In this paper, I suggest that the moral incompetence in narcissism is associated with a particular type of emotional incompetence, namely the incompetence to experience the moral emotions, such as empathy, solidarity, loyalty, or love. I then move on to discussing the ethical ramifications of this incompetence, primarily from the point of view of sentimentalist ethics, and conclude that emotional incompetence does not in fact reduce the moral responsibility of a narcissist person, whether diagnosed with Narcissistic Personality Disorder or not. My argument is based on the three criteria of moral responsibility proposed by Philip Pettit, namely those of value relevance, value judgment, and value sensitivity. I suggest that a sentimentalist ethical perspective entails that the satisfaction of two of the mentioned criteria (awareness of the social meaning of one’s choices and sufficient control of one’s actions) constitutes a moral obligation for the agent to satisfy the third criterion, namely to develop the appropriate moral sensibility and competence to actually choose morally correctly. This type of structure of obligation elucidates why narcissism is at the same time a moral failure and a psychopathology. At the same time, my argument portrays narcissism as a particular type of personality disturbance that almost uniquely reaffirms the role of moral re-education as the psychotherapeutic approach. This conclusion points to a potential revival of some of the precepts of Pinel’s affective psycho-pathology, dating back to the very beginnings of the psychotherapeutic clinic.