Abstract: From the perspective of clinical ethics, this article aimed to identify ethical issues and explore resolutions during decision-making process of treatment strategies in patients with rheumatic diseases. We elaborated the topics of medical indications, preference of patients, quality of life, and contextual features by using the model of "four-topics theory". Its application helped to identify and refine ethical issues, search and explore medical evidence, listen to the voice of patients, and finally promote the doctor-patient mutual participation and shared decision-making.