Abstract Alcoholic patients are frequently regarded as responsible for their alcoholism and alcohol-related diseases, such as liver damage. These patients run the risk of receiving lower medical priority for liver transplantation than patients who are considered as not responsible for their liver damage. However, hardly any scientific research findings support this supposed responsibility of the alcoholic patient for his addiction and the related diseases. Many alcoholic patients have comorbid psychiatric disorders such as antisocial personality disorder, schizophrenia and social phobia, and these cormorbid diseases are often linked specifically and also in a neurobiological way to alcohol abuse. Furthermore, concepts such as responsibility and health have multiple dimensions, which can be contrasted against each other. Useful and fair criteria are presented for the assessment of responsibility for our health.