Deus Ex was amazing, but other than that, there really hasn't been much in the way of RPG design that's been very interesting, whether it be the thoroughly awful (Bethsoft's assorted works) mediocre (post-BG2 Bioware) or muddled (anything the remnants of Black Isle have come up with so far), since the times of the Fallouts. You could make a case for maybe Vampire: Bloodlines, maybe, but bad programming and lack of resources stunted that 'un, and I'm sure there are some I'm missing. Regardless, games like Fallout aren't being made anymore, at least not in this country. For one, gameplay design has swung decidedly towards the twitch end of the spectrum, even if companies like Bethsoft make tepid gestures to poindexterism via VATS or whatever.
And Fallout wouldn't fly in a post-Halo gaming environment. It's not for enthusiasts anymore. Even a smash hit like Doom could've been considered "cult", and now games shoot for true blockbuster status, and you can't escape that shift, even less than a small-time filmmaker can resist Hollywood. You may have noticed that Mountain Dew released a soda "designed" for (competitive) "gaming". Games cost too much to make (unless you're making rinky-dink casual games or platformers, and good luck to those people) Companies like Bioware saw where the wind was blowing and started making Events. So did Bethsoft, you can witness the stunningly bad design decisions in Oblivion and envision the reasons for them pretty easily. Not that there's inherently anything wrong with trying to make a boom headshot slam dunk, but the more games you make like that the more the customer base grows accustomed to them and the more that happens the less incentive there is for anyone to take risks. Of course Blizzard/Activision's not going to support Brutal Legend. Of course Bioware's not going to let you side with Saren (though that sort of thing has always been pretty rare, I can only think of Fallout 1 letting you do that) Of course Bethsoft won't let you shoot kids or allow hookers in their games. Of course Firaxis is going to take only the least interesting elements of the brilliant Alpha Centauri and implement them in the mind-numbing Civ games. Of course No More Heroes isn't going to sell.
The Fallouts, for all their greatness, were somewhat archaic and often difficult, which is a bad combination for today's gamers. They also lack flash, even when the art design to this day remains fantastic. I know people who won't play them because they predate Half-Life 2. That's the sort of customer that drives the market. The niche that favors craft over viscera is too small to accommodate the Fallouts these days, and that's unfortunate. Fallout 3 is peculiar, because it potentially resembles the original games in significant ways but differs from them radically in the most significant way, because Fallout is not a Brand amongst the general gaming public and it's a game whose greatest strengths are all Bethsoft's greatest weaknesses. The only explanation for its existence is that the designers loved the first two games. But just because a geek loves football doesn't mean he should be made quarterback.