Abstract: As pilot programs for hospice and palliative care deepen in China, conflicts have emerged in clinical practice between Western ethical principles centered on ‘patient autonomy' and the traditional Chinese family-centered decision-making model, leading to widespread dilemmas regarding informed consent and family conflicts in decision-making. The sinicization of palliative care practice should not involve simply replacing one model with another. Instead, it should be based on a profound understanding of the local culture to achieve ‘relational autonomy', thereby constructing a palliative care ethical system that genuinely aligns with China's national context and can effectively guide clinical practice.