do so. Remember that removing death-saves also removes a tension creation mechanism of combat. So instead of removing death saves, consider the following ideas:

  • Have your monsters fight more "intelligently". Let them make good tactical decisions, and you'll see difficulty ramp up without any extra work.
  • Tweak difficulty of encounters by adding monsters, or using stronger monsters. This might require a little more planning on your part, because it can be a little to easy to overdo it.
  • Reduce the character's opportunities for rest a little. This means they rarely recover their abilities between encounters. It has a similar effect to the second point but is possibly a little easier to manage.
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    \$\begingroup\$ In response to your recommendations at the end, both I and my players already play very tactically in combat. I build my encounters intelligently with powerful combinations of monsters. Also, I almost never allow long rests between encounters during a day (for example, in a dungeon). If the players decide to retreat and rest, then the monsters fortify and replenish their positions. That said, I will certainly take your second suggestion into account, perhaps by designing more hard and deadly encounters. \$\endgroup\$
    – Ladifas
    Apr 3, 2016 at 15:31
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    \$\begingroup\$ If you wanted a middle ground, you could make characters automatically fail death saves. That is, a character would die three rounds after being reduced to 0 hp, unless they were revived. Such a change would increase the deadliness of combat, but not allow a high damage roll to lead to instant death. \$\endgroup\$
    – Vivificient
    Apr 3, 2016 at 21:11
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    \$\begingroup\$ @Vivificient This is the suggestion I eventually ran with, and am reasonably happy with the results. It adds tension without allowing characters to be left unconscious for long periods of time. \$\endgroup\$
    – Ladifas
    Jan 9, 2018 at 17:31
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    \$\begingroup\$ I think your answer is good, enough that I don't want to post my own, so I have a suggestion: maybe mention that Tomb of Annihilation, which is intended to be really hard, has an effect which causes characters to need to roll 15 or better on a death saving throw instead of 10 or better. You might mention such an adjustment as an option in the bullet point list at the end of the answer, just to round out the perspective. \$\endgroup\$
    – Bloodcinder
    Apr 9, 2018 at 12:38
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At 1st level, a single critical hit from all but the weakest monster can reduce a PC to 0 HP.

For example, kobolds (CR 1/8) do 1d4+2; that's a maximum of 10 on a critical, fighter types should survive - most others are at 0. Hobgoblins (CR 1/2) do 1d8+1 plus 2d6 if an ally is within 5 feet of the target, an average of 25 and a maximum of 41 on a critical; this will take out all 1st, most 2nd and a large chunk of 3rd level PCs.

This is a lot more deadly than AD&D because level appropriate monsters did much less damage. Is that deadly enough for you?

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    \$\begingroup\$ I have just looked again at the encounter section in the DMG. For 'Hard', it says 'weaker characters might get taken out of the fight'. Of course, with the house-rule, that becomes 'weaker characters might die'. Perhaps if hard encounters were kept for the most difficult fights, and players were encouraged to retreat if the going got tough (as was common in o and ad&d), then deaths would not be too common. I have also considered removing critical hits (although players do enjoy them). \$\endgroup\$
    – Ladifas
    Apr 3, 2016 at 13:25
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    \$\begingroup\$ The +2 to damage for Goblins makes them a lot more lethal that 1e or 2e Goblins, as does the formal adaptation of critical hits. Good points on what the damage boost does to low level characters. \$\endgroup\$
    – KorvinStarmast
    Apr 3, 2016 at 16:10
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    \$\begingroup\$ @KorvinStarmast That said, characters tended to have fewer hit points in 1e and 2e as well. For example, a magic user could conceivably only have 1 or 2 hit points at first level, so a 1-4 kobold hit could kill them. \$\endgroup\$
    – Ladifas
    Apr 3, 2016 at 17:05
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There's an overall balance factor between HP and death saves. Removing the death saves really makes the PCs HP quite low.

Monsters tend to get a higher relative HP because we don't really expect them to use Hit Dice on short rests. When a player gets to zero HP, we expect to have a round or two to heal them or just finish the fight and let them spend Hit Dice to recover. If you factor in Hit Dice and short rests, PCs can actually take a lot of damage in a single day, they just can't take it all at once.

As 5e is designed, most CR appropriate fights risk knocking out players without outright killing them. In your version, no one gets knocked out, so now every CR appropriate fight becomes a deadly encounter. And if you stack them up over the course of a day (say in dungeon), then each downed player makes everything else harder.

If you change the balance, smart PCs won't get into fights that don't have overwhelming odds in their favor.

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This is not RAW, but one thing I have chosen to do that kind of splits the difference and makes encounters more dangerous without being a lot more deadly, is to make dropping to 0hp worth a level of exhaustion. So yes, you can toss a healing spell, and bring him right back to the fight, but at a reduced efficiency. It makes being dropped something the characters will work to avoid, and can be a problem if it happens too often, but doesn't leave the lifeless bodies of people's characters to litter the landscape unnecessarily.

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    \$\begingroup\$ Ironically, this is similar to the system that I am now using, over three years later. I now have characters gain one level of exhaustion for each round spent unconscious (no other effects, no death saving throw, etc.). Obviously the worst exhaustion result is death anyway, so leaving a character unconscious for too long will result in their death, but even short spells of unconsciousness have a serious impact, which I like. \$\endgroup\$
    – Ladifas
    May 10, 2019 at 23:26
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A few years ago I read an interesting topic:

https://forum.rpg.net/showthread.php?676099-B-X-Misadventures-in-randomly-generated-dungeons

https://forum.rpg.net/showthread.php?686509-B-X-Misadventures-Fellowship-of-the-Bling-Volume-II

That is NOT D&D5e but I still think that it could be useful for you.

Those references - is AP-tread that is centered around playing B/X D&D by-the-rules. And part of that game was 0 HP = death. And another rule - dice fall where dice fall, no ways around that. You could watch rich experience of that DM and you could more adequately judge - will 0 HP fit to you your situation or not.

As for me - I found that play-style quite interesting. To tell the truth - that tread inspired my own campaign. But, I feel this is important - before using that style - you should talk to your players and show them benefits and pitfalls of that play-style. You must set expectations about death: it must be stressed that characters CAN and WILL die in combat. That is because from the player's perspective - it is two different things - when you create character that you feel very invested in that will live long and achieve interesting thins, - and a very different thing - when you create character that will die like in the end of some sad story (manga/film). You can love both characters, but you don't feel destroyed when the second one dies.

Character - is player's investment to, let I say narrative (but I don't mean narrative-style games). Character is investment, work of art. Something meaningful. So, to compensate for character's death, I would recommend to take 'Fellowship's' idea - single character can die, but fellowship lives on. Reputation of your 'fellowship' and how it interacts with a world could give players something they could build even when their characters irreversibly die.

Speaking in general 0HP = death simplifies things in DM's mind. It feel logical as hell. 1 = alive, 0 = dead. If you need to have captives in your game or maimed NPC/PC - you step into the foggy territory of homeruling. Not that it's bad, but it's foggy. Internet is full of ideas about it. Generally, nowadays, I prefer 0 HP = character was at last physically hit and he is maimed/dismembered/traumatized/dead/going berserk (random table included). But it is just a personal preference.

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