For some context, DUrge's madness ending involves defeating Orin and agreeing to become Bhaal's prophet, then betraying Bhaal by destroying the Elder Brain (currently bugged unless you have Gale blow up). From there, the ending proceeds normally, up to the scene of the party walking away on the pier. At this point, Bhaal will punish you by attempting to drive you insane. You more or less have two options to respond to this: you can commit suicide before he can punish you or you can try to resist him before ultimately succumbing.
I actually like the suicide ending, since it's pretty cathartic going out with a final fuck you, but I can't overlook my biggest problem with it; it completely fails to address the impact Ascended Astarion should have on this ending. By this point in the story, the tadpole is dead, and the DUrge is a full fledged vampire spawn, capable of being compelling by Astarion with a simple command. It makes zero sense that he would stand idly by while you slowly pull out a dagger and begin to stab yourself in front of him. All he would have to say is "stop", and that would be that.
Maybe he doesn't realize what's going on and it dooms you to madness. Maybe he does catch on and starts trying to use his power to fight the urge with you. Either way, there's still an open question as to who's hold over DUrge is stronger. There's no way to have DUrge walk off into the city under Bhaal's control without forcing Astarion and Bhaal into some kind of fight for dominance.
At this point, I don't care whether it gets resolved with a good or bad outcome, but I do expect Larian to resolve it. These are more or less the options they have:
- Bhaal wins and Astarion curses him while vowing to take back his treasure.
- Astarion wins, but DUrge becomes feral.
- Astarion wins, but Bhaal kills DUrge like he did in the temple.
- Astarion wins, but Bhaal kills DUrge, prompting Withers to intervene.
- Astarion wins and is able to protect DUrge from Bhaal, but the two have made a powerful enemy
Otherwise, Larian basically needs to redo this ending in a way that prevents Astarion from being able to interfere.