Can You Save theGoat and theCabbages?Cognitive Functioningin Anorexia NervosaPatients and ItsImplications forPaternalism

The problem : ‘Trying to save the goat and the cabbages’ is an Italian figure of speech that means that at times trying to achieve two irreconcilable goals may lead to achieve neither. The puzzle that I discuss is: How can we carry people to a safe shore without trumping their autonomy? A large part of the literature suggests that anorexics suffer from cognitive dysfunctions, which are thought to impair the deliberation. If this is true, then we could save the goat and the cabbages: paternalistic intervention would not erode the moral principle of respect for autonomy. Methodological approach : This article uses philosophical bioethics methodology, including conceptual analysis and critical evaluation of legal reasoning and medical practices. Conclusion : The many attempts to show that anorexics lack capacity and/or autonomy because of some cognitive dysfunctions are circular, or incomplete. It does not necessarily follow that competent refusals of food or medical treatment should always be respected; what follows is that if we believe that paternalistic intervention is justified, we must make a case for a strong version of paternalism.