You are absolutely correct about shot choice and placement when hunting in the mountains.
Hunt in the NC mountains with 1800 feet of elevation change on the property. A few years ago one of our ‘heart lung’ guys popped a nice buck late in the day. It maybe ran 30 yards. Then it slid ‘down hill’ somewhere around 150 to 200 feet. He had no idea how to retrieve it. He was sure it was down, but couldn’t put eyes on it before it got dark. ‘Search team’ located the deer about 10 AM the next morning. A club member spotted it hung up in some rhododendrons. He got within 50 yards or so, but couldn’t easily get closer to the deer. The shooter got to the deer about 2PM. His first comment was it was a perfect double lung shot... Short story, the deer arrived at the cabin about 5PM. Tried to save the the back straps, but even they had turned according to those present. North Carolina, bright sunshine, near 80°...... about 24 hours since shot. Surprise surprise. A perfect double lung shot that wasted no meat..... Oh, need to add, this hunter would ride others who is his opinion ‘ruined’ any meat with their shots. It was made clear to him he was on his own in the future. He hunted one more year with us then vanished.
I have also gravitated towards larger caliber roundballs or heavy conicals. Want to take out at least one shoulder, though prefer taking both, or better yet for that right here right now moment, a low neck or high shoulder shot that takes out the spine.