Living organ donation has raised ethical issues, which have not been fully addressed. The scarcity of organs as well as medical advances promote this procedure. However, the psychological outcome of donors may not be as good as expected. The usual assessment is not able to identify donors who are at risk. Patients' autonomy is privileged but may lead to the underestimation of underlying psychopathological processes. Without minimizing the importance of donors' self-determination, benevolence and sense of justice, we suggest that it could be useful to investigate the roots of donors' motivations. We could consider the existence of a shared responsibility between patients and clinicians. The ethics of responsibility may complete the ethics of autonomy, leading to a better identification of donors at risk