I have seen things in Space Engineers, readers. Horrible, crotch-related things. I got so wrapped up in seeing those things that I didn't actually notice if there was any sort of game in there. Now I'm fine with pure building and messing about being considered gaming, but if you absolutely insist on there being some drama then the newly released Survival mode might be for you. There are a number of toggles that you can set, as well as plenty of starting scenarios to launch from, but the basic gist is everything needs energy, and if you don't have enough of it you'll die. Better get engineering.
To do so, players need to: "harvest and process resources, craft and build things and watch their stats to survive,". It's a more realistic mode that sits alongside the one I was playing, where I didn't need to worry about anything at all. Now everything is expending energy at different rates: mining takes more from you than just standing around, so everything you do needs to be considered against your ability to get to a medical bay to recharge.
I like the detail, here: ships need to be switched off when you leave them, or you risk returning to a drained husk. You even have to make sure you install thrusters correctly, as misaligned jet-blasts will damage your ship and players.
It's their first draft at making a game out of the engineering concept, but it looks intriguingly complex.
Thanks for the reminder, PCGamesN.