Agree completely, i don't see how implementing some choices elements in the understory undermine the gameThe problem is what makes a good story is not necessarily what makes a good game. The inability to kill Dex is something that causes a sense of meandering in the middle of the game as well as third act because there is no one to focus your anger on as a character. It might be "the point" but it's not really a point that makes the game story resonate more. Dex is a character that gets a lot of build-up and all of that build-up is wasted when it could have been used.
The problem with the Evelyn matter is the fact the game outright forces you to ignore what is an option in game. Sandra Dorsett is found later in the game with some issues but mostly fine due to the fact that she had her memory cleansed by the Trauma Team. The lore established that you can buy temporary policies for healing. You could have established Evelyn as already dead or irrepairable but the game wanted to maximize angst and thus you just leave her alone to commit suicide.
In simple terms, the game is heavily on the rails and your inability to affect anything goes beyond what previous games in teh Witcher allowed you to do. The previous games allowed you the chance to save or kill individual characters like Keira, side with different factions, and more. They can't affect the main story save in the very end but they have impacts that made the games feel for stronger for it.
Re: Cyberpsychos
Actually, they completely change it as the point of the Cyberpsycho quest is that it doesn't work remotely like it did in the game world. They also changed it for Cyberpunk Red.
The difference between Evie dead and evie alive but somewhat traumatised would be akin to Keira Metz dead/alive etc