Simple is best. Hidden check box, irreversible. No other bells or whistles. If we try to pile too much onto it, Tom will throw up his hands and toss the whole idea. It will be complicated enough to implement as it is I think seeing as it touches on quite a lot of different areas of code.
Heroes already get some minimal bonus to H/P because of accepting the risk of death. I've always liked that, and thought that should just be an option regardless of class. Want to risk death? Get more H/P.