According to the theme, health must me 'sacrificed'. Does sacrificed mean the player must willingly give up, must they be forced, or either one will fit the theme?
At the end of the day, its based on what rating people give you. And thats all their own interpretation. Im sure as long as there is some mechanical focus on losing health in a non-consequential way (not just taking damage from falling for example). You'll get a good rating.