Originally I kind of disliked Sudden Death.
Creating a modified set of rules to decide a tied game seemed arbitrary and occasionally unfair in the beginning.
I mean, why force a result anyhow?
If two teams have fought for a certain period of time and have proven to be of equal strength why not leave it at that? I, for one, can live with the idea of ending a game in a draw.
Granted, I was also still used to the way TFC handled that issue, which was it simply didn’t. In TFC a draw was a draw and remained undecided (not sure how leagues handled that).
Apparently Valve thought they had to offer a solution to such a (potentially) unsatisfactory situation [1] and thus introduced Sudden Death. No respawn and no healthpacks in SD. Last man standing wins the match for his team, so to say.
Of course that’s pretty much the way CS is played in general. So basically TF2 is played by CS rules during SD. Except that in the regular setting of SD you still have medics and dispensers, which blurs that comparison to some extent.
Sudden Death requires an immediate shift of tactics, since survival is of essence and strength in numbers is often game decisive. And while the timer tries to keep teams from playing too defensive there is still the tendency to play it safe and try to diminish the enemy ranks before attacking oneself.
So during that final round one plays a very different game, and quite frankly I never found Sudden Death all that satisfying nor did I necessarily felt the outcome reflected the quality of the teams. So as a serious decision maker for a match I found Sudden Death rather rubbish.
But you have to give kudos to Valve that they implemented Sudden Death to be played in more than one way. So admins are able to restrict SD to a single class and/or to melee weapons only, which offers some nice variations. That (and especially melee) takes all potential seriousness out of that round and often enough turns it into a goofball event.
Since I’m usually more of an uptight and all-too-serious person it took me quite a while to warm up with that kind of Sudden Death, but now I can enjoy it as a nice wind-down period from a game [2]. To me this seems a rather appropriate way to be used for pubs. If you have to end the round in a rubbish way you can at least do it with style 
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