Game settings (like karmic dice, and difficulty), no mods or save scumming are reasonble for people seeking a challange, but not nearly enough to create an actual challange. And permadeath doesn't make the game more difficult, it's likely to make the player more careful which makes the game even easier. And while the rest of the list could give people some ideas to challenge themselves, it's presented as an answer to requests for the game itself to have a higher difficulty, and that is just silly. People seeking a challenge generally don't want to artificially restrict themselves to get any sort of challenge, they want to test themselves against the game, within the game's own rules and mechanics.
