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I believe Save or Die's intention is to create the mood of a good horror film/novel, it's about building suspense. Knowing that jewel shoots an adventurer disintegrating death ray builds suspense, makes you real cautious as a mistake can have the party carting your ashes to the nearest temple. But when you randomly drop dead without much control, your adventurer feels more like "teenage girl no.3 who gets murderized by masked killer" than "gritty pulp hero"

It's that line between good horror suspense and cheap shock (although goofy slaughterfests can be fun if that's your intention, as long as everyone knows they're on the same page) which is trick to aim for. That's the main problem with SoD as it is in D&D.

Another issue is, in the hands of the players, the jarring effect of a % chance,...