Doctor warned Elizabeth Struhs would not be safe at home years before religious sect killed her by withdrawing medicine

A medical specialist at the Queensland Children’s hospital warned that Elizabeth Struhs would not be safe at home with her mother years before her parents allowed her to die by withdrawing lifesaving medicine, a coronial inquest has heard.

Elizabeth, a type 1 diabetic, died at the age of eight from diabetic ketoacidosis on 7 January 2022, at her family home in Toowoomba, west of Brisbane, after her parents and other members of a religious sect withdrew the insulin she needed to survive and sat around singing and praying while she slowly died over the course of several days.

All 14 adult members of the sect, known as the Saints, were convicted of her manslaughter last year, including her father, Jason Struhs, mother, Kerrie Struhs, and brother, Zachary Struhs, and the leader of their sect, Brendan Stevens.

The group, which some have referred to as “a cult”, did not believe in medicine, and believed Elizabeth would be miraculously healed of her incurable illness and be resurrected after she died.

Elizabeth had been hospitalised in 2019 in a similar incident. Her mother, Kerrie, openly refused to provide her medical care and was charged and convicted with failing to provide her the necessaries of life as a result of the incident in 2021.

A coronial inquest, which sat for its first day on Monday, heard that doctors had attempted to warn the child safety department that Elizabeth could not be safely returned to Kerrie.

Coroner Ainslie Kirkegaard heard from an experienced medical specialist who helped care for Elizabeth after her admission to the Queensland children’s hospital’s intensive care unit on 17 July 2019. The doctor cannot be identified for legal reasons.

The doctor wrote a professional report about the child one day later raising concerns about her safety, the inquest heard.

The doctor said she was concerned partly due to Elizabeth’s condition at presentation, describing her as “extremely unwell” and requiring intubation and a ventilator.

But she was also concerned about the religious beliefs of Elizabeth’s mother, Kerrie, she said.

Kerrie refused to even attend the hospital to see her child, and denied that she was sick or would ever require medication in a phone conversation, the doctor told the court.

Kerrie also had no questions about her daughter’s condition, the doctor said.

Counsel assisting Simon Hamlyn-Harris read from the doctor’s nine-page report, which was sent to child safety and the police.

“‘Type 1 diabetes is a life-threatening condition that requires complicated care by the parents, the report reads,” he said.

“If her mother continues to deny the requirement for insulin and the related treatments Elizabeth could not be in Kerrie’s care’.

“With ‘not’ in bold,” Hamlyn-Harris added.

The doctor consulted the hospital’s child protection and forensic medical service before writing the report.

“My concerns were so strong that if [a nurse at the service] had said not to I was still planning to submit a report,” the doctor said.

Elizabeth was ultimately returned home to live with her family, with an intervention parental agreement: a short-term, voluntary, intensive arrangement which allows child safety authorities to aid a child in danger without a child protection order, the inquest heard.

The court heard this was done without the knowledge of the hospital team.

“There is still significant risk in that context,” the doctor said, on Monday.

“I would not be supportive of that treatment if I was the clinician involved in that discharge home plan.”

The doctor said she raised concerns at the time that diabetes required lifelong treatment, and that the risk posed by the illness can change over time, due to physical or social changes.

Elizabeth’s father, Jason, agreed to care for Elizabeth after her discharge from hospital, which he did for three years.

At the time, Jason was a longtime sceptic of his wife’s religion, and had saved Elizabeth’s life by taking her to hospital against the wishes of his wife in 2019 and then testified against her at a criminal trial.

Both Jason and Kerrie were found guilty in 2021 of failing to supply the necessaries of life for their daughter, relating to the incident in 2019 which was so serious Elizabeth was taken to hospital in a coma.

Jason was sentenced to six months in prison, wholly suspended for a period of 12 months, while Kerrie was sentenced to 18 months’ imprisonment with a specified parole release date of 15 December 2021.

But Kerrie helped convert Jason to her religious beliefs while serving her prison sentence. He was then convinced to give up treating Elizabeth’s diabetes with insulin, leading to her death.