That's a good question, underfire. At my airline there is one aircraft type (Q400) that goes into Eagle County Airport (EGE). Their 10-7 pages specifically instruct them that should they lose an engine anywhere outside of the MAP they are to go elsewhere, unless they have a time-critical failure (uncontrollable engine fire). Of course, how one is to decide, say 2 mi outside of the MAP if something is time-critical or not is not immediately clear. Furthermore, the MDA is 8330'. The missed approach procedure is to turn right, join the SXW 001 radial and track it 24nm to JESIE intersection. Now, the terrain along that radial in the vicinity of the airport is 8,000-10,000', so even EO they would likely clear the terrain, but would not be within legal requirements. I suppose that would be where emergency authority of the PIC would come into play. Do what you have to do, 14 CFR Part 121 be damned, if the situation is dire enough.