Authorities knew of a family’s extreme religious beliefs against medical treatment years before a little girl died, a coroner has heard.

A little girl was killed by her parents after being returned home by authorities despite concerns from medical experts over her family’s extreme religious beliefs, a coroner has heard.

Eight-year-old Elizabeth Rose Struhs died on January 7, 2022 at her family’s home near Toowoomba, west of Brisbane, after her parents, brother and 11 other members of the Saints church group gathered to pray around her.

Her father, Jason Richard Struhs, had stopped administering insulin shots for her type-1 diabetes.

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The Struhs family and their religious beliefs that forbid all modern medical treatments had been known to child protection authorities since 2013, coroner Ainslie Kirkegaard heard at a pre-inquest conference in Brisbane on Thursday.

The inquest will look at the adequacy and appropriateness of decisions by multiple Queensland government agencies in their handling of Elizabeth and her parents.

“The unusual circumstances in which Elizabeth died have drawn widespread public outrage and condemnation,” Kirkegaard said.

Elizabeth had come to the attention of police and child protection authorities in July 2019.

Her father carried Elizabeth into an emergency room after her mother Kerrie Struhs had concealed the severity of her symptoms from undiagnosed and untreated diabetes.

Medical experts had described Elizabeth as “being minutes away from death,” counsel assisting Simon Hamlyn-Harris told Kirkegaard.

Child protection authorities accepted Jason Struhs would treat her diabetes and discharged Elizabeth to the care of her family.

“The decision to return Elizabeth to the family home was in the face of strongly expressed opposition from the child protection and forensic medical service,” Hamlyn-Harris said.

“Elizabeth cannot be safely cared for in a home where her mother resides due to the strong beliefs that she has expressed,” a medical expert emailed at the time.

The parents were later convicted of failing to provide Elizabeth the necessities of life in July 2019, with her mother taken into custody.

Jason Struhs was spared jail and again promised to treat his daughter’s diabetes.

He converted to the Saints after pressure from his wife and adult son, along with 12 other members of the fringe church, Kirkegaard heard.

In August 2021 he was baptised via a backyard ceremony and immersion in an improvised trough.

“He did not want to stop Elizabeth’s insulin,” Hamlyn-Harris said

“It seems he agonised a lot but eventually under that influence in January 2022 he discontinued her treatment.”

Kerrie Struhs had been released on parole just over two weeks prior.

Her husband and the leader of the Saints, former Queensland police officer Brendan Luke Stevens, were charged with murder by reckless indifference to life.

Jason Struhs and Stevens were acquitted of murder but found guilty of manslaughter along with Kerrie Struhs and 13 other members of the Saints after a Supreme Court trial in January 2025.

Some witnesses at the trial testified that the Saints were a “cult”.

Many of the facts around Elizabeth’s death were not in dispute, Hamlyn-Harris said.

“The inquest will be looking closely at the evidence to fully understand what happened and what might be done to prevent similar deaths in the future,” he said.

The inquest into Elizabeth’s death will be held over two weeks from October 12.