Luke, a young man, was seriously injured in a road traffic accident and suffered permanent brain damage. He has been in hospital several months, and has made good progress, but he gets very frustrated at his inability to concentrate or do things for himself.
Luke now needs surgical treatment on his leg. During the early morning ward round, the surgeon tries to explain what is involved in the operation. She asks Luke to sign a consent form, but he gets angry and says he doesn't want to talk about it. His key nurse knows that Luke becomes more alert and capable later in the day.
After lunch, she asks him if he would like to discuss the operation again. She also knows that he responds better one-to-one than in a group. So she takes Luke into a private room and repeats the information that the surgeon gave him earlier. He understands why the treatment is needed, what is involved and the likely consequences.
Therefore, Luke has the capacity to make a decision about the operation.