My idea is to introduce karma and permadeath in a way that could perhaps be acceptable by most players and that would reduce a bit the number of trolls and douchebags (it would be still possible to be one, but now it would also be a real risk - IMHO making the game more interesting for EVERYONE, also for those who want to play some "psychopaths") while keeping more mature PvP (TC battles) intact.
1. Introduce karma.
2. The karma would drop in every location when you shoot (-30), kill (-90), successful steal (-stolen item base price/100) or do other "bad" things to players, UNLESS:
a) the person you attacked is on "permadeath" timeout
b) the person has "unprotected" flag (like a thief who failed stealing and was spotted by guards)
c) the location you are in is a war arena (there is Town Control timeout in the location).
d) the person you attacked has very low karma (I don't know, something like -2000)
3. Every time your karma drops, you enter permadeath timeout for N seconds/turns where N = karma drop. If you die during the timeout it's equal to permanent death of the character. It would reduce "shot first, ask later" attitude which is unrealistic and unfalloutish IMHO, even if it's wasteland most people aren't psychos shooting everything that moves.
4. Suiciders who will manage to kill someone are automatically permadead. Make sure there are proper checks to prevent causing permadeath by planting explosive on dead body etc exploits.
5. Add some way to turn off peramdeath timeout during events in specific locations.
6. Perhaps there should be some skull icon over a head of people on permadeath timeout, blinking during the last 5 seconds / last turn of the timeout.