Speaking as a wearer.
My multifocal vision is FAR from "artificial, unnatural, foreign", Rich. It's nearly perfect at all distances and that's NOT correcting a diopter of ATR astig. I find that my PALs, perfectly done Zeiss Individual 2 or Solidar 4K---that's what I find weird and foreign. I use them only to find my contact lenses. (Farsighted presbyopia sucks.)
As to the decentration issue: a definite problem. I had a patient yesterday. Tried B&L's Ultra Presby, Biotrue MF, Alcon Dailies MF and Alcon DT1 MF. -6 with 2 add. A little oblique cyl, r and l. The DT1 worked perfectly! The others all failed terribly. The DT1 centered and the other three did not.
Had a patient today. +2 with 2 add. No cyl. Biotrue worked perfectly, all the others failed. Biotrue centered, others did not.
So any of you who complain that you can't be successful with MF it is specifically because you are not fitting them correctly.
Consider that I have a 90% success rate initially and probably close to 80% longer term.
Yes, it's a pain in the butt to trial and error with these things but it is what it is. It takes more chair time. Charge for it.
How many of you even care if a spherical soft lens decenters? Does it matter? I say it does. Do you A/B two different brands/designs to see what yields the best acuity? It matters. Sometimes the more comfortable lens provides the best optics, sometimes it is the "this feels terrible" lens that is clear and sharp.
One size, one design does not fit all.