Under the combined influence of filial piety emphasizing “nourishment” and technical rationality, patients at the end of life often face a predicament of diminished subjectivity and dignity, while the continuation of life may be alienated into a burden of numerical life-sustaining indicators. Although active euthanasia has gained some moral justification based on autonomy and dignity, it remains highly controversial globally. Particularly in the context of Chinese filial piety culture, where the practice of filial piety in end-of-life care often tends to prioritize nourishment over respect, active euthanasia struggles to gain normative acceptance. Through a contextualized reconstruction of Kantian moral philosophy, this paper explores the limited moral permissibility that active euthanasia might obtain under certain extreme conditions. It attempts to point out that the key to resolving this normative dilemma lies in carefully distinguishing the value hierarchy between “nourishment” and “respect”, and in shifting the core of filial piety from an absolutized adherence to “nourishment” toward compliance with “respect” as subsumed under rational laws in end-of-life medical situations, thereby offering a possible approach to addressing the normative challenges of active euthanasia.