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The issue that I have found is the way that people shoot - there is target shooting and then there is defensive shooting.

Quicker paced shot follow ups, center of mass targeting - vs standing in perfect position, taking a shot and waiting 4-5 seconds to acquire a perfect sight for a head shot picture then waiting for your "breath to pause" and then squeeze. I cannot imagine that I am going to have much time if I have to draw my weapon and train as such.

Shot placement is vital - a .45 will not create a bigger hole if it does not connect with the intended target. That being said - neither will a .22 or a .223 or shotgun etc. If you cannot handle or shoot anything larger than a .22 then please carry a .22, but if you can handle something larger then by all means do so.

We cannot argue with physics - if you hit the same target in the same spot with a larger bullet you are going to get a bigger hole.