Abstract: Because of critically ill and deep sedation, ICU patients could not express their end-of-life decisions, especially when facing emergency condition. In this paper, We elaborated the current status of end-of-life decisions in ICU,explored the influencing effect of family meetings on end-of-life decision for the critically ill patients. We found proactive and well prepared family meetings could facilitate the final decision-making of critical patients. However, we still lack effective method about how to comply with the wishes of the critically ill patients and their families in end-of-life decisions, and face the challenges in ICU.