Child safety authorities in Queensland remained determined to return Elizabeth Struhs, a six-year-old girl with type 1 diabetes, to her parents’ care in 2019 despite concerns from medical professionals, a coronial inquest has heard. Elizabeth later died at home in January 2022 after her parents withdrew her insulin treatment, leading to her death from complications related to diabetic ketoacidosis.

Elizabeth’s parents, Jason and Kerrie Struhs, were members of the Saints, a religious sect that rejects medical treatment in favor of faith healing, believing in miraculous recovery or resurrection. Last year, all 14 adult members of the sect, including the Struhses, were convicted of Elizabeth’s manslaughter.

The inquest, presided over by Queensland coroner Ainslie Kirkegaard, heard testimony from senior doctors at the Queensland Children’s Hospital who had raised alarm following a 2019 hospitalization of Elizabeth after she lapsed into a coma caused by her diabetes. At that time, Kerrie Struhs had informed authorities she did not believe in medicine and discouraged her husband from seeking medical help, instead advocating reliance on prayer. Both parents were charged and convicted of failing to provide the necessaries of life following the 2019 incident, with Kerrie Struhs serving a prison sentence.

Despite concerns from hospital staff about Kerrie potentially undermining Elizabeth’s treatment, child safety officers decided that returning her to her father’s care would be preferable. Evidence presented detailed a meeting held by the suspected child abuse and neglect team, which included child safety officials, police, and health professionals. Minutes of the meeting revealed that while the Queensland Children’s Hospital strongly opposed the decision, child safety staff believed that removal from home would be more detrimental and that Jason Struhs was capable of administering insulin.

A police officer who attended the meeting testified that once child safety staff had made a decision, it was virtually impossible to alter their position. The officer described this as a matter of professional protocol, emphasizing that their decisions were guided by structured decision-making tools. This stance was broadly upheld across the department, not limited to individual officers.

Initially, Jason Struhs had complied with medical treatment, administering insulin despite opposition from his wife and other family members. However, after his conversion to his wife’s religious beliefs and involvement with the church group in 2021, he ceased the treatment, contributing directly to Elizabeth’s death.

A pediatric specialist involved in child safety services at Toowoomba Hospital expressed general satisfaction with the approach to the case, including the decision to return Elizabeth home, provided that the family continued engaging with healthcare providers. According to her testimony and contemporaneous notes, ongoing hospital engagement and attendance with a diabetes educator were considered critical safeguards, with plans to intervene if contact was lost.

Conversely, two other doctors from the Queensland Children’s Hospital in Brisbane criticized the handling of the case, describing it as insufficient to address the risks posed by the family’s beliefs and practices. One physician noted strained relations between the Brisbane and Toowoomba hospitals, which affected communication and decision-making. This was contested by the Toowoomba specialist, who denied any poor relationship between the institutions.

The inquest remains ongoing, with restrictions on witness identification due to legal constraints.