We have them because some people need them. We run a 3/4 ton long box on weekends and some evenings, because we had a house to strip of stucco, a yard to dig out and re-do, and assorted projects that have and will require gyproc, lumber, and various other goods that I simply can't carry in the minivan, and need too often to pay for delivery constantly. But we drive it accordingly. We don't think it's a tank that will keep us safe no matter what. We know it's limits.
Karrie there are lots of pickups out there that can haul as much and more and still get decent gas mileage. You don't need neck-snapping acceleration in a bloody pickup. Nor do they need the hundred mph speed that these trucks can't handle.