I think Last Breath works great for one-shots or short campaigns, but I think there's a little bit of an issue with it as written for long-term play.

7-9, statistically, is the outcome that is most likely to come up since there's now +stat to the roll.  This means that most people who have to take this move are going to get a bargain with Death.

In the short term, I love it. Great flavor. Great consequences. Just a really cool idea. In a more long-terms game, where Death will be making deals time after time after time I see two ways to approach it.

1) Death: The Master Manipulator - With PCs likely having multiple deals with Death, you can't just fall back on the whole alignment change option time after time.  You have to start having Death make deals that either cause the PC to keep giving up pieces of himself (boring after the first time) or basically give out quests. If you fully embrace the latter, you have to dismiss that Death itself is impartial and instead has an active influence in the world. This line of thought can lead to some really cool events in play, I think, when you start to imagine the repercussions, but it isn't normally how we think of Death. Just think of the awesomeness that could spawn from the PCs being forced to become Death's hand in the world each time they die.

2) Death: The Flux - Each time you get the bargain result you make a deal that changes something on your character sheet. Alignment. Stats. Whatever.  As mentioned above, this is something cool in the short term that would end up suffering as it came up, time and again, in the long term.  It gets old.

My point is that I think there needs to be some other option for Last Breath for campaign play. Making continual deals with Death, if you don't go the route of #1 up there, will eventually get trite...which it should never be.  I'm in favor of there being a more mundane 7-9 option for Last Breath for games that plan to go the long haul. 

What do you think?