The revenge of Blood and Guts

Ray Chapel at Quasar Knight has been talking about hit points, one of my favourite topics for RPG argument.  He does a nice job of summarising the usual case for the "action movie" interpretation of hit points (in which hit points are luck, fitness, and the like) being the natural one for D&D and leaves off by saying that if hit points are going to be blood and guts it's going to take some conversion work.

Now, I don't necessarily disagree with the points Ray made, but I think he's left out the source of the controversy: death's door.  If characters simply die at 0hp, then clerical "healing" magic is in fact some sort of special pleading to the saints (or whoever) for renewed favour.  But we know from descriptions of characters at negative hit points that they are gravely wounded and need attention or they will die.  How is it that the same effects - including the warlord's "shouting" - can restore such characters?

I can think of a few ways out of the problem that don't introduce too much more complexity:

1. "He dies": as implied above, death at 0hp probably solves the problem (all so-called "healing" being restoration of fortune, willpower, and energy), although this does raise a question about whether any hit point damage reflects real physical harm.
2. "Only the worst villains kill people": The interpretation of "death" at 0hp could be changed to "defeated", with a range of effects such as unconsciousness and surrender imposed upon characters who have lost all of their hit points.  Actually killing a character requires a little bit of extra effort after that.  This does mean moving from action movie to Saturday morning cartoons, though it's not without its charms.  In particular, the DM no longer needs to have any squeamishness about the party being crushed by an encounter - clap them in irons and discuss how they'd like to deal with the problem!  (I seem to recall that John Wick used this approach in his Houses of the Blooded.)  The downside here is that the rule doesn't seem to meet our intuitions about the deadliness of a swordfight, let alone a fireball.
3. "No more miracles": One might choose to amend healing magic (or some classes of healing magic) so that it cannot restore negative hit points.  This makes it very clear where the line is being drawn, but may scandalize players used to being drawn back from death's door by cure light wounds.  It also concerns me just a little that any "real damage" incapacitates a character.
4. "Do not look behind the curtain": This isn't a gameplay problem, so there's no pressing need to change the rules.  Many role-playing systems have suffered as a result of trying to be too realistic, D&D among them.

I have a feeling that most DMs not using "blood and guts" go with options 1 or 4, but I would be curious to hear from anyone who has tried a solution like 2 or 3 (or something else altogether).