I'm not really a sucker for "realism". I liked Arma series all the way from it still being Operation Flashpoint, but with these sorts of games... I don't really see it being "fun" to constantly getting a *poof*
you're dead message.
I'd really prefer the game played more with abstraction and more systemic approach. Abstracted, more character based accuracy -- and instead of a HP bar, I'd like to see something of sort of like the "wound" system from the PnP.
Let's say you (and the NPC's) have 7 different basic states of being:
- Buffed
- Well
- Fatigued/disoriented
- Lightly wounded
- Moderately wounded
- Severely wounded
- Mortally wounded
- Dead
Each state of being is a bundle of effects that grows on top of the previous state.
- Buffed happens under drugs
- Stat bonuses according to what you've consumed.
- Well
- Dead
- Fatigued
- Timed
- Cures itself eventually
- Can be treated by the character with basic means
- Slight hit to speed (slower movement)
- Slight hit to accuracy (blurry and "alive" crosshair that widens and contracts itself, disaligned ironsights)
- Slight timely visual blurriness (can be compensated with drugs)
- Lightly wounded
- Remains until treated
- Can be treated by a doc or the PC with appropriate medical skills and tools
- Can be somewhat compensated with drugs
- Slightly bigger hit to speed
- Slightly bigger hit to accuracy
- No further effects to vision
- Moderately wounded
- Remains until treated
- Causes slow bleeding effect that will eventually turn the wound into severe (can be treated separately with relateive ease)
- Can be treated by a doc or the PC with appropriately higher medical skills and tools
- Can be slightly compensated with drugs
- A noticeable hit to accuracy
- A noticeable hit to speed
- Slightly more blurry vision
- Severely wounded
- Remains until treated
- Causes faster bleeding effect that will eventually turn into mortal wound (can be treated separately, but not easily)
- Can be treated by a doc or the PC with really high medical skills and tools
- Can be slightly compensated with drugs
- Heavy hit to accuracy
- Heavy hit to movement
- Noticeable visual distortions
- Mortally wounded
- Trauma team time, hope you have your insurances in order
- Heavy bleeding that will eventually kill you
- Heavy hit to vision and speed
- Almost incapable to fight
- Requirement to get somewhere where the TT can fix you to what ever end your insurance allows
- TT not guaranteed to save you (chances based on insurance level, location and threat level for the TT)
- Can be treated by a companion with appropriately high medical proficiency
- Companion can also be asked to try and take you to a safe enough location for TT
When an enemy hits you or whe you hit an enemy, the game rolls for the wound based on your accuracy, the base damage of your gun, the armor class and the location of the hit. The more accuracte you are, the more
likely you are to pull off a really devastating shot (your ability to hit targets is better physically
and after you can hit something, your chances of causing greater wounds or instant kills increases). Lower level enemies are less accuracte and less likely (but not incapable of) to create higher wound states.
The wound states do pile up, but not in a strictly linear order. For example, you might have to cause 5 "fatigues" to jump to "light wounds, 4 "light wounds" before it jumps to a "moderate wound" and 3 "moderates" to jump to "severe", and so on, but based on your character and roll, you might do a "severe wound" straight away in one shot, or jump from "fatigued" to "mortal" in one shot, or even kill someone in one shot. All right from the start, but the efficiency and chances alter based on your characters aptitude (and of course, the same goes for NPC's shooting/hitting you).
It's all based on the character while the player does the action (moving, choosing when and whom to shoot). How combat itself would work is another topic.
And if difficulty modifies the PC's based abilities before skill and other modifiers and the game is built for set difficulty (like I suggested earlier), it'll be really hard for a low level PC to function properly in combat in harder difficulties.
(Disclaimer: don't take the points literally, they are just to provide a general idea.)