While I agree that certain constructs, like "goto" should not be used, I will point out that the full title of the 2004 version of the MISRA C document is:
MISRA C:2004 Guidelines for the use of the C language in critical systems
Note the word "Guidelines".
Also note section 4.3.2, which discusses deviation procedures. In summary, it recognizes that full compliance is not always practical. And when deviations are made, they must be documented, justified and reviewed. Sometimes, such reviews involve showing 2 versions of the code in question: One without the deviation and the other with, so that the relative risks can be analyzed and discussed. Sometimes this process can result in an alternative with either a "less serious" deviation or no deviation. And sometimes the deviations are approved as-is.
At the consulting company I work for, how strictly the various guidelines (not just MISRA, as only a few of our clients are automotive) deviations are approved depend on the customer. We certainly make great effort to only deviate from the various guidelines when the risks of compliance outweigh the risks of non-compliance. Sometimes business considerations override engineering considerations.