PCGen vs E-tools
E-tools is OK. It works, but not all that well. As you can see by reading many of the other posts around here, it's full of bugs and God knows when (or if!) they'll get fixed. Third-party programs have made E-tools more usable, but it's still a long way off. You can get most feats to work, but not some of the more interesting ones, like Monkey Grip. Most PrCs are next to impossible. Many are flat-out impossible
PCGen is better. It used to be somewhat slow, and definitly clunky. It's now nice and fast, and only very slightly clunky. Well, maybe "clunky" isn't the right word. Once you've created a few NPCs on it, it's a breeze, though there is a learning curve (but not a very steep one). PCGen also handles pretty much any and everything. Only the most insanely exotic or rule-shattering PrCs and feats give it pause, and the really great thing is that if you need some functionality specifically for your own feat or PrC, you can put in a feature request.
Also, as soon as you download PCGen (it's free, in case you didn't know) it comes with Psionics built right in (and you can't even add psionics to e-tools), as well as templates (another thing E-tools lacks), the ability to convert classes into ex-classes (barbarians that become lawful, monks that stop, clerics that loose their religion, ect). I think e-tools only does the ex-palladin, but I could be wrong.
And, of course, PCGen comes with tons of non-WotC stuff. Atlas Games, Avalanche Press, Bastion Press, Chaosium, Fantasy Flight Games (including, of course, Dragonstar), Green Ronnin, Kenzer, Malhavoc Press, and many more are all included in the PCGen download.
And if you have custom stuff, adding it really isn't that hard, though it does require some text-editing. I know you said you didn't want that, but to be honest I don't think sucha a program exists. E-Tools requires MS Access database management to change stuff, so at least PCGen is more easily managed than E-tools. And the PCGen mailing list has lots of helpful people on it for when you have questions editiong the list files.