Funny you should say that. I agree but many may not.
True realism isn't always the answer as you well said. However it could be done but would require a completely different approach to not only level design but combat and AI. You would need to take replace heavy fast paced combat with more slow paced strategic combat. I Am Alive is doing something along these lines.
I have been playing around with ideas for possible mechanics to make a "realistic" yet still fun and acceptable action game.

