Spare the Dying: Use Sparingly
Spell Level: 0 (cantrip)
School: Necromancy
Casting Time: 1 action
Range: Touch
Duration: Instantaneous
Components: V, S
You touch a living creature that has 0 hit points. The creature becomes stable. This spell has no effect on undead or constructs.
Review by Sam West, Twitter:@CrierKobold
A tense battle flows. The gnome barbarian leans into their longsword strike, sinking it deeper into the gnolls stomach. It lets out a horrifying, maddening laugh and takes a last desperate bite at the barbarian, maiming him. As the gnoll drops, so does the gnome; the battle rages on as the barbarian lays on the field, coughing up blood and convulsing. The elven cleric turns, having narrowly beaten back a rabid aggressor, spotting their friend bleeding. They dash over, and just before the life leaves the unconscious gnome’s form, a gentle hand waves light into his chest, mending the wound and sparing the dying.
Those tense moments making death saves: they are some of the most tense moments in 5e. Close fights trading ally for ally, hit points going down every which way, they are some of the highest peaks of intensity D&D has to offer. In exactly those moments, Spare the Dying can come in clutch as a guaranteed lifeline, a miracle that occurs when the cleric reaches their dying ally on their 2nd failed death save. Here’s the problem: those moments aren’t the majority of the time, nor anywhere close to it, and in those moments, there is a much easier and cheaper solution: proficiency in Medicine, a healer's kit, or just a helped check.
Dedicating one of your few known cantrips to working exclusively when an ally is literally about to die is not great. Guidance and Sacred Flame both can come out regularly session to session. They’re tools that empower your character in a variety of environments. Spare the Dying is an improved medicine check made to stabilize a dying creature. It's not something new to engage the game with. This doesn’t change how your character can interact with the world in any exciting new ways. It's a peace of mind cantrip that sometimes won’t even be enough in the moments you can’t reach the creature laying on the floor failing death save after death save.
The nail in the coffin for this cantrip for me is Healing Word: a ranged healing option whose entire purpose is getting friends off 0 in critical conditions. This doesn’t just stop a creature from dying. Healing Word returns them to consciousness and lets them get back in the fight, reposition to safety, or contribute some other way to the game immediately. It does so much more than a medicine check that it earns its spot on your character sheet. Spare the Dying will feel the same as a bonus to stabilizing dying creatures. You don’t need that.
If you’re playing a cleric, don’t bother with Spare the Dying. I know it may seem counterintuitive that the healer character doesn’t take something whose name literally evokes preventing death, but I promise you it is ghoulish overkill. You’re going to have a tool to handle creatures on 0 hit points: Healing Word. Every member of your party already can stabilize a dying creature. Don’t waste a cantrip on an effect you, and all your friends, can already do.
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