Nurses often encounter patients who, despite best efforts by both the nurse and the patient, are unable to follow the treatment plan and may even pursue hurtful behaviors, like a patient with COPD who continues to smoke. Editor-in-chief Shawn Kennedy speaks with the author, who is also AJN’s contributing editor for ethics, about this issue, how it can interfere with the nurse-patient relationship, and approaches nurses can take when patients do self-defeating behavior.