Objective: The qualitative research was conducted face-to-face in-depth interviews with each of the three stakeholders: patients, medical staff, and family members. The transcribed data were analyzed using thematic analysis. Methods: The main finding of this study is that patients, medical staff, and family members considering critical points in making advanced decisions were different. The medical staff thought that stopping hemodialysis was considered an act of cutting their lifeline. Being able to live tomorrow by receiving dialysis today is meaningful to medical staff. In contrast, patients felt that it was an extension of meaningless time and accepted it as useless due to the extreme limits of their daily life. The caregivers were burdened with care such as assistance in moving to the hospital for frequent dialysis and anxiety about emergencies. Korea's medical culture, where the opinion of medical staff is prioritized, long-term hemodialysis experience, and the patient's old age affect the patient's decision-making. And the quality of the patient-caregiver relationship, decision-making pattern in their family, and patient’s comorbidity status are turned out to be critical conditions in decision-making. Results: Medical staff who are well aware of the patient's disease trajectory should continue to support the patient and their family's decision-making from a long-term perspective to decide that reflects the patient's genuine willingness. Further research is needed to explore the time to explain and suggest the advanced decision and the time and degree of involvement by the medical staff. Conclusions: Objective: This qualitative research aims to explore the end-of-life decision-making experience of patients with end-stage of renal disease. Situation-specified explanations from this study’s result would suggest an appropriate strategy to pursue shared decisions since the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care was enacted in 2018, South Korea. Methods: The qualitative research was conducted face-to-face in-depth interviews with each of the three stakeholders: patients, medical staff, and family members. The transcribed data were analyzed using thematic analysis. Results: The main finding of this study is that patients, medical staff, and family members considering critical points in making advanced decisions were different. The medical staff thought that stopping hemodialysis was considered an act of cutting their lifeline. Being able to live tomorrow by receiving dialysis today is meaningful to medical staff. In contrast, patients felt that it was an extension of meaningless time and accepted it as useless due to the extreme limits of their daily life. The caregivers were burdened with care such as assistance in moving to the hospital for frequent dialysis and anxiety about emergencies. Korea's medical culture, where the opinion of medical staff is prioritized, long-term hemodialysis experience, and the patient's old age affect the patient's decision-making. And the quality of the patient-caregiver relationship, decision-making pattern in their family, and patient’s comorbidity status are turned out to be critical conditions in decision-making. Conclusions: Medical staff who are well aware of the patient's disease trajectory should continue to support the patient and their family's decision-making from a long-term perspective to decide that reflects the patient's genuine willingness. Further research is needed to explore the time to explain and suggest the advanced decision and the time and degree of involvement by the medical staff.