Given the proven fact that single pistol bullet impacts are rarely fatal, giving up much greater firepower for the hope of a slightly better chance of a "one-shot stop" with a single .45 bullet is a bad choice.
An oversimplification of the damage a bullet does. Using that logic a 30-06 rifle bullet would do less damage than a .45 acp because its a smaller diameter.
Shot placement is important but the real test is how much energy does the bullet transfer to the target.
Nobody proposes limiting to a single shot but if you only have a single shot then I’d rather it came from a .45. I have smaller hands and dont have an issue putting 7 rounds in a 1 inch circle. Proper technique and training are all thats required, not massive biceps.