Jeff I agree completely, and I don’t see these things as mutually exclusive. I’m all about having a great mutual/partner relationship with my clients. You’ve put a few words and ideas into my mouth that I didn’t say.
What I was expressing is that you need to be very clear up front with your clients what your design obligation are, and the good clients will understand and respect you more for it. Once you pass that hurdle, it doesn’t mean you’re free to do whatever you want even if it displeases your client. Of course they need to be satisfied! The point is that you want them to be satisfied that you’ve delivered the best result for their customers. As I clearly stated you need to be achieving the goals you and your client have set out at the beginning of the project.
Part of that process is knowing how to explain and justify your design decisions so they see the user-centric value in your solutions.
I do believe there is a point where you are doing a disservice to your clients if you do not stand your ground on certain issues, especially usability ones. But that’s just a single tool in your communication toolbox, and if you manage your client relationships correctly — and establish trust early — there’s usually little ground-standing required.