After literally sleeping on it, I want to put in to words some things that I don't think I've said before:
First, Soulkiller. I am a broken record about this being the death of original V, but for the sake of this, let's pretend we don't know what exactly it does. Alt makes it very clear that Soulkiller "destroys" something crucially important to a person, and V can't question it. There's no line of dialogue, no possible ending branch, where you can suggest that maybe what Soulkiller takes isn't worth it. You can acknowledge that it'll destroy something, or even after the fact that something has been destroyed, but V can never actually hash out whether that destruction will be worth it. This one I'll say outright is bad writing, instead of just me being dissatisfied with unhappy endings.
Second, all of the unhappy endings are incongruous with the rest of the game. The game presents itself as a cool game about an Edgerunner -- all of the promos, as false as all of them turned out to be, were "look how cool NC is, look how much there is to do in NC." After the life path opening, you have real friends, like Jackie, and a ripperdoc who tries to refuse to let you pay your debt once he finds out you're dying. Throughout the entire rest of the game, you're helping people like Panam and Takemura and even Johnny improve things for themselves. Hell, if you do Johnny's sidequests at the end, he even has a speech in the junkyard where he tells you how much you've affected him and that he'll not only go willingly when the time comes, but wants to actively help you save yourself. But I guess, as the meme goes, "V leads others to a treasure she cannot possess." Apparently this is the pinnacle of edgy storytelling.
Which brings me to the endings. Again, I'll ignore Soulkiller here. These endings aren't just bad, or bleak, or about not being able to change things in a grimdark cyberpunk world: they are all downright mean-spirited. Save your Soul program: In other endings, it's revealed the whole thing was a scam to collect people as data, so fuck you. Arasaka surgery: you get rid of Johnny, but you're practically a vegetable and have 6 months to live, so fuck you. Leave the net and go back in your body: You have 6 months to live and have to endure an epilogue where you have no choice but to actively tell your love interest that you choose the casino heist over them, and then play out a crushingly lonely final walk to the job, fuck you. Stay in the net: assimilated with Alt, fuck you. Let Johnny have the body: Oh turns out he can live in it fine, and gets the rest of your life that you can never have, fuck you. The only ending that isn't a "fuck you" and a spit in the face is the Panam one -- again, if we're completely ignoring the ramifications of Soulkiller.
I can imagine a good story about an Edgerunner whose only hope for survival is to abandon everything they've ever known, to painfully rip themselves away from NC because it's the City that made them and the City that's killing them. But that story should never have been an RPG.