Have you thought about playing with less lethal, but equally debilitating results? Dismemberment, extensive burn scars, blindness, deafness, etc… One game I played in had a rule that ‘cure’ spells left scars; it took a Heal or greater spell to remove them. So someone burned by a dragon might have such extensive scarring that his Dex, Con, and Cha are reduced quite a bit, possibly along with his movement rate and carrying capacity.

On the other hand, taking a full power blast of dragonfire to the face, after extensive injury, probably should just leave a pile of ash and a pair of smoking boots. (Literary convention pretty much requires the latter.)

I can say that it was the player’s actions or lack of them that got their characters killed. I’m a fudger, always have been. If players are playing smart or simply not stupid then I’ll nudge dice, to hit and damage, and monster decisions a bit so that things work out so the players are unlikely to die. With 4th edition, things are balanced though to the point where I now roll my dice in the open and I’ve only occasionally had to nudge the bad guys to shift targets to spread the damage around.

I really like 4e for that. It’s so closer to being balanced than previous editions that it takes a load of work off me to constantly adjust things on the fly.

I’m glad to hear you rarely kill off a character. I tend to kill very few myself, but I have had more than several kill themselves through stupid actions. Stupidity in action is rarely forgivable, but equally rare is the random kill just because the dice say so.