A religious group accused of killing an eight-year-old girl believed "God would heal" her diabetes after they withheld life-saving insulin, a judge has heard.
The group of six men and eight women, including the girl's parents, refused to enter pleas to murder or manslaughter in Brisbane Supreme Court on Wednesday.
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 medication for six days.
Instead they prayed next to her and did not alert authorities as the girl's health deteriorated, police alleged.
Elizabeth died while lying on a mattress on the tiled floor of the downstairs living area in her family's Rangeville home on January 8.
Crown prosecutor Caroline Marco said Elizabeth had been "suffering for days" from insulin withdrawal.
"Her parents were well aware of Elizabeth's condition and consequences that would follow having lived through the experience of diabetic ketoacidosis two years earlier when she was first diagnosed and nearly died," Ms Marco said.
She said the religious group had aided or encouraged Elizabeth's parents to lower and then stop her doses of insulin as the treatment came from doctors and was created by man.
"Their extreme beliefs as a small congregation were that God would heal her," Ms Marco said.
The girl's father, Jason Richard Struhs, said "no plea, Your Honour" when formally arraigned on a charge of murder.
Justice Martin Burns entered a not guilty plea on his behalf.
The group's leader, Brendan Luke Stevens, said "I enter no plea" when he was next to be arraigned on a murder charge.
Justice Burns entered a plea of not guilty for Stevens and for the girl's mother, Kerrie Elizabeth Struhs, who said "no plea" in response to a manslaughter charge.
Ms Marco said Jason Struhs and Brendan Stevens were charged with murder as they acted with reckless indifference towards human life as they knew withholding Elizabeth's medication would probably kill her.
The judge entered not guilty pleas for the other 11 defendants as they said either "I enter no plea" or "no plea" to their manslaughter charges.
All defendants were clad in jail-issue uniforms, with the men wearing light prison tracksuits and thongs and the women wearing blue shirts and trousers with socks and sandals.
The prosecution was previously granted a judge-only trial after arguing the "notoriety of the matter" could prejudice members of jury.
Ms Marco said Elizabeth's mother Kerrie Struhs had just been released from prison before her daughter's death for a conviction of failing to provide her the necessities of life.
Elizabeth's father Jason Struhs in 2019 had carried the girl in his arms into the Toowoomba Base Hospital and she had been evacuated by helicopter to Brisbane because of her extreme diabetic shock.
Ms Marco said Elizabeth's hospital treatment saved her from permanent health consequences in 2019 but two years later her father had relented to the group's views and stopped providing her medication, leading to her death.
"Elizabeth started vomiting, she was described as lethargic ... she fell into a state of altered consciousness and was slurring her words," Ms Marco said.
The defendants, all of whom are representing themselves at trial, were granted a four-hour meeting in a closed courtroom before the trial to discuss their defence.
Ms Marco said there were 60 witnesses along with 76 hours of recorded conversations that would take three weeks to play in court.
The other accused are Zachary Alan Struhs, Loretta Mary Stevens, Therese Maria Stevens, Andrea Louise Stevens, Acacia Naree Stevens, Camellia Claire Stevens, Alexander Francis Stevens, Sebastian James Stevens, Keita Courtney Martin, Lachlan Stuart Schoenfisch and Samantha Emily Schoenfisch.
The youngest was 20 years old when charged while the eldest was 66.
Ms Marco is due to continue her opening address on Thursday with the trial expected to go for 11 weeks.
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