DFC:
In this case it would be possible to design a missed approach procedure for emergency purposes that avoided the higher obstacles.
That certainly could be done at some locations. But, where the published missed approach is 40:1-clear (2.5% clear) what would be the point?
And, unlike OEI contingency procedures, any alternate missed approach would have to have full TERPs or PANS-OPs lateral containment areas. And, unlike any OEI contingency procedure, the alternate missed approach would have to be accepted by the approving authority.