Wasteland 3 is getting permadeath as part of a new update coming soon.
Patch 1.3.3, titled Death & Taxes, adds permadeath mode as well as an optional difficult skill checks mode, respeccing, new character customisation items, and a raft of improvements and fixes.
Wasteland 3’s permadeath works as you imagine it should: when activated at a game’s start, your characters will die good and proper when their health reaches zero.
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