If you are flying any NPA in IMC using a VOR or NDB as track reference, please tell me how you accurately place an aircraft right over the departure end of a runway with a ±150m lateral tolerance?
Well, if you loose an engine below MDA and you follow the EO departure procedure, you are merely starting your "departure" from an earlier point with speed and altitude as a bonus. Now...tracking precisely will always be difficult. Don't forget that these are only procedures to cover you ON PAPER, and not neccessarily in practice.
The 300m gate you're refferring to, will be equally difficult to hit from a EFATO scenario. Anyway, I'm not expecting any skyscrapers 151m left/right of DER. And regardless of your abilities, I would rather be at 1000 ft, 200m right of DER, than at 35ft, 149m form DER and within the corridor.