Healthy vs unhealthy true damage.
Look at some of the most broken or toxic champions in the game with true damage.
. Notice anything about them? Their true damage has high base value, and is spammable. Darius and Irelia's true damage is mentioned somewhat frequently as being overpowered, but not unmanageable, while Fiora and Vayne's % maximum health true damage has 0 counterplay and is connected to champions who have the means to solo carry (Fiora's riposte + dash + massive heal, Vayne's tumble + condemn). Darius and Irelia are examples of champions with extremely powerful but not toxic and broken true damage. Fiora and Vayne are the poster children for toxic as fuck champions with no counterplay.
First of all, % max hp true damage should not exist, especially not in spammable form. If you want to give it to someone's ultimate so they can only use it once every 80 or so seconds, depending on the nature of their kit, this can be dealt with. However, giving it to a champion on her permanent passive is just inherently toxic, even without taking into account that the 2 champions with this permanent true damage have kits that synergize with it to make it even less manageable. % current health or flat true damage is bad enough but % max health just doesn't fit into this game. Fiora is especially toxic as a drain tank now. A Fiora who went even in lane can 1v3 any composition that isn't just flat out high dps because when she's built drain tank she can win trades with anyone in the game all while healing any of the damage she may have sustained.
Now look at the champions with healthy true damage. I have never seen these champions called toxic or overpowered because of their true damage, not even once.

Notice anything? Corki will most likely never build more than 350 or so AD, so his true damage is very minimal. Ahri can't spam her true damage and it's a tiny 35% AP ratio. Vel'Koz must hit 3+ skillshots to deal a small amount of true damage and will never reliably proc his passive more than twice in a fight. Zyra and Kog'Maw both have 1 off true damage that can't even activate unless they're dead, ensuring they don't go on a 1v5 neverending true damage rampage like Vayne and Fiora. Twitch, like Corki has extremely low true damage, but his doesn't even scale by any means. One more thing to note, all of this is flat true damage. These champions can't walk up to a tank with 4000 HP and 300 Armor and melt them.
So let's try to learn our lesson and not release any more % health true damage into the game, especially when it scales with items and is on champions with kits who make it even more toxic than it is by itself.
