Straight talk and honest communication work. Bluntness does not equate to disrespect. It can be therapeutic to tell a patient that he or she has asked you for advice but declined to follow your suggestions. My patients continue to regard me with affection because I do not dissemble. This gives them the controlling responsibility and honors their freedom of choice.—ELOISE LUKAS, ARNP-C, Little Rock, Ark. (141-11)