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The other way to approach this issue is to abstract it. In the indie-rpg Dogs in the Vineyard, whenever your character is hit (Punch, gunshot, losing a debate), you get Fallout dice. Those can be used to represent whatever makes sense at that point in the story (Bleeding out, bruises, poorer relationship with the person you argued with). I dislike rpg's that have complex (but realistic rules) because I find that it bogs down play, but go with whatever floats your boat. In addition, DnD is a 'gamist' RPG. It's not meant to simulate reality particularly well, it's meant to be a game where you can go into a dungeon and fight dragons without getting into a headache over the rules (although 3.5 introduced plenty of headaches).