The third revision of Taiwan’s "Hospice and Palliative Care Act" was effective from January 9th, 2013, which resolved the problems of futile medical treatment in terminally-ill and unconscious patients without advanced care planning (ACP) and relatives. According to the 2013 amendment and based on the best interest of patients, physicians in charge can withhold and/or withdraw futile medical treatment from incompetent patients who do not have relatives or surrogates after consultation with hospice team. However, while physicians decide to withhold cardiopulmonary resuscitation or withdraw the futile life-sustaining treatment for patients’ best interest, they may hesitate because of fear of against moral rules or legal regulations. This article is a discussion about the principles of medical ethics and legal consideration in western world. We expect to reduce the plight of end-of-life care in such situation in Taiwan based on the amendment and above discussion. Now, in Taiwan, we have legal protection in dealing with end-of-life care of patients without relatives and surrogates. We also suggest medical institution should have stipulated procedural approach and a written check list to smooth the way for physicians to withhold cardiopulmonary resuscitation or withdraw life-sustaining treatment. More important, we must help patients without relatives to have their advanced care planning while they are still competent. As patients’ autonomy getting more important, we hope physicians can also provide adequate medical treatment under legal protection.