There’s an interesting post at The Frisky Pagan, You are (probably) doing it wrong: Hit points, literature, and D&D. It’s an interesting read, citing Gygax (page 82, AD&D DMG), going in-depth about what hit points really represent.
Ever since I started playing RPGs I’ve always assumed there was a level of abstraction to hit points. Sometimes they represent character skill level, sometimes they represent actual health. Bigger monsters get more hit points. And so on.
Hit points are a nice suspension of disbelief. They work. Though in earlier versions of D&D characters died right when they hit zero hit points. That was sort of jarring (“Whaddya meaning my fighter at 1 point can fight like he’s perfectly healthy but just suddenly dies at 0 points?”)
But house rules and, later rules, took care of this with negative hit points.
There’s been plenty published about using critical hit charts.
D&D Third Edition made its own adjustments.
D&D 4e really made hit points abstract and even counter-intuitive. (“Really? That giant minion only has one hit point?”) Characters were also harder to kill.
I’m not sure about D&D 5e–I’ve only played it once.
My preference: I like the abstraction of hit points combined with critical hit charts.
I first encountered this in the old Middle Earth Role Playing game (MERP) by Iron Crown Enterprises. Characters got more hit points, but they could die from critical hits. Armor offered a reduction in the chance of a critical hit, but you could still take a loss of hit points.
This biggest downside to MERP, however, was the math involved.
When AD&D 2e came out with the Combat & Tactics Guide, I tried the charts in there. But they seemed to be incomplete. I recall a player running a gnome illusionist who got his hands cut off. And the group didn’t have any access to magic to regenerate those hands–so his character ended up retiring.
Dungeon Crawl Classic RPG seems to have a nice middle ground. Your character (if he or she survives 0-level) has a little more hit points than the average old school 1st level character. Yet you still want to be wary getting into combat–those charts can be lethal.
Even so, clerics at 1st level have a chance of mending bones and healing critical wounds. So it balances out.
Is there a right way of doing hit points?
It depends on the tone and concept of the game you want to run. Something like hit points really wouldn’t work in most grim-dark science fiction RPGs. Dungeon Crawl Classics RPG would play completely differently without those critical hits.
I remember when the d20 version of Star Wars RPG came out. Really? Hit points? To each their own, I guess.
The “standard interpretation” of hit points, however, works fine with a high-fantasy, swords & sorcery, or a “beer & pretzels” old school dungeon crawl.