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

A specialist child safety doctor was “stonewalled” by a child safety officer after repeatedly warning that Elizabeth Struhs would not be safe living with her mother, years before her parents allowed her to die by withdrawing lifesaving medicine, a coronial inquest has heard.

Elizabeth returned to live with her parents at her family home in Toowoomba in 2019, after both of them were convicted of neglecting her.

The type 1 diabetic died there on 7 January 2022 from diabetic ketoacidosis, after they and other members of their religious sect withdrew the insulin she needed to survive.

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. They sat singing and praying while she slowly died over the course of several days.

Elizabeth had been hospitalised in 2019 after a similar incident left her in a coma and on a ventilator after being taken to intensive care in Brisbane from the Toowoomba hospital.

The inquest, which began in Brisbane on Monday, heard the department of child safety had been alerted to the family’s extreme religious beliefs as early as 2013, after another child fled the family.

The coroner, Ainslie Kirkegaard, heard from two senior paediatricians working in the Queensland children’s hospital who raised the alarm after the 2019 incident. They cannot be identified for legal reasons.

Both put their concerns in writing repeatedly.

They told the inquest they were worried about Elizabeth’s very poor condition and her mother’s extreme religious beliefs.

Counsel assisting, Simon Hamlyn-Harris, read from a nine-page report written by another doctor the day after Elizabeth’s admission to the Queensland children’s hospital, 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.

Another email he read said Elizabeth “cannot safely be cared for in a home where her mother resides due to the strong beliefs that she’s expressing”.

The entire section was underlined and bolded.

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

Kerrie did not ask any questions about her daughter’s condition, the doctor said.

In an email sent at the time and read in court on Monday, the other doctor made a clinical assessment that Kerrie was “delusional” and recommended she receive a mental health assessment.

“Even now mum is expecting divine intervention and insulin is unnecessary. Elizabeth was minutes away from death,” the email read.

If Elizabeth lived with her “the risk is too high”, it read.

The doctor described Kerrie’s perspective about her daughter’s condition as “chilling”.

She attended a meeting with a child safety officer to urge for additional protection but was given the impression they could not intervene because Elizabeth’s father, Jason, was willing to assist her to treat her diabetes.

“I felt I was expressing my concerns, but I actually felt stonewalled by it,” the doctor told the inquest.

“It’s not common that I feel that way when I’m communicating with child safety.”

The doctor was later not invited to a subsequent suspected child abuse and neglect team meeting about Elizabeth, despite asking to attend, she said.

The doctor blamed a poor relationship with the Toowoomba hospital and health service for a lack of consensus on the best approach to keep Elizabeth safe.

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 inquest heard the plan put the onus on Elizabeth to “essentially protect herself by identifying if she feels unwell”, one of the two doctors said.

“Putting the onus on Elizabeth is not an appropriate thing to do for a six-year-old child in this environment,” she said.

“Elizabeth can become extremely unwell in a matter of hours without appropriate care of her diabetes,” a 2019 email read.

One doctor described herself as “distressed” about the situation, and told the coroner she believed she had exhausted every available pathway to report her concerns.

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.

The inquest continues.