Eight-year-old Elizabeth Struhs died at the family home in Toowoomba, west of Brisbane, on January 7, 2022, after her parents and 12 others allegedly withheld her diabetes insulin medication for six days in favour of prayer.
Brendan Luke Stevens, the 62-year-old leader of the Christian group calling itself "The Saints", is on trial for murder along with the girl's father, Jason Richard Struhs, 52, in the Brisbane Supreme Court.
Elizabeth's mother, Kerrie Elizabeth Struhs, 49, and the other 11 members of the congregation are charged with manslaughter.
Louise Conwell said she explained lifelong medication would be necessary to keep Elizabeth alive. (Jono Searle/AAP PHOTOS)
Queensland Children's Hospital senior endocrinologist Louise Conwell testified on Tuesday during the judge-only trial's fifth day before Justice Martin Burns.
Associate Professor Conwell said Elizabeth was flown by helicopter to the hospital in Brisbane in July 2019 after her then-undiagnosed type-1 diabetes left her relying on adrenaline doses and a ventilation tube to keep her heart and lungs working.
"It was extremely rare ... she was the most seriously unwell child I have ever seen," Assoc Prof Conwell said.
Under questioning from crown prosecutor Caroline Marco, Assoc Prof Conwell said she explained diabetes to Jason and Kerrie Struhs and that lifelong medication would be necessary to keep Elizabeth alive.
"I explained she was near to death at that time and was still critically ill ... she would require ongoing insulin treatment," the specialist said.
All 14 defendants are self-represented and have refused to enter pleas with Stevens telling the court they had reasonable belief that God would cure Elizabeth's diabetes.
Camellia Claire Stevens, 28, one of the 11 charged with manslaughter, cross-examined Assoc Prof Conwell and asked if Elizabeth's recovery in 2019 had been "quite miraculous".
"It was very fortunate. She had excellent treatment from the moment she was taken to Toowoomba hospital. It is a testament to her prompt treatment and continued care ... without that treatment she would have died. She was minutes from death," Assoc Prof Conwell said.
Jason Struhs told police he had taken Elizabeth to hospital against the wishes of Kerri Struhs, who would later be imprisoned for five months for failing to provide Elizabeth with the necessities of life in 2019.
Kerrie Struhs told Detective Sergeant Andrew Lowe that "God can work the seemingly impossible".
"I believe thoroughly that God is in our life. He has promised healing," Mrs Struhs said in a police interview played to Justice Burns.
When asked what treatment she provided to Elizabeth as her undiagnosed diabetes worsened, Kerrie Struhs said she gave her nappies to wear at school.
Assoc Prof Conwell earlier testified that Elizabeth had suffered incontinence as her body tried to rid itself of excess sugar.
The other defendants are Loretta Mary Stevens, 67, Andrea Louise Stevens, 34, Acacia Naree Stevens, 31,Therese Maria Stevens, 37 Keita Courtney Martin, 22, Lachlan Stuart Schoenfisch, 34, Samantha Emily Crouch, 26, Zachary Alan Struhs, 21, Sebastian James Stevens, 23, and Alexander Francis Stevens, 26.
