End-of-life care in intensive care unit trends toward palliative care in modern time. For dealing with medical futility, we can reach a consensus through health care team meeting with the focus of "good death" and "the four boxes of clinical ethics". To avoid "the slippery slope" in ethics due to the issue of withholding or withdrawing the ordinary treatment, and not to violate "Hospice Care Regulations" and "Regulations on Human Organ Transplantation" are also important. Thereafter, ways to come to an agreement with patient and family requires empathic communication during family meetings. If communication becomes difficult, "time-limited trials" is another approach. It should be minded that no argument about medical futility launches palliative care into cares of other symptoms, psychosocial and spiritual needs, favored death point, and announcement of death. Sometimes, it is not easy to manage above, but inviting other specialists or other medical teams may smooth the processes. By incorporating palliative care with end-of-life care in intensive care unit can help to empower personnel and achieve self-values.