The father of an eight-year-old girl who died several days after her insulin was withdrawn was well aware of the consequences of that decision, a court has heard.
Disturbing details of Elizabeth Struhs's final days were revealed as her father, 50-year-old Jason Richard Struhs, faced a committal hearing in Toowoomba Magistrates Court on Tuesday over charges of murder, torture and failure to provide the necessities of life.
The court heard Elizabeth died in a Toowoomba house on January 7 after she was denied medical care for her Type 1 diabetes.
Police charged 14 people — including her parents — with murder after her death.
The court heard all 14 were members of a religious community.
Magistrate Clare Kelly told the court the cause of death was diabetic ketoacidosis and questioned the charge of torture, asking police prosecutor Sergeant Alistair Windsor to make a case.
"The prosecution must prove that the defendant inflicted severe pain and they inflicted the severe pain or suffering intentionally," she said.
Sergeant Windsor said Mr Struhs had been told Elizabeth would die if he didn't continue the administration of insulin.
"A witness statement from a diabetic educator states that Jason Struhs had a sound knowledge of Elizabeth's condition and reaffirms that it had been made [known] to Jason that there was no cure for diabetes and Elizabeth needed to remain on insulin for life," Sergeant Windsor said.
He told the court a paediatrician at Toowoomba Base Hospital, who had followed up with Elizabeth after a hospital visit in 2019, said she also made Mr Struhs aware Elizabeth needed to remain on insulin for the rest of her life.
He said it was the doctor's opinion that in her final days, Elizabeth experienced the symptoms of diabetic ketoacidosis within hours of being denied insulin.
"It is alleged the insulin was withdrawn on Monday, January 3, and the child died on Friday, January 7," Sergeant Windsor said.
Symptoms would have included excessive urination, thirst, abdominal pain, vomiting, weakness, lethargy and altered levels of consciousness, incontinence and coma until respiratory failure and death eventuated, the court heard.
"Mr Struhs had the requisite knowledge to know that withholding her diabetic treatment would result in pain and suffering to Elizabeth," Sergeant Windsor said.
"He made the decision to withhold the insulin, he knew the consequences of withholding the insulin, he'd been told by specialists what those consequences might be.
"Withholding that insulin is what sustained that pain and suffering for Elizabeth prior to her death."
Ms Kelly said a statement Mr Struhs had provided to police went into a significant level of detail about his thought processes and the basis for the decision he took to stop providing lifesaving medication to Elizabeth.
However, she was not satisfied there was sufficient evidence to support the torture charge and it was dropped.
"There was certainly no evidence the defendant intended the act to inflict severe pain and suffering upon his daughter," Ms Kelly said.
Mr Struhs, who had refused legal representation, had his head in his hands and wiped tears from his face at times throughout the hearing.
He was ordered to stand trial for murder over the death of his daughter and failure to provide the necessities of life, and was remanded in custody.
The court heard Mr Struhs, his wife Kerrie Struhs, 46, who is also facing a murder charge, and their children were members of a religious community.
"The religious beliefs held by the religious community include the healing power of God," Ms Kelly said.
"And the shunning of medical intervention in human life."
She asked Mr Struhs if he had anything to say, he replied "no, your honour".
Two more appear
Two other people charged with murder over the death of Elizabeth Struhs appeared for committal hearings earlier in the day.
Keita Courtney Martin, 20, and Samantha Emily Crouch, 24, again refused legal representation and said they didn't want to cross-examine witnesses.
When asked by Magistrate Louise Shepherd why she was appearing, Ms Martin replied, "I'm being charged with the so-called murder of Elizabeth Struhs".
The court was then briefly adjourned to allow time for Ms Martin to look at further information from prosecutors.
The evidence, which included dozens of witness statements, medical information and Elizabeth's diabetes action plan, was then handed to the magistrate along with photographs taken of Elizabeth at the Rangeville house after her death and a floor plan of the residence where the arrest of the accused were made.
Ms Crouch appeared via videolink from the Brisbane Women's Correctional Centre.
The magistrate asked if she understood why she was appearing.
"No, sorry I actually don't know," she told the court.
"It was just a mention last time now it's … I don't know."
When asked if she wanted to access a lawyer or cross examine witnesses Ms Crouch said "No, I'm not concerned with that".
Ms Shepherd adjourned both matters until later this month, when she will decide whether or not to order the pair to stand trial in the Supreme Court.
