And for a noob’s perspective…
I agree with @JohnnyC, and I think it stands to reason that if you’re resisting harm when you’ve already been harmed, it’s more challenging. Pain tolerance, mental fatigue, and other things can affect your ability to think clearly. Helps the narrative, for me.
I like the option to make things more lethal in this way, and it further encourages the buy-in from the PCs to embrace the scoundrel’s life and get back up again.
Also, I like @John_Harper’s post about adding an XP tick if someone remembers or roleplays their harm.
Inspired by that, I’m thinking of adding a house rule for my group:
"Remember harm: If you roleplay your harm and suffer the die consequences without me asking for it, tick an XP track. "
An aside: We also have one “edge” token on the table. Gives the PC a bennie in the bank when someone exercises exceptional RP or has a great idea. I basically use the players to trigger it. “That was really good./That deserves the token.” Use it or lose it when someone else gets it. For now we’re using it for a +1, but we may revisit it.