The writers seemed to think the only two choices were 'Use powers to do evil' or 'Do not use powers at all'.
The third, more interesting choice is similar to the True Q route. She tries to resist using her abilities. She comes across a village dying of famine and uses her telekinesis to spur growth because she can't bear to see them starve. But then she sees somebody attacking a defenseless person in an alley, about to kill him. She reacts, uses her telekinesis to stop the attack, and in doing so accidentally kills the attacker.
Incidents like this tempt her with the feeling of superiority Tannis had, competing against her fear and desire to stay connected to people. Her powers start to take her full blown 'Gandalf if he had the ring'.
Maybe too dark for the Voyager writers but would have been more interesting.
I don't think Endgame was a bad episode. It was, at the very least, the logical conclusion of established precedents.