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This discussion is about PUGs. Specifically, examples are given for 5-man PUGs. There is no need for any self-injuring abilities in any heroic 5-man pug. If there is, then the group is unprepared in gear or experience.
Let's rewrite those last 2 sentences:
There is no need for drastic prioritizing of heals in any heroic 5-man pug. If there is, then the healer is unprepared in gear or experience.
If you can't handle throwing a Renew on a life-tapping Warlock - which is after all just a transfer of mana - or get ticked off by a Shadow Priest using SW:Death, then something is quite obviously wrong with your performance as a healer. If you're letting people die on purpose, you might just not have the right philosophy for being a healer in the first place.
You're free to **** and moan after a pull, but if you find yourself in a position where you're making life-and-death decisions during a pull that go beyond the standard healing priorities, you're wasting time that could and should be better spent doing your job - which is healing.
You know EXACTLY the risks associated with playing in a PuG. But you're putting your desire for loot an badges over those the moment you enter LFG, which ultimately means that you have to blame nobody but yourself if things should go wrong. You're making a commitment to this group of people you don't even know, and not giving anything you could regardless of the situation makes you look just as bad as those people conveniently blamed for the failure.
There are guilds to allow you to surround yourself with people you know and trust. There are plenty of addons that help you remember people you've had good or bad experiences with. You don't have to blindly run into a PuG, but if greed wins against common sense, don't blame others.
Some of my guild's most valued members are people we picked up during PuGs. I wouldn't want to miss out on those and what brought them into our ranks in the first place.
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A good healer knows who they would have to let die
No. A good healer doesn't "let" anybody die. A good healer does whatever he can to keep everybody alive, and feels terribly sorry if he fails at that. You're trying to play God, not healer.