Withdraw of life-sustaining treatments in long-term respirator dependence of cases often lead to a variety of ethical legal issues. This article describes that decision-making experience of inter hospital shared care RCW ventilator-dependent case by the four boxes of clinical ethics. In inter hospital shared care process, respect the wishes of autonomy and maintain their best interests principle by the four boxes of clinical ethics discussion. Finally we help the case sign Advance hospice palliative care and life sustaining treatment choices of intent, Withdraw of life-sustaining treatments, solving the ethical care problems, make the case good death and families good grief. We expected by this case to improve autonomous right in hospice palliative care.