In real life, if you've not noticed, we don't have hit points. Getting stabbed by a sword once is pretty much crippling if not outright fatal. Fall too far and you don't suffer some uniform amount of damage across your whole body -- you frequently wind up breaking your legs or your spine, and it can be a slow and painful recovery process if you ever recover. We can't wander through the world without ever bothering to eat, drink, or sleep, and when you get shot to death, there will not be a fresh clone waiting to get you back into the action. In the interests of being polite, we'll not even mention the usual lack of other important facilities.
We accept that there's going to be some degree of unreal mechanics in a video game, of course, but that doesn't mean that some of us don't want the game to stick fairly close to the real world. By the same token, though, some of us take the Mystery Science Theater 3000 mantra to heart -- it's just a game, and it's not all that important if it makes real-world sense in sticky parts. Where do you fall on the scale? Do you like your games fairly realistic, fairly unrealistic, or do you not care so long as the game itself is still fun?