The original damage dealt for survival is 0.5x with 2.0x as the damage taken. Increasing the amount of damage you take for getting hit makes the game a lot more realistic, but you should also be able to damage enemies at the same rate.
Being able to craft ammunition makes Fallout a lot more realistic as crafting ammunition would be a huge part of a real-life post-apocalyptic environment. Spending the time and effort crafting ammo also helps the game feel like it's a precious resource.
The original damage dealt for survival is 0.5x with 2.0x as the damage taken. Increasing the amount of damage you take for getting hit makes the game a lot more realistic, but you should also be able to damage enemies at the same rate.
Reduced visibility at night makes the game a lot more realistic and makes the night vision scopes a more important item to consider just like in real life.