And HP can be represented as both the ability to take a hit and power through it, or the intrinsic ability to cause things to just barely miss or other plot armor abilities that you see in action movies. Roleplay either or.
And none of those abilities actually cause a condition called pain. The condition is incapacitated. If you want that to be, can't move/can't speak, sure. If you want that to be repeatedly saying ow over again that works too. Or you could go full screaming and flailing. Whatever. Point is that 'pain' isn't actually defined in D&D rules and thus is whatever you want it to be.
Cool, thanks for the link.
That's my point.
Fair enough, though I'd call that being a griefer. I wouldn't say we've seen Ghouls act like that yet. They do seem to be actually 'playing' the game, whatever game it might be. As far as we can tell, the only people they consider players would be other ghouls and very maybe Tobi, but I doubt they do.
Also where are you getting that Ghouls made/run the Smile Foundation? You keep mentioning it as if it is a clearly stated fact, but I've never seen that suggested anywhere in the comic.