Ms Dodd suffered brain damage in a road accident and is unable to speak. At first, her family thought she was not able to make decisions. But they soon discovered that she could choose by pointing at things, such as the clothes she wants to wear or the food she prefers.
Her behaviour also indicates that she enjoys attending a day centre, but she refuses to go swimming. Her carers have assessed her as having capacity to make these decisions. Ms Dodd needs hospital treatment but she gets distressed when away from home.
Her mother feels that Ms Dodd is refusing treatment by her behaviour, but her father thinks she lacks capacity to say no to treatment that could improve her condition. The clinician who is proposing the treatment will have to assess Ms Dodd's capacity to consent.He gets help from a member of staff at the day centre who knows Ms Dodd's communication well and also discusses things with her parents.
Over several meetings the clinician explains the treatment options to Ms Dodd with the help of the staff member. The final decision about Ms Dodd's capacity rests with the clinician, but he will need to use information from the staff member and others who know Ms Dodd well to make this assessment.