This alternative rule replaces the unconscious condition which is triggered from dropping to 0 hit points. Instead, characters make one last stand and gains the condition On Death's Door. This variant rule allows players to continue controlling their characters while at 0 hit points but they run a great risk doing so, and they still roll for death saving throws!

The standard rules as described on page 197-198 in the PHB still apply unless stated otherwise.



Dropping to 0 Hit Points

If a you drop to 0 hit points and isn't killed outright, you enter the On Death's Door condition.



Instant death Unchanged, use the standard rules as descibed in the PHB.

Falling Unconscious This rule has been removed, instead players who drop to 0 hit points gain the On Death's Door condition.

Condition: On Death's Door Being at 0 hit points doesn't cause you to fall unconscious.

You cannot maintain concentration.

The condition ends if the you gain at least one hit point.

You gain three temporary levels of exhaustion while the condition persists.

Death saving throws are not affected by the disadvantage imposed from exhaustion. Fight. At the cost of a death saving throw you may attempt an ability check, use an item, take the attack action, casts a spell or use a bonus action. Flight. A creature affected by this condition is able to move and take the dash, disengage and dodge actions without having to make a death saving throw. Exhaustion Level Effect 1 Disadvantage on ability checks 2 Speed halved 3 Disadvantage on attack rolls and saving throws 4 Hit point maximum halved 5 Speed reduced to 0 6 Death

Death Saving Throws Unchanged, use the standard rules as descibed in the PHB.

Stabilizing a Creature The best way to save a creature with 0 hit points is to heal it. If healing is unavailable, the creature can at least be stabilized so that it isn't killed by a failed death saving throw. You can use your action to administer first aid to a creature on death's door and attempt to stabilize it, which requires a successful DC 15 Wisdom (Medicine) check. A stable creature gains 1 hit point.

Variant: Hard Core Using this variant, players gain one level of exhaustion once they recover from the on death's door condition. This means that a character will die instantly if they already have three levels of exhaustion when they are reduced to 0 hit points. The levels of exhaustion represent a character being mortally wounded from being brought back from 0 hit points. The design of this mechanic is aimed to make death feel more real than playing a game o 0 hp whack-a-mole. To make this mechanic more flexible a GM might allow for players to recover two levels of exhaustion from a long rest instead of one.