For days Elizabeth suffered a slow and painful death as her body shut down from a lack of insulin in her family's home west of Brisbane in January 2022.
Instead of providing life-saving insulin, her parents and brother gathered around her with other members of religious group "the Saints" and held a vigil, praying.
More than three years after the "profoundly disturbing" death, Elizabeth's father, Jason Richard Struhs, 53, and mother, Kerrie Elizabeth Struhs, 49, received 14-year jail terms at Brisbane Supreme Court on Wednesday.
They were sentenced for manslaughter along with the 12 other group members after being found guilty in a 2024 judge-alone trial.
Justice Martin Burns found them all responsible for the child's death, saying they staked her life on their personal religious beliefs.
"Each of you engaged in some sort of spiritual gamble with the life of a child," he told court.
"The arrogance of your belief ... remains bewildering."
The Saints leader Brendan Stevens received 13 years imprisonment with Justice Burns calling him a "highly dangerous individual".
Elizabeth's brother Zachary Alan Struhs, 22, received six years with the other church group members - including Stevens' wife and six children - sentenced to terms ranging from six to nine years.
In 2019, Elizabeth was minutes from death when she was rushed to hospital by her father with her then-undiagnosed diabetes causing damaging changes to her blood chemistry.
Her parents were charged and convicted of failing to provide the necessities of life to Elizabeth for her medical treatment.
Kerrie Struhs was jailed after maintaining she would continue refusing medical treatment to her daughter despite the near-death experience.
Her husband received a suspended sentence, promising to never let it happen again.
But he slowly began to change his beliefs while his wife was behind bars, worn down by church members.
He eventually agreed to join the Saints, becoming baptised in August 2021 in what he described as the "greatest day of my life".
His wife returned home on December 16, 2021 and he stopped giving Elizabeth her rapid-acting insulin on New Year's Day, later ceasing her remaining slow-release doses.
She died six days later while lying on a mattress in the Toowoomba family home's living room.
Justice Burns said Stevens "procured and aided" Elizabeth's unlawful killing alongside the other church group members - including his wife and kids - by encouraging Jason Struhs to stop providing insulin.
Without Stevens' "intense and unrelenting" pressure to cease Elizabeth's medical treatment, the girl might still be alive today, he said.
Justice Burns slammed the church group for letting their faith blind them as Elizabeth suffered, taking the "life of a vibrant, happy child who should have gone on to enjoy a full life".
He said it was unlikely any of the members would be rehabilitated during their time in prison nor would the hefty sentences act as a deterrent.
Justice Burns warned if the conduct of the group was repeated in the case of any other child he had no doubt it would pose a "serious risk" to their life.
Elizabeth's sister Jayde Struhs welcomed the sentences, saying it finally provided justice for a young, bright girl with big dreams of helping others with diabetes.
"Her kind soul and infectious laughter will forever hold a place in our hearts as we remember her," she told reporters.
Female church group members were dressed casually with the majority of the men in dress shirts as they chatted and smiled before their sentences were handed down.
After calling each sentence, Justice Burns called for them to be "sent down" to their cells.
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