Seems like hardcore mode is not enabled after the new quest mod got added. I can't consume hearts, just says i need to enable hardcore mode first. Im on titan.
Welcome to the new (bad) questbook where the ui is terrible and there is no such thing as lives enjoy... Yeah i dont like it either and i want hqm back..
To bad, as it is being removed from the pack completely on the next update. Why not contribute to a solution instead of complaining about it all the time? If you dislike the UI so much, make a new one and submit it to the github for better questing.